This study had two major aims: (1) to explore the relationship between sleep related difficulties and behavioral and emotional problems in young children, and (2) to identify predictors of child fear and problematic sleep behaviors.
Sixty-eight children (34 boys), ages 4–6 years (M = 4.9, SD = 0.9) who experienced nighttime fears and who co-slept with their parents were evaluated using parental reports of internalizing and externalizing behavioral problems, sleep difficulties and related anxiety, as well as child and parental reports of fear.
Child-reported fear was significantly predicted by internalizing problems when controlling for other variables whereas parent-reported fear was primarily related to child endorsed fears on a preschool fear questionnaire when controlling for the other variables. In contrast, sleep-related problems were primarily related to externalizing behavior problems whereas the number of nights slept alone was primarily related to separation anxiety on a preschool anxiety questionnaire.
Findings from the present study point to the multiplicity of factors that account for nighttime fears and sleep difficulties in young children. Child fear and separation anxiety were related to co-sleeping. Moreover, internalizing symptoms in young children predicted child fear whereas, externalizing symptoms predicted sleep problems. Based on the reciprocal relationship between emotional/behavior problems and sleep, frequent co-sleeping and nighttime fears might serve as a risk and/or maintaining factor of disrupted sleep practices. When treating nighttime fears in young children, co-sleeping should be targeted for intervention as well.
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R.R.F. designed and executed the study, assisted with the data analyses, and wrote the paper. K.M.L. assisted with the data analyses and collaborated in the writing of the study and editing of the final manuscript. T.M. analyzed the data, wrote of the results and collaborated in the writing and editing of the final manuscript. T.H.O. helped design the study, assisted with the data analyses, and collaborated in the writing and editing of the final manuscript.
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All study procedures were approved by the University of São Paulo, São Paulo IRB.
Informed consent was obtained from all individual participants included in the study.
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El Rafihi-Ferreira, R., Lewis, K.M., McFayden, T. et al. Predictors of Nighttime Fears and Sleep Problems in Young Children. J Child Fam Stud 28, 941–949 (2019). https://doi.org/10.1007/s10826-019-01332-9
- Nighttime fears
- Sleep problems
- Child anxiety
- Behavior problems