Background: Sleep problems in children have serious physical and psychological consequences such as obesity, aggression and attention deficit disorder in toddlers. The aim of the present study was to determine the prevalence of sleep problems and its relation with sleeping habits of toddlers in 2017. Methods: By random sampling from rural families of Razan city of Hamadan province, 120 mothers of 12- to 36-month-old children were selected and data collection tools included contextual questions, medical history and 33-question questionnaire of children's sleep habits (CSHQ) completed. Data were analyzed by SPSS software version 23, independent t-test, chi-square, Pearson correlation coefficient and multiple linear regression. Results: The mean age of the children was 22.82±7.53 months and 55% of them were boys and the prevalence of sleep problems was 70.8% (95% confidence interval: 71.9-69.7). The average sleep duration of the children was 11 hours and more than 60% of the children went to bed after 23 o'clock. Results show that age is an important factor in most dimensions of CSHQ and age predicts daytime sleepiness (β = -0.263), nocturnal wakefulness (β = -0.113) and duration, Sleep time (β = -0.108) and sleep resistance (β = 0.194) respectively. Also, parents' education and child's current weight were predictors of subscales of CSHQ questionnaire (P <0.05). In addition, there was a positive and significant correlation between sleep duration with infant sleep anxiety (r = 0.527) and resistance to sleep (r = 0.473) as well as nocturnal wakefulness with parasomnia (r = 0.416) (P <0.001). Conclusion: Given the alarming prevalence of sleep problems in toddlers in the present study and the impact of some changeable factors on children's sleep health, designing interventions aimed at educating mothers to improve healthy sleep habits in toddlers is necessary.

Background: Sleep problems in children have serious physical and psychological consequences such as obesity, aggression and attention deficit disorder in toddlers. The aim of the present study was to determine the prevalence of sleep problems and its relation with sleeping habits of toddlers in 2017. Methods: By random sampling from rural families of Razan city of Hamadan province, 120 mothers of 12-to 36-month-old children were selected and data collection tools included contextual questions, medical history and 33-question questionnaire of children's sleep habits (CSHQ) completed. Data were analyzed by SPSS software version 23, independent t-test, chi-square, Pearson correlation coefficient and multiple linear regression. Results: The mean age of the children was 22.82±7.53 months and 55% of them were boys and the prevalence of sleep problems was 70.8% (95% confidence interval: 71.9-69.7). The average sleep duration of the children was 11 hours and more than 60% of the children went to bed after 23 o'clock. Results show that age is an important factor in most dimensions of CSHQ and age predicts daytime sleepiness (β = -0.263), nocturnal wakefulness (β = -0.113) and duration, Sleep time (β = -0.108) and sleep resistance (β = 0.194) respectively. Also, parents' education and child's current weight were predictors of subscales of CSHQ questionnaire (P <0.05). In addition, there was a positive and significant correlation between sleep duration with infant sleep anxiety (r = 0.527) and resistance to sleep (r = 0.473) as well as nocturnal wakefulness with parasomnia (r = 0.416) (P <0.001). Conclusion: Given the alarming prevalence of sleep problems in toddlers in the present study and the impact of some changeable factors on children's sleep health, designing interventions aimed at educating mothers to improve healthy sleep habits in toddlers is necessary.

BACKGROUND: Sleep health is a prerequisite for mental and physical health. The family affects the sleeping habits of the child. OBJECTIVE: The purpose of this study was to investigate the theory of mothers’ planned behavior in predicting sleeping habits of toddlers. METHODS: The participants of this descriptive-analytical study were 120 mothers of 12- to 36-month-old children living in Razan, Hamadan province, Iran. Data were collected in three stages in order to develop a theory-based tool. Semi-structured qualitative interviews with mothers were conducted to investigate the application of theory in predicting mothers’ intention and behavior (n = 25). The face and content validity of the questionnaire was confirmed by a panel of experts. Test-retest method was used to determine the reliability of the questionnaire at 3 weeks interval (n = 25). Validity of Structural Convergence and Divergence with Factor Analysis, Internal Consent with Cronbach’s Alpha and predictive validity was determined by multiple regression coefficients (n = 120). RESULTS: The mean age of the children was 22.8 ± 7.5 months, 55% (66 children) were boys, the mean score of the children’s sleep questionnaire was 49 ± 6, and the children’s sleep duration was 9 ± 1 hour. Theoretical constructs have a positive and direct correlation with each other and with children’s sleep habits, which demonstrates the validity of the theory in predicting toddler sleep habits. Regression analysis showed that perceived behavioral control was the strongest predictor of sleeping habits of toddlers (𝛽 = 0.446) (P = 0.000). The theory of planned behavior can explain 30.5 to 25.7% of the variance of toddler sleep habits. CONCLUSION: While recommending more comprehensive studies, the findings of the study emphasize the application of the theory of planned behavior in identifying factors influencing sleep habits and designing child sleep improvement interventions.