SLEEP PROBLEMS OF ELEMENTARY-SCHOOL-CHILDREN - A COMMUNITY SURVEY

Objective: To examine the prevalence, co-occurrence, and correlates of sleep problems among elementary school children. Design:Survey. Setti ng: General community. Participants: The parents of 987 children aged 5 to 12 years completed an anonymous survey distributed in their child ren's schools. Main Outcome Measures: The survey form asked about back ground characteristics, children's sleep environment, sleep habits, ad ult interventions, sleep history, and specific sleep problems. Results : Bedtime resistance was the most prevalent sleep problem (27%). Sleep -onset delays (11.3%), night waking (6.5%), morning wake-up problems ( 17%), and fatigue complaints (17%) were also common. Among children wi th sleep-onset problems, 80% displayed bedtime resistance, while 34% o f bedtime resisters had onset problems. Onset problems correlated with more fears, night waking, psychiatric and medical conditions, the nee d for reassurance and caregiver proximity, and history of sleep proble ms. Bedtime resistance was associated with an inconsistent bedtime and falling asleep away from bed. Those who display delayed sleep onset a nd bedtime resistance also wake later, suggesting that sleep-phase del ays may maintain these problems. Conclusions: The results confirm bedt ime resistance as parents' principal sleep-related complaint for this age group but reveal a subgroup more prone to insomnia, night waking, and anxiety-related features. Phase delay findings suggest the importa nce of limits around wake-up time as well as bedtime. The results high light the importance of distinctly evaluating bedtime resistance, slee p onset, sleep maintenance, waking, and emotional adjustment.