SUMMARY The aim of this study was to investigate the effects of various forms of TV exposure on the quality of children's sleep. In this randomized population-based survey questionnaires concerning TV viewing, sleep disturbances, and psychiatric symptoms were administered to 321 parents of children aged 5-6 years. Sleep disturbance scores were the main outcome measures. Active TV viewing and passive TV exposure were related to sleeping difficulties, especially sleep-wake transition disorders and overall sleep disturbances. Particularly, passive TV exposure and viewing adult-targeted TV programs were strongly related to sleep disturbances. The association remained significant when socioeconomic status, family income, family conflicts, the father's work schedule, and the child's psychiatric symptoms were controlled statistically. The adjusted odds ratios were 2.91 (95% CI 1.03-8.17) and 3.01 (95% CI 1.13-8.05), respectively. TV viewing and particularly passive TV exposure and viewing adulttargeted programs significantly increase the risk of sleeping difficulties. The results suggest that health-care professionals should be aware of the association between TV exposure and sleep disturbances.

To cite this version:E. Juulia Paavonen, Tarja Porkka-Heiskanen, Anja Riitta Lahikainen. Sleep quality, duration and behavioral symptoms among 5-6-year-old children. European child & adolescent psychiatry, 2009, 18 (12), pp.747-754. <10.1007/s00787-009-0033-8>. Abstract The objective of the present study was to examine whether parent-reported short sleep duration and sleeping difficulties are related to behavioral symptoms among pre-school aged children. The study is a crosssectional survey of 297 families with 5-6-year-old children. The Sleep Disturbance Scale for children was used to measure sleep duration and sleeping difficulties, and the Child Behavior Checklist and Teacher's Report Form were used to measure attention problems, and internalizing and externalizing symptoms. In multivariate logistic regression models, short sleep duration was according to parental reports related to inattention (adjusted odds ratio 4.70, 95% CI 1.58-14.00), internalizing (adjusted odds ratio 3.84, 95% CI 1.32-11.21), and total psychiatric symptoms (adjusted odds ratio 3.53, 95% CI 1.23-10.17) while according to teacher's reports it was almost significantly related to internalizing symptoms (adjusted odds ratio 4.20, 95% CI 0.86-20.51). Sleeping difficulties were strongly related to all subtypes of psychiatric symptoms according to parental reports (adjusted odds ratios ranging from 6.47 to 11.71) and to externalizing symptoms according to teachers' reports (adjusted odds ratio 7.35, 95% CI 1.69-32.08). Both short sleep duration and sleeping difficulties are associated with children's behavioral symptoms. Intervention studies are needed to study whether children's behavioral symptoms can be reduced by lengthening sleep duration or improving sleep quality.

The article introduces two interview methods for studying young children' fears, applied in separate studies with representative samples of children aged 5-6 in Finland ( N = 222) and Estonia ( N = 117). The semi-structured interview was based on the question, `What things are you afraid of?' The article describes the interview scheme as well as the interview process. The picture-aided interview was designed on the basis of the Fear Survey Schedule for Children - Revised (FSSC-R). The semistructured interviews showed that young children are capable of expressing a much wider range of fears (e.g. television programmes) than had been assumed earlier. The picture-aided interviews revealed more fears related to social relations than did the semi-structured interviews. Both methods are recommended for research use.

The results may be helpful in identifying families who need early professional support and call for studies where the prenatal phase is explored as a proactive phase for the development of the child-parent relationship.

The findings suggest that co-viewing and discussing television programmes are more common in families where television exposure is high. Because both co-viewing and discussing television programmes were associated with higher fear scores regardless of the quantity and quality of television exposure, the research shows that in everyday life co-viewing may not be done in such a way that it leads to a reduction of children's fears. More studies are needed to explore the co-viewing practices of families in more detail.