Sleep Behaviors and Sleep Problems in School-Aged Children in Thailand
Tawima Sirirassamee MD*, Weerasak Chonchaiya MD**, Chandhita Pruksananonda MD**
Affiliation : * Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand ** Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Background : Sleep problems can have a significant effect on children behaviors, emotional and cognitive developments.
However, limited information is available regarding the sleep behaviors and sleep problems of school-aged children in
Thailand. The purposes of this study were to examine the prevalence of sleep problems and to describe sleep/wake pattern of
Thai children.
Material and Method: The school-based, cross-sectional study was conducted in 5 primary public schools selected from
Bangkok and three regions of Thailand. The samples were selected from the first and fourth grades of each school. The
Children’s Sleep Habits Questionnaire (CSHQ) was used to evaluate sleep behaviors and sleep problems.
Results : Grade 1 children went to bed earlier and had longer weekday sleep duration comparing with grade 4 children. Sleep
duration was significantly shorter in children living in Bangkok, comparing with those living in rural areas. Mean total
CSHQ score was significant higher in grade 1 children, when comparing with grade 4 children (51.30 vs. 50.18; p = 0.026).
Grade 1 children scored significantly higher on bedtime resistance (10.96 vs. 10.39; p = 0.004) and sleep anxiety subscale
(6.68 vs. 6.41; p = 0.022), while grade 4 children scored significantly higher on sleep-onset delay subscale (1.41 vs. 1.23;
p<0.001). Prevalence of sleep problems was highest in the category of “falling asleep while riding in car or bus” (69.5%),
followed by “awakening by others in the morning” (68.5%).
Conclusion : Sleep problems were common in Thai school-aged children. The most common sleep problems were in the
domains of daytime sleepiness and bedtime resistance and anxiety.
Keywords : Sleep, Sleep problem, Sleep behavior, Children’s sleep habits questionnaire, Children
