Prevalence and Correlates of Sleep Problems in Chinese Schoolchildren

STUDY OBJECTIVES: This study examined the prevalence and correlates of sleep problems in Chinese schoolchildren. DESIGN AND SETTING: A cross-sectional questionnaire survey was undertaken in Shandong Province, People's Republic of China. PARTICIPANTS: A total of 2004 elementary school children (998 boys and 1006 girls) participated in the survey. MEASUREMENTS AND INTERVENTIONS: The parents completed a questionnaire that asked about sleep problems, and characteristics of the family and child. Teachers completed a questionnaire that included the Modified Conners Hyperkinesis Index (MCHI), whether the child slept in class, and school achievement. RESULTS: Parent-reported sleep problems that occurred "sometimes" or "often" were sleep walking/talking, 14.2%; too little sleep, 14.0%; too much sleep, 12.5%; nightmares, 12.0%; trouble sleeping, 6.1%; and nocturnal enuresis, 4.5%. Teachers reported that 9.4% of children slept in class "sometimes" or "often". Approximately 11% of children were reported to have any sleep problem "often". Children with sleep problems were more frequently reported to be hyperactive, and to have poorer child-parent relations, poorer peer relations, and poorer social competency and school achievement. Multivariate logistic regression analysis indicated that sleep problems were significantly correlated with following factors: poor parental relations, crowded homes, bedwetting cessation after age 4, chronic physical diseases, reported hyperactivity and poor peer relations. CONCLUSIONS: Parent-reported sleep problems in Chinese children were less prevalent than those reported in Western countries, and associated with multiple family, prenatal, and child developmental factors. Children with sleep problems were reported to be more hyperactive, and to have social and academic problems more frequently. <=