3~6岁儿童睡眠质量问题及其与父母教养方式的关联研究

Sleep problems in children aged 3 to 6 years and their association with parenting styles

摘要

目的 了解3~6岁儿童睡眠质量问题状况及其与父母教养方式的关系,为改善学龄前儿童睡眠质量提供参考和帮助。方法 采用分层整群抽样的方法于2023年4—6月在华中地区(河南、湖北、湖南)对4 246名3~6岁儿童家长进行儿童睡眠质量问题及父母教养方式的问卷调查,并对结果进行单因素分析和logistic回归分析。结果 华中地区3~6岁儿童睡眠质量问题检出率为15.83%。不同年龄段儿童延迟入睡检出率差异有统计学意义(χ²=27.649,P＜0.01),城乡儿童在睡眠阻抗(χ²=11.549)和睡眠持续性方面(χ²=38.886)差异有统计学意义(P＜0.01)。Logistic回归分析显示,父亲敌意强制较高者发生睡眠质量问题的风险增加(OR=2.21,95%CI:1.59~3.15,P＜0.01);母亲敌意强制较高者发生睡眠质量问题的风险增加(OR=2.56,95%CI:1.88~3.33,P＜0.01);父母敌意强制均高者发生睡眠质量问题的风险也增加(OR=3.59,95%CI:2.81~4.48,P＜0.01)。结论 华中地区3~6岁学龄前儿童睡眠质量问题检出率较高。父亲敌意强制较高、母亲敌意强制较高和父母敌意强制均高的学龄前儿童发生睡眠质量问题的风险均增加。

Abstract

Objective To understand the sleep problems among children aged 3 - 6 years in Central China and their association with parenting styles, in order to provide reference for improving sleep quality in preschool children. Methods Using a stratified cluster sampling method, a questionnaire survey on sleep problems among children and parenting styles was conducted among 4 246 parents of children aged 3 - 6 years in Central China (Henan, Hubei, Hunan) from April to June 2023. Univariate analysis and logistic regression analysis were used for statistical analysis. Results The detection rate of sleep problems among children aged 3 - 6 years in Central China was 15.83%. The detection rate of delayed sleep onset differed significantly among different age groups (χ²=27.649, P<0.01). Significant differences were observed between urban and rural children in sleep resistance (χ²=11.549) and sleep continuity (χ²=38.886) (P<0.01). Logistic regression analysis showed that children with higher levels of paternal hostile coercion had an increased risk of sleep problems (OR=2.21, 95%CI: 1.59 - 3.15, P<0.01). Children with higher levels of maternal hostile coercion had an increased risk of sleep problems (OR=2.56, 95%CI: 1.88 - 3.33, P<0.01). Compared with children whose parents both exhibited low levels of hostile-aggressive behavior, those whose parents both exhibited high levels of hostile-aggressive behavior also had an increased risk of sleep problems (OR=3.59, 95%CI: 2.81 - 4.48, P<0.01). Conclusions The prevalence of sleep problems among preschool children aged 3 - 6 years in Central China is relatively high. Preschool children with high levels of paternal hostile coercion, maternal hostile coercion, or parental hostile coercion all exhibit an increased risk of sleep problems.

