Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Center of Excellence for Maximizing Children's Developmental Potential, Division of Growth and Development, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Paediatr Child Health. 2024 Nov;60(11):703-708. doi: 10.1111/jpc.16662. Epub 2024 Sep 7.
The aim of the study was to examine the relationship between sleep problems and executive functions in pre-school children as reported by parents/caregivers.
This cross-sectional study of caregiver-child dyads was conducted in a public kindergarten school in Northern Thailand. Sleep problems were evaluated using the Children's Sleep Habits Questionnaire (CSHQ), whereas executive functions were assessed using the Behavioural Rating Inventory of Executive Function - pre-school version (BRIEF-P). T-scores greater than 65 of the BRIEF-P were defined as deficits in executive functions. Multiple linear regressions were performed to assess the association between the executive function components and the total CSHQ scores.
Participants included 356 children, with a mean age of 5.04 (0.54) years. The total CSHQ scores of the executive dysfunction group were significantly higher than those of the group with executive functions below the cutoff (P < 0.001), which indicated more of sleep problems, including sleep-onset delay, night waking and daytime sleepiness. However, the duration of night sleep, night awake, afternoon nap and total sleep time reported by parents did not differ between the two groups. Weak positive correlations between the total CSHQ and subscale scores and the Global Executive Composite score of the BRIEF-P were noted. After adjusting for confounding variables, including child's age, gender, prematurity, maternal age and education, family income and media viewing time from the multiple linear regression analysis, the total CSHQ scores were significantly correlated with worse Global Executive Composite scores, which is the summary of five domains of executive functions (P < 0.001).
This study highlights the association between sleep problems and deficits in executive functions in healthy pre-school children. Health-care providers are encouraged to consistently advocate for proper sleep hygiene and practices to enhance executive functions in pre-schoolers.
本研究旨在调查家长/照顾者报告的学龄前儿童睡眠问题与执行功能之间的关系。
本横断面研究以泰国北部一所公立幼儿园的照顾者-儿童对为研究对象。睡眠问题采用儿童睡眠习惯问卷（CSHQ）进行评估，而执行功能则采用行为评定量表-学前版（BRIEF-P）进行评估。BRIEF-P 的 T 分数大于 65 被定义为执行功能缺陷。采用多元线性回归评估执行功能各成分与 CSHQ 总分之间的关系。
研究对象包括 356 名儿童，平均年龄为 5.04（0.54）岁。执行功能障碍组的 CSHQ 总分明显高于低于临界值组（P<0.001），这表明存在更多的睡眠问题，包括入睡延迟、夜间醒来和白天嗜睡。然而，两组父母报告的夜间睡眠时间、夜间醒来时间、下午小睡时间和总睡眠时间并无差异。CSHQ 总分与 BRIEF-P 的总括执行复合得分和各分量表得分之间存在弱正相关。在调整了混杂变量，包括儿童年龄、性别、早产、母亲年龄和教育程度、家庭收入和媒体观看时间后，多元线性回归分析显示，CSHQ 总分与较差的总括执行复合得分显著相关，而总括执行复合得分是五个执行功能领域的综合得分（P<0.001）。
本研究强调了健康学龄前儿童睡眠问题与执行功能缺陷之间的关联。鼓励医疗保健提供者始终倡导适当的睡眠卫生和实践，以增强学龄前儿童的执行功能。
