Carneiro Inês Marques, Fonseca Pedro, Ferreira Rosário
Department of Pediatrics. Hospital Santa Maria. Lisbon Academic Medical Centre. Lisbon. Portugal.
Center for Applied Mathematics and Economics (CEMAPRE). Lisbon School of Economics and Management (ISEG). University of Lisbon. Lisbon. Portugal.
Acta Med Port. 2019 Oct 1;32(10):628-634. doi: 10.20344/amp.11841.
Children's sleep habits are profoundly affected by socio-economic, cultural, and environmental factors. We aim to describe the sleep habits of pediatric sub-populations from Cape Verde and Mozambique using the Children's Sleep Habits Questionnaire, and to ascertain the determinants of the questionnaire's score.
We conducted cross-sectional surveys in surveillance appointments in Cape Verde and in a school in Maputo (Mozambique). The Cape Verde sample included 206 children (mean age: 6.5) and the Mozambique sample 454 children (mean age: 8). The Portuguese version of the Children's Sleep Habits Questionnaire was used to evaluate the children's sleep habits. The distributions of the questionnaire's scores across different levels of the demographic variables were compared using the Mann-Whitney and the Kruskal-Wallis tests. We used regression models to quantify the relationship between the demographic variables and the questionnaire's scores.
Cape Verde sample: Questionnaire median score: 50 (range 36 - 81). Prevalence of sleep problems: 29.9% (cut-off = 56). Prevalence of parent-reported sleep problems: 22.8%. Co-sleeping: 63%. Bedtime television: 30%. Daytime nap: 63%. Questionnaire scores are associated with the mother's educational level, the children's age group, and with the frequency of daytime napping. Mozambique Sample: Median Questionnaire score: 48 (range 35 - 77). Prevalence of sleep problems: 28.4% (cut-off: 52). Percentage of parent-reported sleep problems: 6.9%. Co-sleeping: 29%. Bedtime television: 33%. Daytime nap: 23%. Questionnaire scores are associated with the mother's nationality, the father educational level, and with the frequency of bedtime television.
Parents tend to overestimate the quality of their children's sleep. The prevalence of sleep disturbances and the cut-off values are higher than observed in previous studies, which may be due to the existence of different standards and cultural expectations across populations. Bedtime television, typically associated with more disturbed sleep, is frequent in both samples. Co-sleeping and daytime napping are frequent in the Cape Verde sample; wetting the bed is common and more prevalent than in previous studies. Bed-sharing increases the parents' awareness of their children's sleep quality, contributing to the high prevalence of parent-reported sleep problems.
Parent-reported sleep problems underestimate the Children's Sleep Habits Questionnaire results. This is not necessarily indicative of more disturbed sleep and might reflect differences in sleep behavior, childcare practice, and cognitions and attitudes towards the concept of 'normal' sleep.
儿童的睡眠习惯受到社会经济、文化和环境因素的深刻影响。我们旨在使用儿童睡眠习惯问卷描述佛得角和莫桑比克儿科亚人群的睡眠习惯，并确定问卷得分的决定因素。
我们在佛得角的监测预约点和马普托（莫桑比克）的一所学校进行了横断面调查。佛得角样本包括206名儿童（平均年龄：6.5岁），莫桑比克样本包括454名儿童（平均年龄：8岁）。使用儿童睡眠习惯问卷的葡萄牙语版本评估儿童的睡眠习惯。使用曼-惠特尼检验和克鲁斯卡尔-沃利斯检验比较问卷得分在不同人口统计学变量水平上的分布。我们使用回归模型量化人口统计学变量与问卷得分之间的关系。
佛得角样本：问卷中位数得分：50（范围36 - 81）。睡眠问题患病率：29.9%（临界值 = 56）。家长报告的睡眠问题患病率：22.8%。同睡：63%。睡前看电视：30%。白天小睡：63%。问卷得分与母亲的教育水平、儿童年龄组以及白天小睡频率相关。莫桑比克样本：问卷中位数得分：48（范围35 - 77）。睡眠问题患病率：28.4%（临界值：52）。家长报告的睡眠问题百分比：6.9%。同睡：29%。睡前看电视：33%。白天小睡：23%。问卷得分与母亲的国籍、父亲的教育水平以及睡前看电视频率相关。
家长往往高估孩子的睡眠质量。睡眠障碍的患病率和临界值高于先前研究中观察到的，这可能是由于不同人群存在不同标准和文化期望。睡前看电视在两个样本中都很常见，通常与更紊乱的睡眠相关。同睡和白天小睡在佛得角样本中很常见；尿床很普遍且比先前研究中更常见。同床共眠提高了家长对孩子睡眠质量的意识，导致家长报告的睡眠问题患病率较高。
家长报告的睡眠问题低估了儿童睡眠习惯问卷的结果。这不一定表明睡眠更紊乱，可能反映了睡眠行为、育儿实践以及对“正常”睡眠概念的认知和态度上的差异。
