title: Sleep patterns and sleep disturbances among Chinese school-aged children: prevalence and associated factors.
abstract: OBJECTIVE
  The study aimed to (1) characterize sleep patterns and sleep disturbances among Chinese school-aged children, (2) determine the prevalence of their short sleep duration and sleep disturbances based on clinical cutoffs, and (3) examine possible factors (socio-demographic factors and emotional/behavioral problems) that are associated with sleep disturbances.
  
  
  METHODS
  A large representative sample of 912 children aged 6-14years was recruited from Shenzhen, China. Their parents completed the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ).
  
  
  RESULTS
  The mean bedtime was 9:45pm (SD=1h 11min), mean wake-up time was 7:03am (SD=31min), mean sleep duration was 9h 14min (SD=46min), and 23.8% of the children had sleep duration <9h. Overall, 69.3% of the children suffered from global sleep disturbances (CSHQ total score >41). Bedtime resistance (22.9%), sleep anxiety (22.1%), sleep duration (21%) and daytime sleepiness (20%) were the most prevalent sleep disturbances; followed by sleep disordered breathing (12.1%), parasomnias (9.4%), sleep onset delay (6.9%), and night waking (5.2%). The prevalence of specific sleep disturbances ranged from 3.2% (falling asleep while watching television) to 81.9% (awakening by others in the morning). Correlations between most domains of sleep disturbances and emotional/behavioral problems were statistically significant (p<0.05 or p<0.01). Hierarchical multiple regression analysis revealed that gender (β=0.10, p<0.01), school grade (β=-0.09, p<0.05), co-sleeping (β=0.25, p<0.01), emotional symptoms (β=0.24, p<0.01), conduct problems (β=0.09, p<0.05), and hyperactivity (β=0.17, p<0.01) accounted for significant variance in CSHQ total score.
  
  
  CONCLUSIONS
  Short sleep duration and sleep disturbances are prevalent among Chinese school-aged children. Sleep disturbances are associated with gender, school grade, co-sleeping, emotional symptoms, conduct problems, and hyperactivity.
authors.affiliation: School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China. wang-guanghai@163.com
authors.forename: Guanghai
authors.initials: G
authors.lastname: Wang
authors.forename: Guangxing
authors.initials: G
authors.lastname: Xu
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Liu
authors.forename: Ning
authors.initials: N
authors.lastname: Lu
authors.forename: Rui
authors.initials: R
authors.lastname: Ma
authors.forename: Entao
authors.initials: E
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014851:Wakefulness