Prevalence and patterns of sleep disturbances in pediatric psychiatric and non-psychiatric populations: a cross-sectional study in Lebanon

BACKGROUND: Sleep is vital to physical, cognitive, and emotional development in children, yet sleep disturbances remain underrecognized, particularly in pediatric psychiatric populations. Prior studies suggest a bidirectional relationship between psychiatric disorders and sleep dysfunction. In Lebanon, the compounded effects of social unrest, economic instability, and widespread psychiatric morbidity have raised concern over pediatric sleep health. This study aims to compare the prevalence and characteristics of sleep disturbances among pediatric patients with and without psychiatric disorders in an outpatient tertiary medical setting, and to identify factors associated with sleep disturbances. METHODS: This cross-sectional study was conducted at the American University of Beirut Medical Center (AUBMC) among children and adolescents presenting to pediatric and pediatric psychiatry outpatient clinics. Sleep disorders were assessed using validated questionnaires. The Adolescent Insomnia Questionnaire (AIQ) for insomnia, the Pediatric Sleep Questionnaire (PSQ) for sleep-disordered breathing, and a single NIH-validated item assessing restless legs syndrome (RLS). Additional sociodemographic, behavioral, and dietary data were collected. Statistical analyses included chi-square testing and multivariate logistic regression to evaluate associations between sleep disturbances and potential predictors. RESULTS: Among 95 participants (mean age 12.4 years; 51.6% male), 48.4% had a psychiatric diagnosis. Sleep disturbances were more prevalent in the psychiatric group (80.4%) versus the non-psychiatric group (61.2%). Insomnia (76.1% vs. 61.2%), RLS (26.1% vs. 18.4%), and sleep-disordered breathing (39.1% vs. 26.5%) were all more common among psychiatric patients. Poor academic performance was significantly associated with sleep disturbances (p < 0.05). In multivariate analysis, a balanced diet was protective (OR = 0.29, p = 0.039), while stress increased the odds of sleep problems (OR = 2.07, p = 0.048). CONCLUSION: Sleep disturbances are highly prevalent among Lebanese children, with modifiable factors such as stress and diet having a greater influence on sleep outcomes than psychiatric status. These findings underscore the need for routine sleep assessment in pediatric clinical care. Addressing sleep hygiene and related behaviors may offer therapeutic benefits and support long-term developmental outcomes. CLINICAL TRIAL NUMBER: Not applicable.