Parent perceptions of child sleep: a study of 10 000 Swedish children


Peder Palmstierna, Department of Clinical and Experimental Medicine, Division of Pediatrics and Diabetes Research Centre, Faculty of Health Sciences, Linköping University, SE-58185 Linköping, Sweden.
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Aim: To gather normative data on parent-reported child sleep and investigate what influences it.

Methods: Subjective sleep report data on night wakings, sleep quality, bedtime and risetime were gathered from parents of around 10 000 children from birth to age 5 in a cohort questionnaire study. The data were analysed for trends, and sleep measures were compared with background factors such as child temperament, foreign origin, family situation, parents' age and education and night feedings.

Results: The population trends were towards improved sleep with increasing age. Individual sleep patterns show some stability. Reports of frequent night wakings and low sleep quality (LSQ) were strongly associated with each other within and between the age groups (odds ratio [OR] 2.8–60.2, p < 0.001). Perception of poor child sleep was influenced by child temperament at ages 1 and 3 (OR 2.2–4.4, p < 0.001), foreign origin at age 1 (OR 2.1–2.3, p < 0.001), and to some extent, parents' age and education at ages 1–3 (OR 1.4–2.1, p < 0.05 or stronger), but not by single parent status or infant night feedings. Reporting multiple or unspecific causes of night wakings was associated with reporting LSQ (OR 1.8–4.7, p < 0.05 or stronger).

Conclusion: With increasing age, fewer wakings, improved sleep quality and a more uniform sleep schedule seem normal. However, frequent wakings and low quality sleep at early ages seem surprisingly stable. A difficult temperament and foreign origin were associated with lower quality sleep and more frequent wakings in early ages, whereas being a single parent was not. Finally, night feeding does not seem to condition children to frequent wakings.