Association between Sleep Disturbances and Emotional/Behavioral Problems in Chinese and Japanese Preschoolers

ABSTRACT

Objectives: Sleep disturbances are often associated with emotional/behavioral problems in young children, but whether the association differs among Asian countries remains unknown. This study aimed to investigate the association between sleep disturbances and emotional/behavioral problems in Chinese and Japanese preschoolers and to explore potential differences.

Methods: Participants were 1,020 Chinese preschoolers from 10 cities and 438 Japanese preschoolers from 1 city aged 4 to 5 years. Parents filled out the Children’s Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ).

Results: Chinese children with sleep disturbances (defined as total CSHQ score >41) demonstrated more peer problems than children without, while there was no such difference in Japanese preschoolers. Domains of sleep disturbances associated with emotional/behavioral problems in Chinese children were sleep disordered breathing and daytime sleepiness, yet in Japanese children were sleep anxiety and night wakings. Children with a higher score of sleep anxiety showed more emotional problems in Japan, but fewer conduct problems in China.

Conclusions: Sleep disturbances were associated with emotional/behavioral problems in preschoolers with differences between China and Japan, indicating subcultural differences in preschoolers’ sleep within Asian countries.

Abbreviations: CSHQ: Children’s Sleep Habits Questionnaire; SDQ: Strengths and Difficulties Questionnaire; ANCOVA: analysis of covariance; SD: standard deviation; CI: confidence interval.

Acknowledgments

We appreciate Nikki Lindgren from Xiersen Children Service Center for her insightful input into this paper and for refining the language.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Guanghai Wang and Fan Jiang were supported by the National Natural Science Foundation of China (81601162, 81773443, 81602868, 81602870); Ministry of Education of China-New Century Excellent Talents (NCET-13-0362); Ministry of Science and Technology of China (2016YFC1305203); Shanghai Science and Technology Commission (17XD1402800, 14441904004, 17411965300, 19QA1405800, 19411968800); Shanghai Municipal Commission of Health and Family Planning (20164Y0001, 20164Y0095); Shanghai Jiao Tong University (YG2016ZD04); Project of Shanghai Children’s Health Service Capacity Construction (GDEK201708); Shanghai Children’ Medical Center Fund (YJY-SCMC2016-5); Fundamental Research Funds for the Central Universities from the Key Laboratory of Child Development and Learning Science(Southeast University) and the Ministry of Education (CDLS-2018-03); Science and Technology Commission of Pudong New Area Foundation (PKJ2018-Y45). Michio Takahahshi was supported by the Hirosaki University Grant for Exploratory Research by Young Scientists and Newly-appointed Scientists. Manabu Saito was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI (16K10239). Kazuhiko Nakamura was supported by the Hirosaki city, Hirosaki Institute of Neuroscience in Japan, Hirosaki University Institutional Research Grant, Japan Society for the Promotion of Science (JSPS) KAKENHI (15H04889).