title: Frequent nightmares in children: familial aggregation and associations with parent-reported behavioral and mood problems.
abstract: OBJECTIVE
  To conduct a systematic investigation on the prevalence, correlates, and familial aggregation of frequent nightmares in children, and to scrutinize the associations between frequent nightmares and parent-reported behavioral and mood problems in children.
  
  
  METHODS
  A cross-sectional study was conducted by collecting the data on sociodemographic, sleep, behavioral, and family-related information from a total of 6359 children (age: mean [SD]=9.2 [1.8] years; girls: 49.9%) and their reported biological parents.
  
  
  METHODS
  Community.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Prevalence of frequent nightmares with a criterion of at least once per week was 5.2%. Multinomial regression analysis indicated that monthly family income, paternal and maternal nightmares, insomnia symptoms, parasomniac symptoms, and daytime consequences were significantly associated with nightmares in children. Frequent nightmares in children were significantly associated with hyper-activity (odds ratio [OR]=1.68, 95% CI 1.16-2.44), frequent temper outbursts/mood disturbance (OR=1.76, 95%CI 1.27-2.44), and poor academic performance (OR=1.62, 95% CI 1.11-2.36), after controlling for potential confounding factors. Approximately 20% of children with frequent nightmares experienced comorbid frequent insomnia. Comorbid nightmares and insomnia were associated with increased odds of hyperactivity (OR=4.13, 95% CI 2.13-8.00) and frequent temper outbursts/mood disturbance (OR=2.41, 95%CI 1.27-4.60).
  
  
  CONCLUSIONS
  Frequent nightmares in children are associated with a constellation of child-, sleep-, and family-related factors, including comorbid sleep problems, such as insomnia and parasomnia, family economic status, and parental predisposition. Frequent nightmares are independently associated with emotional and behavioral problems in children.
authors: Department of Psychiatry, 2Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
authors: Shirley Xin
authors: SX
authors: Li
authors: Mandy Wai Man
authors: MW
authors: Yu
authors: Siu Ping
authors: SP
authors: Lam
authors: Jihui
authors: J
authors: Zhang
authors: Albert Martin
authors: AM
authors: Li
authors: Kelly Yee Ching
authors: KY
authors: Lai
authors: Yun Kwok
authors: YK
authors: Wing
mesh_terms: D000339:Affect; D000704:Analysis of Variance; D002648:Child; D002653:Child Behavior Disorders / Q000523:psychology*; D003430:Cross-Sectional Studies; D004325:Dreams / Q000523:psychology*; D004522:Educational Status; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000523:psychology*; D016017:Odds Ratio; D010290:Parents / Q000523:psychology*; D012044:Regression Analysis; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires