Sleep disturbances in a community sample from
preschool to school agecch_1288 1..9
P. Simola,*† E. Laitalainen,*† K. Liukkonen,‡ P. Virkkula,‡ T. Kirjavainen,§ A. Pitkäranta‡ and
E. T. Aronen*§
*Clinic for Children and Adolescents, Institute of Clinical Medicine, University of Helsinki
†Department of Psychology, University of Helsinki
‡Department of Otorhinolaryngology, Helsinki University Central Hospital, and
§Children’s Hospital, Helsinki University Central Hospital, Helsinki, Finland
Accepted for publication 19 June 2011
Keywords
paediatric, persistent
sleep problems, sleep
Correspondence:
Petteri Simola, Clinic
for Children and
Adolescents, University of
Helsinki, Tukholmankatu
8 C 613, 00290 Helsinki,
Finland
E-mail:
petteri.simola@hus.fi
Abstract
Objective To study the prevalence of various sleep problems at school age in a Finnish community
sample and to evaluate the persistence of the sleep problems from the preschool age to school age
in a 4-year follow-up.
Methods Parents completed the Sleep Disturbance Scale for Children questionnaire on their
child’s sleep during the preschool years (3–6 years) and again during the school years (7–11 years).
At follow-up the parents also completed a questionnaire on family structure and socio-economic
status.
Results The parents of 481 children completed the questionnaires during both the first study
and the follow-up (girls 49%, boys 51%; mean age 9, range 7–11). At the population level, sleep
problems slightly declined from preschool to school age (P < 0.05). However, sleep problems at
preschool age showed a strong persistence to school age. At the follow-up, 35% of the children
who were considered to have a sleep disorder at preschool age still suffered from it at school age.
At the community level, this equates to 9% of the children. The children with no sleep problems at
preschool age rarely developed sleep problems at school age.
Conclusions This study showed that various types of sleep problems are common at school age.
Sleep problems persisted from preschool to school age at the individual level. It is important to
recognize all types of sleep problems, especially persistent ones. Persistent sleep problems in
children may cause and exacerbate other somatic, cognitive and psychiatric problems.Therefore,
more attention should be focused on sleep problems in paediatric health care with interventions
aimed particularly at children with prolonged sleep problems.
Introduction
In recent years several studies have suggested insufficient sleep
to be a risk indicator of later difficulties in the development of
children (Aronen et al. 2000; Blunden et al. 2005; Shang et al.
2006; Jan et al. 2010). Insufficient amount or poor quality of
sleep has been found to be a risk factor for cognitive, behav-
ioural and emotional problems in both preschool- and school-
aged children (Aronen et al. 2000; Archbold et al. 2002; Gottlieb
et al. 2003, 2004; Jan et al. 2010).
Despite the adverse effects and associations between sleep
problems and other health and behavioural symptoms, only a
Child:
care, health and development
Original Article doi:10.1111/j.1365-2214.2011.01288.x
© 2011 Blackwell Publishing Ltd 1