关键词

华中地区 / 睡眠质量问题 / 父母教养方式 / 学龄前儿童

Key words

Central China / sleep problems / parenting style / preschool children

[1] Bai M, Wu L, Zhao M, et al. Integrated analysis of EGFR mutated non-small cell lung cancer reveals two distinct molecular subtypes[J]. Clin Transl Med,2023, 13(10):e1431.
[2] 汤路瀚, 任丽, 徐方忠. 学龄前儿童睡眠与行为问题研究[J]. 预防医学, 2020, 32(6):4.
Tang LH, Ren L, Xu FZ. Sleep behaviors and behavioral problems in preschool children[J]. China Prev Med J, 2020, 32(6):4.(in Chinese)
[3] Deng Y, Zhang Z, Gui Y,et al. Sleep disturbances and emotional and behavioral difficulties among preschool-aged children[J]. JAMA Netw Open,2023, 6(12):e2347623.
[4] 汪小燕, 殷刚柱, 邵子瑜,等. 母亲童年期不良经历与学龄前儿童睡眠质量的关联[J]. 中华疾病控制杂志, 2021, 25(5):6.
Wang XY, Yin GZ, Shao ZY, et al. The role of maternal adverse childhood experiences on the sleep quality of preschool children[J].Chin J Dis Control Prev, 2021, 25(5):6.(in Chinese)
[5] Tangwijitsakul H, Likhitweerawong N, Boonchooduang N, et al. Sleep problems and executive dysfunctions in pre-school children[J].J Paediatr Child Health,2024, 60(11):703-708.
[6] Hongnipon S, Jirakran K, Sukkul A, et al. Caregiver health literacy, sleep practices, and child sleep outcomes in Thai children aged 3 - 12 years: A cross-sectional study[J].Eur J Pediatr,2025, 184(7):394.
[7] Liu J, Ji X, Pitt S,et al. Childhood sleep: Physical, cognitive, and behavioral consequences and implications[J]. World J Pediatr, 2024, 20(2):122-132.
[8] Lollies F, Schnatschmidt M, Bihlmeier I, et al. Associations of sleep and emotion regulation processes in childhood and adolescence - a systematic review, report of methodological challenges and future directions[J].Sleep Sci,2022, 15(4):490-514.
[9] GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990—2021: A systematic analysis for the Global Burden of Disease Study 2021[J].Lancet,2024, 403(10440):2100-2132.
[10] Matzliach O, Horwitz A, Ran-Peled D, et al. A longitudinal study of the bi-directional relations between parental bedtime and nighttime involvement and infant sleep[J]. Sleep Med,2025, 129:55-66.
[11] 李生慧, 金星明, 沈晓明,等. 儿童睡眠习惯问卷中文版制定及测量性能考核[J].中华儿科杂志, 2007, 45(3):176-180.
Li SH, Jin XM, Shen XM, et al. Development and psychometric properties of the Chinese version of Children's Sleep Habits Questionnaire[J]. Chin J Pediatr,2007,45(3):176-180.(in Chinese)
[12] 王广海,徐光兴,孙越异,等.自闭症谱系障碍儿童睡眠问题与情绪行为问题的相关研究[J].中国特殊教育,2014(11):53-57.
Wang GH, Xu GX, Sun YY, et al. A correlative study on sleep problems and emotional and behavioral problems in children with autism spectrum disorder[J].Chin J Spec Educ,2014(11):53-57.(in Chinese)
[13] 李生慧. 学龄儿童睡眠健康流行病学调查及相关基础研究[D].上海:上海交通大学, 2007.
Li SH. Epidemiological study on school-age children's sleep behaviors and correlated experimental research[D].Shanghai:Shanghai Jiao Tong University, 2007.(in Chinese)
[14] 贾守梅, 汪玲, 谭晖, 等.中文版父母行为问卷在儿童早期父母中应用的信效度检验[J].中国儿童保健杂志,2013,21(9):916-919.
Jia SM, Wang L, Tan H, et al. Application of the Chinese version of Parent Behavior Inventory[J].Chin J Child Health Care,2013,21(9):916-919.(in Chinese)
[15] Chen S,Ding R,Tang X,et al. Association between alchol consumption and risk of hyperuricaenia among adults:A large cross-sectional study in Chongging,China[J].BMJ Open,2023,13(12):e074697.
[16] 黄铁牛,何蓉.某医学高职院校大学生吸烟及认知影响因素调查[J].中国公共卫生管理,2017,33(3):391-394.
Huang TN, He R. Survey on smoking and cognitive influencing factors of college students in a high vocational college[J]. Chin J of PHM,2017,33(3):391-394.(in Chinese)
[17] 朱玲,杜娟,张华,等.太原市学龄前儿童睡眠状况现况调查[J].中国药物与临床,2020,20(19):3199-3201.
Zhu L,Du J, Zhang H,et al. Investigation on the current situation of sleep status of preschool children in Taiyuan City[J].Chin Rem Clin,2020,20(19):3199-3201.(in Chinese)
[18] Breda M, Lucchini M, Barnett N,et al. A cross-sectional study on the relationship between infant sleep, temperament, and bedtime practices[J].J Clin Sleep Med,2024, 20(12):1965-1974.
[19] Crider K, Williams J, Qi YP,et al. Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas[J]. Cochrane Database Syst Rev,2022, 22(2):14217.
[20] Cook G, Carter B, Wiggs L,et al. Parental sleep-related practices and sleep in children aged 1-3 years: A systematic review[J]. J Sleep Res,2024, 33(4):e14120.
[21] Werner A, Mayer A, Lohaus A. Sleep-related parenting self-efficacy and parent-reported sleep in young children: A dyadic analysis of parental actor and partner effects[J]. Sleep Health,2022, 8(1):54-61.
[22] 丁鹏,耿梦龙,伍晓艳,等. 学龄前儿童父母养育行为与其睡眠问题的关联[J]. 中国学校卫生, 2024, 45 (12): 1747-1751.
Ding P, Geng ML, Wu XY, et al. Essociation between parenting behaviors and sleep problems in preschool children[J].Chin J Sch Health, 2024, 45 (12): 1747-1751.