Pattern of Sleep in Infants and Toddlers Visiting at a Teaching Hospital in Lalitpur

Abstract

Introduction: Sleep is an integral part in a child's health and development. During different stages of development, there are aberrations in normal physiology of sleep which make children more susceptible to various types of sleep problems. This study was conducted to identify sleep pattern and sleep problems in Nepalese children using Nepali translation of Brief Infant Sleep Questionnaire (BISQ) screening tool. Materials and Methods: This was a descriptive cross-sectional study. Data were collected from parents of children aged 6 to 36 months attending paediatric out-patient clinic for general health check-up from July 2013 to December 2013. Nepali translation of the BISQ was used as a screening tool for sleep problems in this study. Results: The study included 553 children (52.4% boys). Mothers completed the questionnaire in 92% of children. Mean total duration of sleep in 24 hours was 11.7 ±1.7 hours. Respondents reported sleep problem in 16.9% of children whereas 20.3% of children had sleep problems according to BISQ criteria. As per this criteria, 2.7% of children had total sleep duration less than 9 hours, 5.9% of children had total night awakening duration of more than one hour, 13.9% of children had night waking >3 times. These BISQ sleep parameters differed significantly in children with and without sleep problems (p<0.001). In addition, children with sleep problem took longer time to sleep than children without sleep problems (p<0.001). Conclusion: Sleep problems are common in Nepalese infants and toddlers according to the BISQ. Screening for sleep problems is highly recommended during health care visits given the prevalence of sleep problems identified by this study to reduce their potential adverse impact.

Study of sleep pattern in children aged 1-12 years attending OPD at tertiary care hospital, Puducherry, India

“…16,17 However, in our school children, only in 2% which is much lower than that reported from China where 9.8% school children had frequent night awakenings. 18 This again could be due to dietary factors and environmental conditions like temperature which have a direct or indirect effect on sleep habits.…”

Sleep Pattern and Problems in Young Children Visiting Outpatient Department of a Tertiary Level Hospital in Kathmandu, Nepal

“…Overall, 19.6% of the children had sleep problems in our study as per the BISQ parameter for sleep problems which is similar (20.3%) to the study findings of another study carried out in Lalitpur, Nepal [ 11 ]. However, only 5.6% of the respondents perceived that their children have sleep problems.…”

“…Though supine sleep position is generally recommended for infants to prevent the risk of sudden infant death syndrome (SIDS) [ 18 ], in our study, the most common sleeping position was found to be lateral. The lateral sleeping position has been reported to be the most common one in another study done in Nepal [ 11 ]. Most of the children in our study coslept with their parents, and research study suggest that there is no proven position for a child to sleep on in relation to their parents to prevent SIDS [ 19 ].…”

“…Similarly, the respondents included had to be primary caregivers, who had a major responsibility of looking after the child and lived together with the child. Taking the prevalence of sleep problems among young children as 20.3% [ 11 ], 249 respondents were recruited from the study site using statistical formula of n = z 2 pq / d 2 , where d (allowable error) = 0.05, z (confidence level) = 1.96, p (prevalence of sleep problem) = 0.203, and q (1 − p ) = 0.797.…”

“…A study suggests that 21% of the sleep problems that arise during infancy can persist up to 36 months [ 10 ]. A research study carried out in Lalitpur, Nepal, showed that 20.3% of young children have sleep problems [ 11 ]. Furthermore, the duration of night time sleep seems to be lower in developing countries like Nepal and India as compared to developed countries [ 11 , 12 ].…”