Validação Clínica da Versão Portuguesa do Questionário de Hábitos de Sono das Crianças (CSHQ-PT) em Crianças com Perturbações do Sono e PHDA

Abstract

Introduction: The Portuguese version of the Children’s Sleep Habits Questionnaire showed adequate psychometric properties in a community sample but the American cut-off seemed inadequate. This study aimed to validate this questionnaire in clinical populations of children with sleep disorders and with attention deficit/ hyperactivity disorder.Material and Methods: The study sample included 148 Portuguese children aged 2 to 10 years old that where divided in 3 groups: 1. Clinical group with sleep disorders (behavioral insomnias, parasomnias or sleep-related breathing disorders); 2. Clinical group with attention deficit/ hyperactivity disorder; 3. Control group. The sleep habits and sleep problems were evaluated using the Children’s Sleep Habits Questionnaire. Sleep-related disorders were confirmed by polysomnography.Results: The questionnaire’s internal consistency (Cronbach α) in the clinical sample (sleep disorders and attention deficit/ hyperactivity disorder) was 0.75 and ranged from 0.55 to 0.85 for the subscales. Children with sleep disorders and attention deficit/ hyperactivity disorder had a higher sleep disturbance index (full scale score) compared to the control group. The subscales presented significant differences between the subgroups with different sleep disorders showing discriminative validity. The receiver operating characteristic analysis of the sleep disturbance index comparing the sleep disorder and control sample determined a cut-off of 48 (sensibility 0.83;specificity 0.69).Discussion: Children with sleep disorders and attention deficit/ hyperactivity disorder evidenced higher Sleep Disturbance Index (full scale score) comparing to the control group. The subscales presented significative differences between the subgroups with different sleep disorders showing discriminative validityConclusion: The Portuguese version of the Children’s Sleep Habits Questionnaire showed adequate psychometric properties for children with sleep disorders and/or attention deficit/ hyperactivity disorder. The cut-off value 48 is better adjusted for the Portuguese population.

Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children

“…However, the cutoff of 41 might overestimate sleep disturbances in young children from some countries, especially China . We used 48 as the cutoff to screen for sleep disturbances according to a previous study, while 41 was used for the sensitivity analysis. In addition, a subscale score greater than 2 SDs above the published community control reference mean score identified specific sleep disturbance of clinical significance in each of the 8 subscale domains .…”

Adormecer a Ver Televisão como Fator de Risco para Perturbação do Sono na Idade Escolar

“…Foi considerado como ponto de corte do IPS para o rastreio das perturbações do sono um valor igual ou superior a 48 com base num estudo prévio de validação com amostras clínicas de crianças com distúrbios do sono. 20 O hábito de adormecer a ver TV foi avaliado através do respetivo item do questionário: "Adormece a ver televisão", com a mesma escala de resposta de três opções. Os pais indicaram também as horas de deitar e acordar em dias de semana e no fim-de-semana e a sua estimativa do tempo total de sono diário (TSD), referente a um dia típico de semana.…”