title: Longitudinal study of bad dreams in preschool-aged children: prevalence, demographic correlates, risk and protective factors.
abstract: OBJECTIVE
  To (1) clarify the epidemiology of bad dreams in children and investigate risk and protective factors related to (2) the child's sleep, (3) parental sleep-enabling practices, and (4) the child's temperament.
  
  
  METHODS
  Longitudinal with 6 time points from 5 months to 6 years.
  
  
  METHODS
  Subjects' homes.
  
  
  METHODS
  Representative sample of 987 children in the Province of Quebec.
  
  
  METHODS
  None.
  
  
  RESULTS
  Longitudinal logistic regression analysis models with primary endpoints of presence or absence of parent-rated bad dreams at 29 months, 41 months, 50 months, 5 years, and 6 years and predictor variables of demographic characteristics, parent ratings of child's sleep characteristics, parental sleep-enabling practices (e.g., cosleeping), and child's psychological characteristics at 5 and 17 months (anxiousness, temperament). Mothers' ratings indicated lower than expected prevalence of frequent bad dreams (1.3% to 3.9%). Demographic correlates of bad dreams were high family income, absence of siblings at 29 months, and a non-immigrant mother. The best predictor at 41 and 50 months was the presence of bad dreams the preceding year, whereas at 5 and 6 years, it was their earlier presence at 29 months. Early protective factors were parental practices favoring emotional nurturance after night awakenings (29 and 41 months); early risk factors were sleep-onset emotional nurturance (29 months), difficult temperament (5 months), and anxiousness (17 months).
  
  
  CONCLUSIONS
  Bad dreams in preschoolers are less prevalent than thought but, when present, are trait-like in nature and associated with personality characteristics measured as early as 5 months. A stress-diathesis model may best account for the observed pattern of predictive factors.
authors.affiliation: Centre d'etude du sommeil, Hôpital du Sacré-Coeur de Montréal, Quebec, Canada.
authors.forename: Valérie
authors.initials: V
authors.lastname: Simard
authors.forename: Tore A
authors.initials: TA
authors.lastname: Nielsen
authors.forename: Richard E
authors.initials: RE
authors.lastname: Tremblay
authors.forename: Michel
authors.initials: M
authors.lastname: Boivin
authors.forename: Jacques Y
authors.initials: JY
authors.lastname: Montplaisir
mesh_terms: D000704:Analysis of Variance; D002648:Child; D002652:Child Behavior / Q000523:psychology; D002675:Child, Preschool; D004325:Dreams / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D020184:Night Terrors / Q000453:epidemiology*; D010287:Parent-Child Relations; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013694:Temperament; D014851:Wakefulness