title: Does assessing sleep inadequacy across its continuum inform associations with child and family health?
abstract: BACKGROUND
  The purpose of this study was to examine the prevalence and characteristics of children experiencing a continuum of inadequate sleep and its associations with child, family, and environmental variables.
  
  
  METHODS
  A secondary analysis of weighted responses of 68,418 parents or caregivers of children aged 6 to 17 years participating in the 2003 National Survey of Children's Health was conducted. Inadequate sleep was categorized as mild, moderate, or severe.
  
  
  RESULTS
  Approximately one third of parents reported their child's sleep inadequacy as mild (18.6%), moderate (6.8%), or severe (5.8%). Age (P < .001), fair/poor health status (P < .001), frequent depressive symptoms (P < .001), and high parental stress (P < .001) demonstrated a progressive relationship from adequate to severe inadequate sleep. Controlling for child, family, and environment variables, parents of children with inadequate sleep were more likely to report frequent child depressive symptoms, high parental stress, and violent family conflict style.
  
  
  CONCLUSIONS
  Sleep inadequacy affects 15 million American children, 6 million at a moderate or severe level. Identification of inadequate sleep should prompt further assessment of its associated factors-depressive symptoms, parental stress, and family conflict-for targeted clinical intervention.
authors.affiliation: Columbia University School of Nursing, New York, NY 10032, USA. ams130@columbia.edu
authors.forename: Arlene
authors.initials: A
authors.lastname: Smaldone
authors.forename: Judy C
authors.initials: JC
authors.lastname: Honig
authors.forename: Mary W
authors.initials: MW
authors.lastname: Byrne
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D012892:Sleep Deprivation