Sleep patterns and determinants of sleep disturbances in preschool children in the CoAlHaS cohort.

INTRODUCTION

Sleep disturbances represent a significant public health concern from early childhood, given the long-term implications for health and development. This study examined sleep patterns and factors associated with sleep disturbances in preschool-aged children.

METHODS

Data were collected from 1287 participants (544 born in 2018 and 743 born in 2020/21) within the CoAlHaS cohort (Cantabria, Spain). Baseline information was obtained at birth, with follow-up data collected through face-to-face visits, including parent interviews, anthropometric measurements and linkage to medical records. Sleep patterns and disturbances were assessed by the Spanish version of the Children's Sleep Habits Questionnaire (CSHQ-SP). Children were classified as 'poor sleepers' using the validated Spanish threshold of 50.35 points. Associations with perinatal, lifestyle and sociodemographic factors were analysed using one-way ANOVA, independent-samples t-tests and multivariable logistic regression.

RESULTS

The prevalence of sleep problems was 36.22% in the total sample. Recommended sleep duration was generally met, although patterns varied between cohorts. Globally, prematurity (OR 2.10, 95% CI 1.24-3.56), increased screen time exposure (OR 1.06, 95% CI 1.01-1.10) and late bedtimes (OR 1.46, 95% CI 0.99-2.13) were linked to being a poor sleeper, whereas higher maternal educational attainment (OR 0.62, 95% CI 0.40-0.96) and younger age (OR 0.24, 95% CI 0.07-0.77) were associated with reduced odds.

CONCLUSION

Sleep disturbances are frequent among early childhood, despite achieving recommended sleep duration. Early identification of children at risk and targeted interventions focusing on sleep routines and modifiable family-level factors could be essential to improve sleep habits.