Sleep disturbances in young children are common concerns seen in pediatric healthcare settings
and is accompanied with health burdens on the family. Children’s sleep disturbances have been
found to be linked to cognitive and academic challenges (Sadeh et al., 2002, 2003), behavioural
problems (Smedje et al., 2001), and an overall poorer quality of life (Quach et al., 2009). As
early sleep disturbances show persistence in kindergarten and upon school entry (Kataria et al.,
1987; Quach et al., 2009), it is imperative for abnormal sleep patterns to be detected early
through accurate screening and sleep assessment, with the aim of alleviating short- and long-term
outcomes of children.
As sleep is multidimensional in nature, capturing of subjective variables such as behavioural and
developmental factors can give a holistic view of a child’s sleep trajectory. Developed and
validating by Sadeh (2004), the Brief Infant Sleep Questionnaire (BISQ) is a caregiver-report
subjective tool assesses children’s sleep patterns and sleep-related behaviour over the last two
weeks. The BISQ has been found to be significantly correlated other sleep measures such as
actigraphy and sleep diaries in an infant sample (Sadeh, 2004). While it is well-validated for
infants and toddlers up to 3 years of age, it has not been validated as a screening tool for
kindergarten aged children. Due to the variability of sleep across early childhood years, there is
utility in establishing a standardised screening tool that can assess young children at different
developmental stages. Further, we can expect it to be time and cost-effective method to be
utilised as a screening tool in clinics, as compared to using costly methods such as that of
actigraphy. Therefore, one aim of this study is to validate the use of BISQ for screening in
children at different time-points – 24, 36 and 54 months.
Sleep plays an important role in children’s behaviour and developmental milestones,
Due to these reasons, there has been a long-standing interest in studying the relationship between
sleep and children’s functioning. However, this has been limited by few longitudinal studies that
study the relationship between young children’s sleep patterns and their functional outcomes
over time. Of the few studies, there are mixed findings when it comes to studying this
association. For example, a prospective longitudinal study by Price et al. (2012) found that early
sleeping issues have minimal repercussions on children’s outcomes upon school-entry. In
contrast, in a separate study, it was found that children’s sleep difficulties are predictive of later
sleeping disturbances (Simard et al., 2008). Furthermore, it remains unclear on whether
children’s developmental and behavioural outcomes in preschool and primary school are directly
associated to past or coexisting sleep problems. Thus, to reconcile these mixed findings, this
study would aim to investigate the associations between children’s behavioural and
developmental outcomes with their early sleep patterns.
Research Approach
By obtaining the longitudinal data
Takes about 10 minutes to answer
The BISQ measures time of sleep onset (hours), duration of night-time sleep (hours), duration of
daytime sleep (hours), total sleep duration (hours), night-time awakenings (number), duration of
night-time awakening (hours)
Definition of poor quality of sleep in BISQ
BISQ has been studied to compare sleep patterns in breastfed and formula-fed infants
Prevalence of sleep disorders in preschool children
Validating a suitable screening would be beneficial for early detection of sleep patterns, timely
intervention that can result in the betterment of children’s psychosocial and cognitive outcomes
Actigraphy is
References
Kataria, S., Swanson, M. S., & Trevathan, G. E. (1987). Persistence of sleep disturbances in preschool
children. The Journal of pediatrics, 110(4), 642-646.