Sleep problems in the first year of elementary school: The role of sleep hygiene, gender and socioeconomic status.

OBJECTIVES: To determine (1) the relationship between sleep hygiene practices and parent-reported child sleep problems in students in the first year of elementary school, (2) whether the relationship differed by (a) gender and (b) SES and (3) in a multivariate explanatory model. DESIGN: Cross-sectional survey of a population-based sample. SETTING: Forty-five elementary schools in metropolitan Melbourne, Australia. PARTICIPANTS: Families of children aged 4-6 years in the first year of elementary school in Melbourne, Australia. MEASUREMENTS: Exposures: Parent-reported child sleep hygiene, gender and data linkage to community-based disadvantage. OUTCOME: Parent-reported child sleep problems. ANALYSES: Logistic regression models were used to examine each aim. RESULTS: Of 6635 approached parents, 4901 (74.30%) participated. In the final model, using audio devices at bedtime was associated with increased risk of child sleep problems (OR 2.12, 95% CI 1.60, 2.81) as was an inconsistent bedtime routine on school nights (OR 2.52, 95% CI 1.76, 3.60) and non-school nights (OR 1.66, 95% CI 1.09, 2.55). Boys with an inconsistent bedtime routine on non-school nights had a higher risk (OR 2.07, 95% 1.49, 2.88) than girls (OR 1.61, 95% CI 1.15, 2.28). SES was not associated with sleep problems. CONCLUSION: Inconsistent bedtime routines and audio device use were each associated with an increased risk of parent-reported sleep problems. Associations did not differ based on SES but did for boys and girls in terms of inconsistent bedtimes on weekends. Behavioral sleep interventions targeting sleep hygiene could have similar benefits for all children, regardless of socio-economic status.