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Sleep disturbances and correlates among a sample of preschool children in rural China

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Abstract

This study aimed to explore the prevalence of sleep disturbances among preschool children in rural areas of China and identify the underlying associated factors. A cross-sectional study was conducted in rural areas of Anhui Province, China, from September 2019 to January 2020. The caregivers of children from 26 kindergartens completed the demographic questionnaire, the Children’s Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), the Self-rating Anxiety Scale (SAS), and the adapted Identification and Management of Feeding Difficulties (IMFeD) tool. One-way analysis of variance, independent-samples t-test, and hierarchical multiple linear regression were conducted to explore the potential influencing factors of sleep disturbances in preschool children. For the specific sleep disturbances based on each subscale of the CSHQ, bedtime resistance (54.9%) and sleep anxiety (47.9%) were the most common types of sleep disturbances, followed by daytime sleepiness (21.3%), sleep duration (20.8%), parasomnias (16.5%), sleep-onset delay (12.6%), night wakings (12.2%) and sleep-disordered breathing (10.3%). The ages of children, children’s emotional/behavioral problems, children’s feeding difficulties, inconsistent parenting attitudes of parents, poor parenting styles, non-parent caregivers, and caregiver anxiety contributed significantly to the CSHQ total score, accounting for approximately 27.1% (R2 = 0.271) of the variance. Our study indicates that the prevalence of sleep disturbances among preschool children in rural areas of China is quite high. Furthermore, the potential risk factors are complicated, including factors related to both children and their caregivers.

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Acknowledgements

We appreciate the authors listed in this paper for their contributions to this study, including study design, site investigation, data collation and analysis, and paper writing; in addition, we also appreciate Dr. Sun Liang, Dr. Qin Qirong and their colleagues in the local Center for Disease Control and Prevention and all kindergartens for their great cooperation.

Funding

This work was supported by the National Natural Science Foundation of China (Grant number: 81872704).

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Author notes

  1. Tianming Zhao and Kun Xuan contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China

    Tianming Zhao, Kun Xuan, Haixia Liu, Xin Chen, Guangbo Qu, Yile Wu, Jian Zhang & Yehuan Sun

  2. Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China

    Yile Wu

  3. Department of Neonatology, Anhui Provincial Children’s Hospital/Children’s Hospital of Anhui Medical University, Hefei, 230051, Anhui, China

    Jian Zhang

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  1. Tianming Zhao
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Contributions

Dr. YS: designed the study and made the final revision; TZ, KX, HL, XC, and GQ: collected the data; TZ and KX: wrote the manuscript; HL and XC: helped in manuscript writing; YW and JZ: critically reviewed the manuscript and helped in revising the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Yehuan Sun.

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This study was approved by Ethics Committee of Anhui Medical University (20180402) and followed the principles of informed consent and strict confidentiality.

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Zhao, T., Xuan, K., Liu, H. et al. Sleep disturbances and correlates among a sample of preschool children in rural China. Sleep Biol. Rhythms 20, 123–136 (2022). https://doi.org/10.1007/s41105-021-00348-3

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