Childhood sleep/wake patterns: Local norms, associations, health outcomes and interventions.

Background and Objectives The rapid development of sleep/wake patterns that occur throughout childhood is one of the most important changes that occur during the first few years of life. Sleep problems, such as inadequate sleep duration and poor sleep quality are prevalent in young children, affecting 20--40% of the pediatric population. Sleep/wake patterns are heavily influenced by local culture and ethnicity, and there may be no cut-offs or normative values that are clinically appropriate cross cultures. Therefore, establishment of local norms of sleep/wake patterns is necessary for clinical and research purposes. Methods Sleep/wake patterns of infants and toddlers and influencing parental behaviors: One thousand and forty nine participants completed an online survey about their children's sleep via email. Parents completed the Brief Infant Sleep Questionnaire (BISQ) which included specific questions about infant daytime and nighttime sleep/wake patterns, as well as sleep-related behaviors. Sleeping arrangements (bed-sharing and room-sharing) and bedtime routines were also assessed. The respondents were asked to describe their children's behavior during the preceding two weeks. A screening questionnaire for sleep of preschool children: test-retest reliability and validation against sleep diary/actigraphy: Forty children (aged 3 to 5 years) were randomly selected in our cohort of 1746 children recruited from kindergartens throughout the four geographic regions of the Hong Kong. Parents completed two test-retest sleep related questionnaires with same content but different format separated by an interval of at least 2 months. At the second assessment, in addition, Children's Sleep Habits Questionnaire (CSHQ) questionnaires were completed by the parents. Parents also recorded their children's sleep/wake patterns by sleep diary and concurrent actigraphy monitoring for seven days. Sleep of preschoolers, demographic/socioeconomic characteristics, sleep related behaviors, environmental factors, and sleep of family members: One thousand seven hundred and forty six healthy preschool children were recruited from 59 randomly chosen kindergartens throughout Hong Kong. Parents of these children completed our validated sleep questionnaires on sleep/wake patterns, demographics/socioeconomic status, sleep related behaviors, environmental factors, and sleep/wake patterns of other family members. Association between sleep, behavior, neurocognitive performance, and BMD in preschool children: Healthy children were randomly recruited from our community-based cohort of preschool children. Recruited parents of 171 children completed CSHQ and reported their children's sleep/wake patterns by sleep diary for 7 days before follow-up interview. In the interview, parents completed the Children Behavior Checklist (CBCL) questionnaires for their children. The participants underwent anthropometric measurement, neurocognitive assessment, and BMD measurement. Neurocognitive test included Connor's Kiddie-Continuous Performance Test (K-CPT) and sky search of The Test of Everyday Attention for Children (TEA-Ch). BMD was assessed twice each in the non-dominant radius and tibia by quantitative ultrasound (QUS). Extended parent-based educational intervention improving sleep in children with ASD and their parents: Parents of 54 children aged less than 6 years old with a clinical diagnosis of ASD and sleep problems were recruited to our intervention workshop. Three workshop sessions were conducted over 3 consecutive weeks, which lasted for 2 hours each focusing on themes of sleep hygiene and sleep regularity, behavioral strategies to tackle bedtime resistance and night wakings, and other sleep concerns, for example obstructive sleep apnea and allergic rhinitis. (PsycINFO Database Record (c) 2016 APA, all rights reserved)