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Child sleep behaviors and sleep problems from infancy to school-age

Highlights•Sleep problems decrease from 17.1% in infancy to 7.7% in middle childhood.•Waking overnight is most common in infancy and associated with a sleep problem.•Difficulty falling asleep was most linked with middle childhood sleep problems.•Links between sleep behaviors and a caregiver-reported sleep problem vary by age.AbstractObjectiveFew studies have examined the sleep behaviors associated with a caregiver-reported sleep problem beyond early childhood and across different age groups. This study examined sleep behaviors associated with a caregiver-reported sleep problem from birth to middle childhood.MethodsParticipants were 5,107 children from the Longitudinal Study of Australian Children—Birth Cohort. Caregiver-reported child sleep problems and sleep behaviors were assessed biennially from ages 0-1 to 10-11 years. Logistic regressions were used to examine associations between three child sleep behaviors (waking overnight, difficulty falling asleep, and difficulty sleeping alone) and the odds of having a caregiver-reported sleep problem at each age.ResultsCaregiver-reported child sleep problems were most prevalent in infancy (17.1%) and decreased through middle childhood (7.7%). All three sleep behaviors were associated with a sleep problem at each age. Whereas waking overnight was the most common sleep behavior and was associated with the highest odds of having a sleep problem from infancy to age 6-7 years (ORs = 5.78- 8.29), difficulty falling asleep was the most common sleep behavior and was associated with the highest odds of having a sleep problem at ages 8-9 and 10-11 years (ORs =10.65 and 17.78, respectively).ConclusionCaregivers’ endorsement of a child sleep problem is associated with developmentally-relevant sleep behaviors, with night awakenings most relevant during infancy and difficulty falling asleep most relevant in middle childhood. Study findings have implications for targeted and developmentally-focused sleep problem screening questions in child healthcare settings. Future research examining additional indicators of caregiver-defined sleep problems is required.

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