School-aged children need screening for sleep disturbances

Sleep disturbances may be more common among school-aged children than previously recognized, according to a study of children in kindergarten through fourth grades.

"Despite increasing evidence of the importance of sleep on children's health and functioning, many sleep disorders in middle childhood still go unrecognized by health care providers," said lead author Judith A. Owens, MD, MPH, Assistant Professor at Brown University and affiliated with the Hasbro Children's Hospital in Providence.

Owens and colleagues found that 37 percent of 494 school-aged study participants suffered from at least one sleep-related problem. Their findings appear in the February issue of the Journal of Developmental and Behavioral Pediatrics.

Sleep-related problems included bedtime resistance, sleep anxiety, difficulty in falling or remaining asleep, behaviors such as bedwetting or sleepwalking, breathing conditions including snoring or gasping during sleep, and daytime sleepiness.

The researchers collected data from the children, as well as from their parents and teachers. Collecting data from parents alone may give an incomplete picture of childhood sleep behavior, according to Owens. Teachers, for example, noted higher levels of daytime sleepiness in younger children than in older, while parents did not. "This finding underscores the potential importance of obtaining teacher observations when assessing children for daytime repercussions of disordered sleep," said Owens.

"Teachers are routinely observing children in a different environment and under a different level of stimulation than are parents," she added.

The reports of children themselves are equally important, according to the researchers, who noted discrepancies between parents and children's reports. Children reported higher levels of certain sleep problems, like difficulty falling asleep and waking in the night, than did their parents, the researchers found.

In general, Owens and colleagues found sleep-related problems – particularly bedtime struggles and night wakings – to be more prevalent among kindergartners through second graders than among third and fourth graders.

"Primary care providers are generally aware of sleep issues in infants and toddlers but often fail to adequately screen children past the pre-school years for sleep problems in the clinical setting," said Owens.

"The results of this study emphasize the importance of screening school-aged children for sleep problems and the need for health care providers to understand the possible consequences of disordered sleep on children's daily lives," said Owens.

The Journal of Developmental and Behavioral Pediatrics is published bimonthly by the Society for Developmental and Behavioral Pediatrics. For information about the journal, contact Mary Sharkey at (212) 595-7717.

Posted by the Center for the Advancement of Health < http://www.cfah.org >. For information about the Center, call Petrina Chong, < pchong@cfah.org > (202) 387-2829.