Association between Sleep Disturbances and Emotional/Behavioral Problems in Chinese and Japanese Preschoolers

Sleep disturbances and related factors among preschool children in rural areas of China: a cross-sectional study

“…In this study, we utilized Chinese version of CSHQ [20], which included 33 items describing sleep disturbance and items are rated through 3-point scale: “usually” if the sleep behavior occurred 5 to 7 times per week; “sometimes” for 2 to 4 times per week; and “rarely” for 0 to 1 time per week. Among those 33 items, the sleep disturbances are evaluated on eight subscales including bedtime resistance, sleep onset delay, sleep duration, sleep anxiety, night wakings, parasomnias, sleep-disordered breathing, and daytime sleepiness, and higher total and subscale scores represent more severe disturbances [7]. Parents or other caregivers are asked to recall the sleep behaviors of included child occurring over a “typical” recent week [21].…”

“…Parents or other caregivers are asked to recall the sleep behaviors of included child occurring over a “typical” recent week [21]. Given the fact that CSHQ is not regarded as a diagnostic questionnaire but as a screening tool for existing sleep disturbances, we utilized the definition of previous studies which defined total score > 41 as the potential clinical sleep disturbances [7, 21]. And the cutoff value for subscales are defined as scores >2 standard deviations above the published community control reference mean values [18] (bedtime resistance >10.84, sleep onset delay >2.31, sleep duration >5.27, sleep anxiety >7.79, night wakings >5.29, parasomnias >10.61, sleep-disordered breathing >4.50, daytime sleepiness >15.24) according to previous studies [10, 22, 23], Cronbach’s α coefficient was 0.668 for the full scale in this study.…”

“…The copyright holder for this this version posted October 21, 2020. ; https://doi.org/10.1101/2020.10.20.20215806 doi: medRxiv preprint screening tool for existing sleep disturbances, we utilized the definition of previous studies which defined total score > 41 as the potential clinical sleep disturbances [7,21]. And the cutoff value for subscales are defined as scores >2 standard deviations above the published community control reference mean values [18] Cronbach's α coefficient was 0.668 for the full scale in this study.…”

“…In this period, improper parental supervision such as inadequate care, parental absence and overprotection may have long-term effects on their children’s development and health outcomes such as sleep disturbance even in their adulthood [5, 6]. Nevertheless, the characteristics of sleep practice, sleep patterns and sleep disturbances in different countries varied greatly especially between West and East [7]. Studies indicated that parents were more likely to report sleep problems in their children in Asian countries (24%) compared to their counterparts in Western countries (18%), and in Asian countries, parents’ perception in their children’s experience of sleep problems ranged from 15.1% in Korea to 43.7% in China [8].…”

“…It is commonly believed that sociocultural factors including political conditions, economic considerations, ideological beliefs regarding societal and parental awareness may play an important role in sleep disturbances among preschool children [7, 10, 11], indicating that parents play an important role in ensuring the quality of their children’s sleep. Previous study has proven that parenting behavior is associated with children’s sleep duration [12].…”