Original Article

The Association between Sleep Disorder Patterns in School-Aged Children with Maternal Anxiety, Stress, and Depression: A Cross-Sectional Study

Abstract

Background and Objective: Sleep problems are common in school-aged children and may have negative impacts on their health. This study aimed to determine the sleep disorder patterns in school-aged children and evaluate their associ-ation with maternal anxiety, stress, and depression.

Materials and Methods: This cross-sectional study was conducted between October 2018 and September 2019 and included children aged 7-12 years using convenience sampling. The Persian version of the BEARS questionnaire, which incorporates five basic sleep domains (Bedtime problems, Excessive sleepiness, Awakenings during the night, Regulari-ty of sleep, Snoring), was used to assess sleep disorders. Maternal anxiety, stress, and depression were measured using the short form of the Depression, Anxiety, and Stress Scale (DASS), a caregiver self-report tool. Multivariable logistic regression was applied to assess the association between child sleep problems and maternal mental health.

Results: In the 99 children included, the most common sleep problem was nocturnal awakening, with 48.5% experienc-ing it. Excessive daytime sleepiness was the second most common problem, affecting 38.4% of children. In the multi-variable-adjusted model, awaking during the night [odds ratio (OR): 3.16, 95% confidence interval (CI): 1.27-7.82] and bedtime problems (OR: 4.20, 95% CI: 1.16-15.20) showed a positive association with moderate to severe levels of maternal anxiety, stress, and depression.

Conclusion: The prevalence of sleep problems among school-aged children underscores the need for family awareness and education about sleep problems.

1. Zhao T, Xuan K, Liu H, et al. The association between family function and sleep disturbances of preschool children in rural areas of China: a cross-sectional study. Psychology, Health & Medicine 2023; 28: 895-907.
2. Jalilolghadr S, Hashemi S, Javadi M, et al. Sleep habits of Iranian pre-school children in an urban area: Late sleeping and sleep debt in children. Sleep Biol Rhythms 2012; 10: 154-6.
3. Jusienė R, Breidokienė R. Preschoolers' self-regulation and developmental trajectories of sleep problems in early childhood. Infant Child Dev 2019; 28: e2158.
4. Asgarian FS, Fallahzadeh H, Etesam F. Sleep Problems in Students of Elementary Schools in Kashan in 2013. J Toloo Behdasht 2016; 15: 26-35.
5. Ebarhim A, Babak G, Alimohammad A, et al. High Prevalence of Sleep Problems in School and Preschool-aged Children in Tehran: a Population Based Study. Iran J Pediatr 2013; 23: 45-52.
6. Francazio SK, Fahrenkamp AJ, D'Auria AL, et al. Parent psychopathology as a mediator of the relationship between anxiety and sleep problems in children. Fam Syst Health 2015; 33: 146-54.
7. El-Sheikh M, Kelly RJ, Bagley EJ, et al. Parental depressive symptoms and children's sleep: the role of family conflict. J Child Psychol Psychiatry 2012; 53: 806-14.
8. Mohammadi M, Amintehran E, Ghaleh-bandi M, et al. Reliability and Validity of Persian Version of “BEARS” Pediatric Sleep Questionnaire. Indian J Sleep Med 2008; 3: 14-9.
9. Mindell JA, Telofski LS, Wiegand B, et al. A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep 2009; 32: 599-606.
10. Dietz WH, Bellizzi MC. Introduction: the use of body mass index to assess obesity in children. Am J Clin Nutr 1999; 70: 123s-5s.
11. Owens JA, Dalzell V. Use of the 'BEARS' sleep screening tool in a pediatric residents' continuity clinic: a pilot study. Sleep Med 2005; 6: 63-9.
12. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 1995; 33: 335-43.
13. Sahebi A, Asghari M, Salari R. Validation of depression anxiety and stress scale (DASS-21) for an Iranian population. J Iran Psychol 2005; 1. [In Persian].
14. Mohammadi M, Ghalebaghi MD, Bandi MD, et al.
Sleep Patterns and Sleep Problems Among Preschool and School-Aged Group Children in a Primary Care Setting. Iran J Pediatr 2007; 17: 213-21.
15. Ritvo ER. Postponing the proposed changes in DSM 5 for autistic spectrum disorder until new scientific evidence adequately supports them. J Autism Dev Disord 2012; 42: 2021-2.
16. Doo S, Wing YK. Sleep problems of children with pervasive developmental disorders: correlation with parental stress. Dev Med Child Neurol 2006; 48: 650-5.
17. Moosaei I, Moodi M, Malaki Moghadam H, et al. A comparison of health behavior and its effective factors in the students of primary schools with and without health educators in Zirkouh County 2015-2016. J Health Sci Technol 2017; 1: 132-8.
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IssueVol 8 No 3-4 (2023): Summer-Autumn QRcode
SectionOriginal Article(s)
Keywords
Anxiety; Depression; Sleep disorders
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Ghorbani A, Najafi A, Behkar A, Zoghi M, Zamanisabzi M. The Association between Sleep Disorder Patterns in School-Aged Children with Maternal Anxiety, Stress, and Depression: A Cross-Sectional Study. J Sleep Sci. 2026;8(3-4):60-66.