Risk and protective factors and processes for behavioral sleep problems among preschool and early school-aged children: A systematic review

Adam T. Newton, Sarah M. Honaker, Graham J. Reid

Research output: Contribution to journalReview article

Abstract

Behavioral sleep problems in early childhood are common, affecting about 25% of children, and include symptoms such as problems going to sleep and staying asleep. This review employed the developmental psychopathology framework and 4P model (Predisposing, Precipitating, Perpetuating, Protective) to organize the diverse risk/protective factors (distal variables experienced indirectly by the child) and processes (proximal variables experienced directly by the child) for child sleep problems among preschool (1–5 y) and school-age (6–10 y) children. Variables were categorized into biological, psychological, and environmental factors/processes at the individual, family/parent, and community levels. The quality of evidence was assessed using GRADE. A literature search identified 98 articles meeting inclusion criteria. Older child age, difficult temperament, previous sleep problems, externalizing psychopathology, internalizing psychopathology, and electronics use (e.g., bedtime TV viewing) were identified as child risk variables predicting sleep problems. Parental presence at bedtime (risk), negative parenting style (e.g., lax or permissive parenting; risk), consistent bedtime routines (protective), and lower composite socioeconomic status (risk) were identified as family/parent variables predicting child sleep problems. No well-established predictors were found at the community level. Future research should employ advanced research designs more frequently and investigate: 1) risk pathways across development; and 2) nightly fluctuations in sleep problems.

Original languageEnglish (US)
Article number101303
JournalSleep Medicine Reviews
Volume52
DOIs
StatePublished - Aug 2020

Keywords

  • Pediatric
  • Predictors
  • Protective
  • Review
  • Risk
  • Sleep problems

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Risk and protective factors and processes for behavioral sleep problems among preschool and early school-aged children: A systematic review'. Together they form a unique fingerprint.

  • Cite this