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Sleep problems and poor academic performance in primary school children

Schlafstörungen und schlechte Schulleistungen bei Grundschulkindern

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Abstract

Objective

Sleep problems may affect daytime performance. Thus, the prevalence of sleep problems and their associations with poor academic performance in a cross-sectional study performed in 27 primary schools in Hannover, Germany, were investigated.

Methods

Sleep problems (e.g., sleep onset delays, night awakenings, sleepwalking, nightmares, and bedwetting) were examined by parental and children’s questionnaires. Poor academic performance, defined as grade 4 or more on a 6-point scale, or requirement for additional lessons in mathematics, science, reading, spelling, or handwriting was assessed using grades from the last term’s school report forms.

Results

Of 1,144 children enrolled (mean age 9.6 years, 51% males), 760 (66.4%) had sleep problems reported by their parents, with sleep onset delays having the highest prevalence (prevalence 49.1%, 95% confidence interval (CI) 46.1–51.9). Children reported sleep problems more frequently than their parents. Significant associations with academic performance were found for night awakenings and nightmares; however, clear dose–response relationships were only found for nightmares. Children who “often” had nightmares (n = 24) were more likely to have poor academic performance in mathematics (odds ratio 5.2, 95% CI 1.6–17.1), science (6.8, 95% CI 1.4–32.1), and spelling (7.5, 95% CI 2.3–24.9).

Conclusion

Sleep problems are common in primary school children. Among these, nightmares may have a negative impact on academic performance.

Zusammenfassung

Ziel

Schlafstörungen können die Tagesleistung beeinflussen. Daher wurde die Prävalenz von Schlafstörungen und ihr Zusammenhang mit schlechten Schulleistungen in einer Querschnittsstudie an 27 Grundschulen in Hannover untersucht.

Methoden

Schlafstörungen (z. B. Einschlafverzögerung, nächtliches Aufwachen, Schlafwandeln, Albträume und Bettnässen) wurden anhand von Eltern- und Kinderfragebögen untersucht. Schlechte Schulleistungen, die als Schulnote 4 oder schlechter definiert wurden, oder die Notwendigkeit von Nachhilfestunden in Mathematik, Sachkunde, Lesen, Rechtschreibung oder Handschrift wurde mithilfe der Noten aus dem Zeugnis des letzten Halbjahrs ermittelt.

Ergebnisse

Von 1144 Kindern in der Studie (Durchschnittsalter: 9,6 Jahre; 51% Jungen) wiesen nach Angaben der Eltern 760 (66,4%) Schlafstörungen auf, dabei war die Prävalenz mit 49,1% für Einschlafstörungen am höchsten (95%-Konfidenzintervall, 95%-KI: 46,1–51,9). Kinder gaben häufiger Schlafstörungen an als ihre Eltern. Ein signifikanter Zusammenhang mit der Schulleistung fand sich für nächtliches Aufwachen und Albträume, eine klare Dosis-Reaktions-Beziehung wurde jedoch nur bei Albträumen festgestellt. Bei Kindern, die „oft“ Albträume hatten (n=24), war die Wahrscheinlichkeit erhöht, dass sie schlechte Schulleistungen in Mathematik (Odds Ratio, OR: 5,2; 95%-KI: 1,6–17,1), Sachkunde (OR: 6,8; 95%-KI: 1,4–32,1) und Rechtschreibung (OR: 7,5; 95%-KI: 2,3–24,9) aufwiesen.

Fazit

Bei Schulkindern sind Schlafstörungen häufig. Unter diesen haben Albträume möglicherweise einen negativen Einfluss auf die Schulleistungen.

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Acknowledgment

The authors would like to thank Dr. Ehrhardt (Department of Public Health, City Council, Hannover, Germany), Ms. Martinsen (Supervisory School Authority, Hannover, Germany), Mr. Hegemann (District Government, Hannover, Germany) and the headmasters and teachers of the participating schools for their support and cooperation. We thank Anke Guenther, Judith Wolff, and Pilar Urschitz-Duprat for contributing to data acquisition and management. We are also grateful to the Hans Meineke Foundation, Hannover, Germany, for supporting this study and we particularly wish to thank all the children and their parents for their patience and cooperation; they made this study possible.

Conflict of interest

The corresponding author states that there are no conflicts of interest.

Author information

Authors and Affiliations

  1. Working Group on Pediatric Sleep Medicine, Department of Neonatology, University Children’s Hospital Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany

    S. Wiechers, M.S. Urschitz MD, MSc & C.F. Poets

  2. Department of Cardiology and Pulmonology, University Children’s Hospital, Tuebingen, Germany

    S. Wiechers

  3. Faculty of Science, Department of Psychology, University of Tuebingen, Tuebingen, Germany

    A.A. Schlarb

  4. Department of Internal Medicine, Agnes Karl Hospital, Laatzen, Germany

    E. Eggebrecht

  5. Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany

    M. Schlaud

  6. Department of Psychology, University of Koblenz-Landau, Landau, Germany

    A.A. Schlarb

Authors
  1. S. Wiechers
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  2. A.A. Schlarb
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  3. M.S. Urschitz MD, MSc
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  4. E. Eggebrecht
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  5. M. Schlaud
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  6. C.F. Poets
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Corresponding author

Correspondence to M.S. Urschitz MD, MSc.

Additional information

*S. Wiechers and A.A. Schlarb contributed equally to this publication.

Appendix

Appendix

Parental questionnaire

  1. 1.

    Does your child take more than 20 minutes to fall asleep?

  2. 2.

    Does your child awake during the night?

  3. 3.

    Does your child sleepwalk?

  4. 4.

    Does your child have nightmares?

  5. 5.

    Does your child wet the bed?

Children’s questionnaire

  1. 1.

    Does it take you more than 20 minutes to fall asleep?

  2. 2.

    Do you wake up at night, when your parents think you are asleep?

  3. 3.

    Do you have trouble falling asleep again, after waking up at night?

  4. 4.

    Do you have nightmares?

  5. 5.

    Do you sleepwalk?

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Wiechers, S., Schlarb, A., Urschitz, M. et al. Sleep problems and poor academic performance in primary school children. Somnologie 15, 243–248 (2011). https://doi.org/10.1007/s11818-011-0535-8

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  • DOI: https://doi.org/10.1007/s11818-011-0535-8

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