Sleep hygiene and problem behaviors in snoring and non-snoring school-age children

Abstract

Objectives The effects of sleep-disordered breathing, sleep restriction, dyssomnias, and parasomnias on daytime behavior in children have been previously assessed. However, the potential relationship(s) between sleep hygiene and children’s daytime behavior remain to be explored. The primary goal of this study was to investigate the relationship between sleep hygiene and problematic behaviors in non-snoring and habitually snoring children. Methods Parents of 100 5- to 8-year-old children who were reported to snore “frequently” to “almost always,” and of 71 age-, gender-, and ethnicity-matched children who were reported to never snore participated in this study. As part of a larger, ongoing study, children underwent nocturnal polysomnography and parents were asked to complete the Children’s Sleep Hygiene Scale (CSHS) and the Conners’ Parent Rating Scales-Revised (CPRS-R:L). Results In the snoring group, strong negative correlations (r = −.39, p <.001) between the CSHS overall sleep hygiene score and the CPRS-R:L DSM-IV total scores emerged. Additionally, several subscales of the CSHS and CPRS-R:L were significantly correlated (p-values from <.000 to .004) in snoring children. No significant correlations were observed between the CSHS and the CPRS-R:L in the non-snoring children. Conclusions Parental reports of behavioral patterns in snoring children indicate that poorer sleep hygiene is more likely to be associated with behavior problems, including hyperactivity, impulsivity, and oppositional behavior. In contrast, no significant relationships between sleep hygiene and problem behaviors emerged among non-snoring children. These results indicate that children at risk for sleep disordered breathing are susceptible to daytime behavior impairments when concurrently coupled with poor sleep hygiene practices.

Sleep Hygiene Practices and Bedtime Resistance in Low-Income Preschoolers: Does Temperament Matter?

“…We used the Children’s Sleep Hygiene Scale 30 (CSHS) total mean score as our primary predictor. The CSHS is a 22-item parent-report measure that has been used in previous research 31,32 and assesses the frequency of use of good sleep hygiene practices (e.g., regular bedtimes and wake times; restriction of caffeine and highly arousing activities prior to bedtime; predictable and comfortable sleeping environment; sample Cronbach’s α = 0.72). Mothers responded to each item on a 6-point scale (1 = never; 6 = always); a higher score indicates that the family is engaging in better sleep hygiene practices.…”

Variable sleep schedules and outcomes in children with psychopathological problems: preliminary observations

“…The responses are graded as “never”, “rarely” (once per week), “occasionally” (twice per week), “frequently” (3–4 times per week) and “almost always” (>4 times per week) by the parent. The Children’s Sleep Hygiene Scale (CSHS)31,32 is a parental tool and an important predictor of sleep quality. The 22 items form six subscales measuring activities surrounding sleep of children, ie, physiological, cognitive, emotional, environmental, bedtime routine and sleep stability, and are rated on a six-point Likert scale (never to always).…”

Behavioral Problems and Neurocognitive Functioning in Snoring School-Aged Children

“…6 The strongest associations for externalizing behaviors include hyperactivity, impulsivity, emotional lability, delinquency, conduct problems, aggressive behavior, and oppositional behavior. [7][8][9][10][11][12][13][14] Snoring children have also internalizing problems, showing more anxious/depressed mood, somatic complaints, withdrawal, thought problems, and social problems. [10][11][12][13][15][16][17][18] A few studies have used teacher reports, 6,7,19 showing that teachers report substantially fewer problems than parents.…”