Association of Sleep-related Parenting Practices and Sleep Problems in Preschoolers: A National Multiprovince Survey in China

Purpose: Sleep is fundamental to the healthy development of preschool children, yet sleep problems are prevalent. Parenting practices are known to be one of the determinants of child sleep, but evidence of large-scale sample in China is limited. We aimed to investigate the association between specific sleep-related parenting practices and sleep problems in Chinese preschoolers. Patients and Methods: The Chinese cohort of the SUNRISE study was conducted, involving 1316 children aged 3– 4 from 49 kindergartens, covering seven major administrative regions of China. Parents or primary caregivers completed a questionnaire which records children’s sociodemographic information and sleep-related parenting practices. Children’s sleep problems were evaluated using the Children’s Sleep Habits Questionnaire (CSHQ). Linear mixed models were used to calculate the association between parenting practices and specific sleep problems, adjusting for potential covariates. Results: Thirteen percent demonstrated sleep problems (total CSHQ score > 54). Girls had greater rate of daytime sleepiness, while the 3-year group had a greater rate of overall sleep problems. After adjusting for covariates, parents using electronic devices during the bedtime routine were associated with children’s short sleep duration on weekdays (β=− 0.314, CI − 0.505~– 0.123, P =0.02), bad sleep quality (β=− 0.34, CI – 0.557~0.124, P =0.029). Children sharing a room with others were associated with serious overall sleep problems (β=− 5.929, CI − 9.919~– 1.945, P =0.036). Children who share a bed with others were associated with serious overall sleep problems (β= − 5.914, CI − 9.697~– 2.134, P =0.026). Conclusion: This study demonstrates that sleep-related parenting practices, including parental screen exposure and co-room/bed sleep arrangements are significantly associated with sleep problems in Chinese preschoolers. These findings help parents to establish a healthy sleeping environment for their children. Keywords: preschoolers, parenting practices, sleep quality, Chinese cohort