Child and Parent Perceived Determinants of Children’s Inadequate Sleep Health. A Concept Mapping Study

Abstract

Many children do not meet the recommendations for healthy sleep, which is concerning given the potential negative effects on children's health. To promote healthy sleep, it is crucial to understand its determinants. This concept mapping study therefore explores perspectives of children and parents on potential determinants of children's inadequate sleep. The focus lies on 9-12 year old children (n = 45), and their parents (n = 33), from low socioeconomic neighbourhoods, as these children run a higher risk of living in a sleep-disturbing environment (e.g., worries, noise). All participants generated potential reasons (i.e., ideas) for children's inadequate sleep. Next, participants sorted all ideas by relatedness and rated their importance. Subsequently, multidimensional scaling and hierarchical cluster analyses were performed to create clusters of ideas for children and parents separately. Children and parents both identified psychological (i.e., fear, affective state, stressful situation), social environmental (i.e., sleep schedule, family sleep habits), behavioural (i.e., screen behaviour, physical activity, diet), physical environmental (i.e., sleep environment such as temperature, noise, light), and physiological (i.e., physical well-being) determinants. These insights may be valuable for the development of future healthy sleep interventions.Knowledge of the most relevant determinants is essential for the development of effective interventions [15]. A recent review of prospective studies [16] found evidence that spending more time on screens (e.g., TV, computer, games), having a difficult temperament, and past poor or inadequate sleep health (i.e., sleep quality or quantity) were longitudinally associated with shorter sleep duration. Another review summarized empirical evidence related to common paediatric sleep recommendations and identified having an inappropriate bedtime, not having a relaxing bedtime routine, having an irregular sleep schedule, a negative emotional environment (e.g., family stress, family conflict), and poorer emotional well-being (e.g., higher levels of internalizing symptoms) as potential determinants of children's inadequate sleep [17]. However, the perspectives of children and their parents are lacking in the current literature.The perspectives of children and their parents could bring about new and important insights into potential determinants of inadequate sleep, which can subsequently inform intervention development. Consequently, the aim of this study is to explore the perspectives of children and parents living in low-SEP neighbourhoods on potential determinants of children's inadequate sleep health. Materials and MethodsA participatory mixed-methods concept mapping study was conducted to assess children's and parents' perspectives on potential determinants of children's inadequate sleep health [18]. For the qualitative part of this approach, participants generated ideas about potential determinants during group brainstorm sessions, and subsequently rated these ideas according t...

Perceived Determinants of Children’s Inadequate Sleep Health. A Concept Mapping Study among Professionals

“…Although several medical and sleep-environmental determinants were mentioned by professionals, they rated none as important. Compared to children and parents, professionals rated medical determinants as relatively less important [ 16 ]. This may be because the underlying ideas were different; professionals mentioned diseases and disorders, while children and parents referred to having a cold or having pain in general.…”

“…This may be because the underlying ideas were different; professionals mentioned diseases and disorders, while children and parents referred to having a cold or having pain in general. Moreover, children rated some parts of their sleep environment (e.g., comfort of their bed and the temperature in their bedroom) as one of the most important potential determinants, while professionals and parents considered children’s sleep environment less important [ 16 ]. These findings highlight that various involved stakeholders can have a different perspective on the importance of potential determinants of children’s inadequate sleep health.…”

“…Many of the perceived determinants identified by professionals in this study were also identified by children and parents [ 16 ]. As this study explored the perspectives of professionals on potential determinants, the results of this study do not provide evidence for a relationship between the identified factors and children’s sleep health.…”

“…Disagreements were discussed and, if needed, resolved by a third researcher (V.B.). For this method, the description can be found elsewhere [ 16 ]. Some ideas were moved to an existing cluster, or a new cluster was created when this made more sense conceptually.…”

“…Another review, which also included cross-sectional studies and trial/intervention studies, found that changeable determinants of children’s healthy sleep included establishing bedtime routines, maintaining a regular sleep schedule, setting age-appropriate bedtimes, ensuring a positive atmosphere at home, falling asleep independently, and meeting children’s emotional needs during the day [ 15 ]. In addition, a participatory mixed-method study identified the determinants of inadequate sleep perceived by children (aged 9–12 years) and parents, and these included fear, affective state, stressful situations, discomfort, physical well-being, sleep environment, energy, screen behaviour, stimulating activities, physical activity, diet, sleep schedule, family sleep habits, and social norms [ 16 ].…”