title: Sleep problems of elementary school children. A community survey.
abstract: OBJECTIVE
  To examine the prevalence, co-occurrence, and correlates of sleep problems among elementary school children.
  
  
  METHODS
  Survey.
  
  
  METHODS
  General community.
  
  
  METHODS
  The parents of 987 children aged 5 to 12 years completed an anonymous survey distributed in their children's schools.
  
  
  METHODS
  The survey form asked about background characteristics, children's sleep environment, sleep habits, adult 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 with sleep-onset problems, 80% displayed bedtime resistance, while 34% of bedtime resisters had onset problems. Onset problems correlated with more fears, night waking, psychiatric and medical conditions, the need for reassurance and caregiver proximity, and history of sleep problems. Bedtime resistance was associated with an inconsistent bedtime and falling asleep away from bed. Those who display delayed sleep onset and bedtime resistance also wake later, suggesting that sleep-phase delays may maintain these problems.
  
  
  CONCLUSIONS
  The results confirm bedtime 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 importance of limits around wake-up time as well as bedtime. The results highlight the importance of distinctly evaluating bedtime resistance, sleep onset, sleep maintenance, waking, and emotional adjustment.
authors.affiliation: Division of Child and Adolescent Psychiatry, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Blader
authors.forename: H S
authors.initials: HS
authors.lastname: Koplewicz
authors.forename: H
authors.initials: H
authors.lastname: Abikoff
authors.forename: C
authors.initials: C
authors.lastname: Foley
mesh_terms: D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003625:Data Collection; D004325:Dreams; D004775:Enuresis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology