Association between sleep patterns and daytime functioning in children with insomnia: The contribution of parent-reported frequency of night waking and wake time after sleep onset

Objective: The aim of this study was to investigate the association between sleep patterns and daytime functioning in children with insomnia. Furthermore, the role of frequency of night waking and wake time after sleep onset for daytime functioning was analyzed in the context of total sleep time and sleep onset latency. Methods: Families with children with parent-perceived sleep problems were recruited for diagnostic clarification and subsequent treatment (if indicated) at an outpatient clinic. Out of 49 families seeking help, 34 children (age 5.2-10.9 years, mean 7.1 years) and their parents were included in the present study. Sleep and sleep problems were assessed by a structured clinical interview according to the diagnostic criteria of the International Classification of Sleep Disorders (ICSD-II). Parents kept a sleep diary over two weeks. In addition, they answered the Child Behavior Checklist, questions concerning the daytime sleepiness of their children, as well as a structured clinical interview assessing comorbid mental disorders. Results: Reduced parent-reported total sleep time predicted more delinquent behavior and more concentration problems. Independent of total sleep time and frequency of night waking, longer parent-reported wake time after sleep onset was associated with greater daytime sleepiness, which in turn predicted more social problems. Conclusions: Besides total sleep time, wake time after sleep onset could be another important determinant for specific aspects of daytime functioning in children with insomnia. (C) 2010 Elsevier B.V. All rights reserved.