Clinical ReviewRisk factors and consequences of early childhood dyssomnias: New perspectives
Introduction
Although sleep plays an important role in many areas of child development, including health, mood, cognition and academic performance,*1, *2 longitudinal studies of normal sleep and sleep problems in early childhood have been conducted only recently. This literature review summarizes the results derived from the current knowledge on potential determinants and consequences of sleep disturbances occurring in early life. A model supported by empirical data is presented, with recommendations for clinicians and parents coping with sleep problems in young children.
Section snippets
Sleep duration and consolidation
Normally, full-term babies sleep around 16–18 h per day at birth, interrupted by waking periods. Total sleep duration declines as children grow up: 13–14 h at 6 months and 10–11 h at 6 years.3 This reduction results largely from the decreasing number and duration of naps. Conversely, waking periods gradually increase during the daytime. Daytime sleep becomes well-defined naps: 2–3 naps per day until age 6 months (3.5 h total), followed by 2 naps per day at around 9–12 months, and finally, 1 nap in
Definitions and prevalence
Dyssomnias are defined in the DSM-IV22 as a group of disorders characterized by difficulty in initiating or maintaining sleep. Dyssomnias are largely under-diagnosed in infants and toddlers.22 A recent study23 has recommended standard criteria to diagnose 2 categories of sleep problems in early childhood: 1) frequent nocturnal awakenings, defined as >2 signaled awakenings/night in 1–2-year-old children and >1 signaled awakening/night in children 2 years old and older), and 2) sleep onset
Consequences of short sleep duration
Do sleep problems have negative consequences on the child's development? Poor sleepers go to bed 1 h later on average, and therefore sleep 1 h less than good sleepers.42 As the child grows up, it becomes imperative to assess the relationship between nocturnal sleep duration and the potential consequences for development.
An integrative model of the risk factors and consequences of dyssomnias
A theoretical model of infant sleep regulation integrating multiple environmental systems was developed in 1993.32 A revised model based on empirical data is proposed here (see Fig. 1).
It relies heavily on a series of analyses*2, *41, *67, 70 performed on a representative sample of children born in the province of Quebec (Canada) in 1997–1998 studied prospectively and longitudinally. This study allowed investigating several spheres of child development simultaneously in order to distinguish
Conclusions
This review stresses the importance of allowing young children to sleep at least 10 h per night, as suggested by the National Sleep Foundation Poll71 for optimal general childhood development. It would be important to more accurately determine the minimum required sleep duration threshold in early childhood. We should keep in mind that the required sleep duration may show inter-individual variation (short- and long-sleepers). To avoid childhood dyssomnias, one recommendation to parents is to
Acknowledgements
This research was supported by a postdoctoral fellowship (E. Touchette) from the Canadian Institutes of Health Research.
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Longitudinal associations between parent, child, family factors and dyssomnias in children from birth to 8 years: The CIKEO study
2023, Journal of Affective DisordersCitation Excerpt :Response options were <10 min, 10-30 min, 30 min-1 h, 1 h-2 h, and >2 h. At each time point, and in accordance with the literature (Petit et al., 2007; Sadeh and Anders, 1993; Touchette et al., 2009; Wang et al., 2019; Zuckerman et al., 1987), dyssomnias were defined as the presence of night awakenings ≥3 times per night or sleep-onset latency >30 min in our main analysis. Children were divided into two groups based on the presence of dyssomnias at baseline.
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