Cross-cultural differences in infant and toddler sleep.
BACKGROUND
To characterize cross-cultural sleep patterns and sleep problems in a large sample of children ages birth to 36 months in multiple predominantly-Asian (P-A) and predominantly-Caucasian (P-C) countries.


METHODS
Parents of 29,287 infants and toddlers (predominantly-Asian countries/regions: China, Hong Kong, India, Indonesia, Korea, Japan, Malaysia, Philippines, Singapore, Taiwan, Thailand, Vietnam; predominantly-Caucasian countries: Australia, Canada, New Zealand, United Kingdom, United States) completed an internet-based expanded version of the Brief Infant Sleep Questionnaire.


RESULTS
Overall, children from P-A countries had significantly later bedtimes, shorter total sleep times, increased parental perception of sleep problems, and were more likely to both bed-share and room-share than children from P-C countries, p<.001. Bedtimes ranged from 19:27 (New Zealand) to 22:17 (Hong Kong) and total sleep time from 11.6 (Japan) to 13.3 (New Zealand) hours, p<.0001. There were limited differences in daytime sleep. Bed-sharing with parents ranged from 5.8% in New Zealand to 83.2% in Vietnam. There was also a wide range in the percentage of parents who perceived that their child had a sleep problem (11% in Thailand to 76% in China).


CONCLUSIONS
Overall, children from predominantly-Asian countries had significantly later bedtimes, shorter total sleep times, increased parental perception of sleep problems, and were more likely to room-share than children from predominantly-Caucasian countries/regions. These results indicate substantial differences in sleep patterns in young children across culturally diverse countries/regions. Further studies are needed to understand the basis for and impact of these interesting differences.
The Children's Hospital of Philadelphia, Saint Joseph's University, PA, USA. jmindell@sju.edu
Jodi A
JA
Mindell
Avi
A
Sadeh
Benjamin
B
Wiegand
Ti Hwei
TH
How
Daniel Y T
DY
Goh
D000328:Adult; D000704:Analysis of Variance; D001210:Asia, Southeastern; D044466:Asian People / Q000706:statistics & numerical data; D001315:Australia; D001722:Birth Order; D002170:Canada; D016009:Chi-Square Distribution; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D005202:Asia, Eastern; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009520:New Zealand; D010290:Parents; D012890:Sleep; D012893:Sleep Wake Disorders / Q000208:ethnology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom; D014481:United States; D044465:White People / Q000706:statistics & numerical data