Parental Behaviors and Sleep/Wake Patterns of Infants and Toddlers in Hong Kong, China

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Background: To describe the sleep patterns of children below 36 months in Hong Kong, and evaluate the associations between parental behaviors and childhood sleep/wake patterns. Methods: Parents of 1049 infants and toddlers completed an internet-based expanded version of the Brief Infant Sleep Questionnaire. Results: Total sleep duration (P < 0.001), frequency (P < 0.001) and duration (P < 0.001) of nocturnal awakenings decreased with age, whereas the longest sleep duration (P < 0.001) and nocturnal sleep duration (P < 0.001) increased with age. Children who room- or bed-shared with parents had later bedtimes (P < 0.001), but similar sleep duration compared with those who had a separate sleep location. Falling asleep independently was associated with longer nocturnal sleep duration (P < 0.001) and less sleep awakenings (P < 0.001). Full-time employment of parents was associated with shorter total sleep duration of children (P < 0.001). Although breastfeeding was associated with more nocturnal awakenings (P < 0.001), no association was detected between breastfeeding and shorter sleep duration in children. Conclusions: As infants and toddlers develop, their sleep consolidates. Falling asleep independently was associated with longer nocturnal sleep duration and fewer sleep awakenings, whereas sleep location was not. This is an important finding, especially for families with limited living space where parent/child room- or bed-sharing cannot be avoided.

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