Sleep problems are major concerns for parents, health professionals, and children and youths themselves. For assessing sleep problems, both parent and child reports are important, with each having its unique features. However, little is known about the correlates of the agreement between parent and child self-reports. This study evaluated the agreement between the youth self-report sleep questionnaire (YSRSQ) and the parent-reported children’s sleep habits questionnaire (CSHQ) and assessed the associated sociodemographic factors, as well as the underlying discrepancies. The participants included 3143 pairs of Chinese preadolescents (mean age = 11.03, SD = 0.98) and parents. Sleep-disordered breathing (SDB), daytime sleepiness, and parasomnia were assessed by both the YSRSQ and CSHQ. Significant but low correlations were present between parent report and preadolescent self-report items on SDB problems, daytime sleepiness, and parasomnias. Although the agreement between SDB symptoms and parasomnias was stronger for girls than for boys, the degree of concordance between SDB symptoms and parasomnia increased with preadolescent age, with the highest agreement achieved among preadolescents aged 12 years or older for SDB problems and 11 years or older for parasomnias. Findings underscore the importance of utilizing both parental and preadolescent self-reports in accurately assessing and diagnosing sleep impairment in pediatric samples.
This is a preview of subscription content, log in to check access
We thank the children, families, teachers, and the research team from the China Jintan Cohort Study Group. Thanks are also extended to Amy Yang and Yingjie Wang for initial data exploration and Jessica Wang for manuscript proofreading.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures for data collection were approved by the Institutional Review Boards from both the University of Pennsylvania and the Ethical Committee for Research at Jintan Hospital in China.
Informed consent was obtained from all individual participants included in the study.
Wang GH, et al. Sleep patterns and sleep disturbances among Chinese school-aged children: prevalence and associated factors. Sleep Med. 2013;14:45–52.CrossRefPubMedGoogle Scholar
Yang QZ, et al. A comparison of sleeping problems in school-age children between rural and urban communities in China. J Paediatr Child Health. 2009;45(7–8):414–8.CrossRefPubMedGoogle Scholar
Liu J, et al. Sleep disordered breathing symptoms and daytime sleepiness are associated with emotional problems and poor school performance in children. Psychiatry Res. 2016;242:218–25CrossRefPubMedPubMedCentralGoogle Scholar
Nevsimalova S, et al. Childhood parasomnia–a disorder of sleep maturation? Eur J Paediatr Neurol. 2013;17(6):615–9.CrossRefPubMedGoogle Scholar
Liu J. Sleep duration and overweight/obesity in children: review and implications for pediatric nursing. J Spec Pediatr Nursing. 2012;17(3):193–204.CrossRefGoogle Scholar
Chiang HL, et al. Association between symptoms and subtypes of attention-deficit hyperactivity disorder and sleep problems/disorders. J Sleep Res. 2010;19(4):535–45.CrossRefPubMedGoogle Scholar
Holley S, Hill C, Stevenson JA. A compraison of actigraphy and parental report of sleep habits in typically developing children aged 6–11 years. Behav Sleep Med. 2010;8(1):16–27.CrossRefPubMedGoogle Scholar
Gregory AM, Sadeh A. Sleep, emotional and behavioral difficulties in children and adolescents. Sleep Med Rev. 2012;16(2):129–36.CrossRefPubMedGoogle Scholar
Ievers-Landis CE, et al. Relationship of sleep parameters, child psychological functioning, and parenting stress to obesity status among preadolescent children. J Dev Behav Pediatr. 2008;29(4):243–52.CrossRefPubMedGoogle Scholar
Owens J, Fernando S, McGuinn M. Sleep disturbance and injury risk in young children. Behav Sleep Med. 2005;3(1):18–31.CrossRefPubMedGoogle Scholar
Dewald JF, et al. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: a meta-analytic review. Sleep Med Rev. 2010;14(3):179–89.CrossRefPubMedGoogle Scholar
Paavonen EJ, et al. Sleep problems of school-aged children: a complementary view. Acta Paediatr. 2000;89(2):223–8.CrossRefPubMedGoogle Scholar
Roeser K, et al., Relationship of sleep quality and health-related quality of life in adolescents according to self- and proxy ratings: a questionnaire survey. Front Psychiatry. 2012;3:76CrossRefPubMedPubMedCentralGoogle Scholar
Owens JA, Spirito A, McGuinn M. The children’s sleep habits questionnaire (cshq): psychometric properties of a survey instrument for school-aged schildren. Sleep. 2000;23(8):1043–51.CrossRefPubMedGoogle Scholar
Ji X, Liu J. Subjective sleep measures for adolescents: a systematic review. Child Care Health Dev. 2016;42(6):825–39.CrossRefPubMedGoogle Scholar
Owens JA, et al. Sleep habits and sleep disturbance in elementary school-aged children. J Dev Behav Pediatr. 2000;21(1):27–36.CrossRefPubMedGoogle Scholar
Kieckhefer GM, et al. Parent-child agreement in report of nighttime respiratory symptoms and sleep disruptions and quality. J Pediatr Health Care. 2009;23(5):315–26.CrossRefPubMedGoogle Scholar
Lofthouse N, et al. Parent and child reports of sleep problems associated with early-onset bipolar spectrum disorders. J Fam Psychol. 2007;21(1):114–23.CrossRefPubMedGoogle Scholar
Paavonen EJ, et al. Four-year follow-up study of sleep and psychiatric symptoms in preadolescents: relations of persistent and temporary sleep problems to psychiatric symptoms. J Dev Behav Pediatr. 2003;24(5):307–14.CrossRefPubMedGoogle Scholar
Mindell JA, et al. Parental behaviors and sleep outcomes in infants and toddlers: a cross-cultural comparison. Sleep Med. 2010;11(4):393–9.CrossRefPubMedGoogle Scholar
Liu X, Liu L, Wang R. Bed sharing, sleep habits, and sleep problems among Chinese school-aged children. Sleep. 2003;26(7):839–44.CrossRefPubMedGoogle Scholar
Liu X, et al. Sleep patterns and sleep problems among schoolchildren in the United States and China. Pediatrics. 2005;115:241–9.CrossRefPubMedGoogle Scholar
Deng S, Liu X, