title: Coexistence of sleep and feeding disturbances in young children.
abstract: OBJECTIVE
  Behavioral insomnia and feeding difficulties are 2 prevalent conditions in healthy young children. Despite similarities in nature, etiology, prevalence, and age distribution, the association between these 2 common disorders in young children has not been examined thus far.
  
  
  METHODS
  Children aged 6 to 36 months with either behavioral insomnia or feeding disorders were recruited. Children aged 6 to 36 months who attended the well-care clinics were recruited and served as controls. Sleep and feeding were evaluated by using a parental questionnaire.
  
  
  RESULTS
  Six hundred eighty-one children were recruited. Fifty-eight had behavioral insomnia, 76 had feeding disorders, and 547 were controls. The mean age was 17.0 ± 7.6 months. Parents of children with feeding disorders considered their child's sleep problematic significantly more frequently compared with controls (37% vs 16%, P = .0001 [effect size (ES): 0.66]). They reported shorter nocturnal sleep duration and delayed sleep time compared with controls (536 ± 87 vs 578 ± 88 minutes, P = .0001) and 9:13 ± 0.55 PM vs 8:26 ± 1.31 PM, P = .003). Parents of children with behavioral insomnia described their child's feeding as "a problem" more frequently compared with controls (26% vs 9%, P = .001 [ES: 0.69]). They reported being more concerned about their child's growth (2.85 ± 1.1 vs 2.5 ± 1.0, P = .03) and reported higher scores of food refusal compared with controls (3.38 ± 0.54 vs 3.23 ± 0.44, P = .04).
  
  
  CONCLUSIONS
  Problematic sleep and feeding behaviors tend to coexist in early childhood. Increased awareness of clinicians to this coexistence may allow early intervention and improve outcome.
authors.affiliation: Pediatric Sleep Center, Dana Children's Hospital, Tel Aviv Souraski Medical Center, Tel Aviv, Israel.
authors.forename: Riva
authors.initials: R
authors.lastname: Tauman
authors.forename: Arie
authors.initials: A
authors.lastname: Levine
authors.forename: Hadas
authors.initials: H
authors.lastname: Avni
authors.forename: Haim
authors.initials: H
authors.lastname: Nehama
authors.forename: Michal
authors.initials: M
authors.lastname: Greenfeld
authors.forename: Yakov
authors.initials: Y
authors.lastname: Sivan
mesh_terms: D002675:Child, Preschool; D005247:Feeding Behavior / Q000502:physiology*; D001068:Feeding and Eating Disorders / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D011795:Surveys and Questionnaires