title: Sleep and behavioral/emotional problems in children: a population-based study.
abstract: BACKGROUND
  The potential relationships between sleep-wake behaviors and emotional/disruptive problems in otherwise healthy school-aged children are unclear.
  
  
  METHODS
  A parental questionnaire was developed for the epidemiologic survey of children's sleep and wake behavioral patterns. The questions covered a wide range of features including sleep length (school days, weekends), time to fall asleep, night awakenings, bedtime and nighttime sleep-related behaviors, daytime sleepiness, irritability, and tiredness. To assess psychiatric symptomatology, the Rutter Scale B2 was completed by teachers. In addition to the total score, sub-scores of emotional, hyperactivity, and conduct problems were obtained. The representative population sample comprised 779 children (403 girls), with an age range of 6-11 years.
  
  
  RESULTS
  Hyperactivity and conduct problems at school in boys were both associated with parental reports of bedtime resistance. Hyperactivity was also associated with longer sleep duration during weekends. Conduct and emotional problems in girls were associated with earlier bedtime during school days. Emotional problems in girls were also associated with longer sleep durations in school days and weekends.
  
  
  CONCLUSIONS
  Bedtime resistance was the only sleep behavior associated with either hyperactivity or conduct problems in children, and longer sleep durations appear to occur more frequently in children with both hyperactive or emotional problems. Information about good sleep hygiene at bedtime may help parents setting sleep limits.
authors.affiliation: Institute of Medical Psychology, Faculty of Medicine, Coimbra, Portugal. sbos@fmed.uc.pt
authors.forename: S
authors.initials: S
authors.lastname: Carvalho Bos
authors.forename: A
authors.initials: A
authors.lastname: Gomes
authors.forename: V
authors.initials: V
authors.lastname: Clemente
authors.forename: M
authors.initials: M
authors.lastname: Marques
authors.forename: A T
authors.initials: AT
authors.lastname: Pereira
authors.forename: B
authors.initials: B
authors.lastname: Maia
authors.forename: M J
authors.initials: MJ
authors.lastname: Soares
authors.forename: A S
authors.initials: AS
authors.lastname: Cabral
authors.forename: A
authors.initials: A
authors.lastname: Macedo
authors.forename: D
authors.initials: D
authors.lastname: Gozal
authors.forename: M H
authors.initials: MH
authors.lastname: Azevedo
mesh_terms: D000342:Affective Symptoms / Q000453:epidemiology*; D002648:Child; D002652:Child Behavior; D002653:Child Behavior Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011174:Portugal / Q000453:epidemiology; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires