title: Sleep problems and mental health in primary school new entrants: cross-sectional community-based study.
abstract: OBJECTIVE
  To determine at school entry (i) the prevalence and types of child sleep problems; (ii) sleep difficulties and hygiene practices associated with sleep problems; and (iii) their associations with child health-related quality of life, mental health and parent mental health.
  
  
  METHODS
  We conducted a cross-sectional community-based study at 22 primary schools in Melbourne, Australia. One thousand five hundred and twelve (70%) parents of children in the first 6 months of the child's first year of primary school took part. Parent report of child sleep problems (none, mild, and moderate/severe); sleep difficulties; pre-bedtime activities (television in bedroom, television or electronic games before bedtime, television or electronic games >2 h/day) and caffeine intake; child mental health (Strengths and Difficulties Questionnaire), health-related quality of life (Pediatric Quality of Life Inventory); and parent mental health (Depression Anxiety Stress Scale-21).
  
  
  RESULTS
  38.6% of children had a parent-reported sleep problem (27.9% mild, 10.8% moderate/severe). Sleep problems were characterised by problematic sleep difficulties but not poor sleep hygiene practices. Moderate/severe sleep problems were associated with poorer child mental health (mean difference -0.8; 95% confidence interval (CI) -1.1 to -0.5, P < 0.001), health-related quality of life (mean difference -9.9; 95% CI -11.9 to -7.9, P < 0.001) and parent mental health (mean difference 9.8; 95% CI 7.7-11.9, P < 0.001).
  
  
  CONCLUSIONS
  In new school entrants, sleep problems are common and associated with poorer child mental health, health-related quality of life and parent mental health. Future research needs to determine if systematically addressing sleep problems improves these outcomes.
authors.affiliation: Department of Paediatrics, The University of Melbourne, Victoria, Australia. jon.quach@mcri.edu.au
authors.forename: Jon
authors.initials: J
authors.lastname: Quach
authors.forename: Harriet
authors.initials: H
authors.lastname: Hiscock
authors.forename: Melissa
authors.initials: M
authors.lastname: Wake
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D010290:Parents / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012574:Schools; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D013690:Television / Q000706:statistics & numerical data; D014739:Victoria / Q000453:epidemiology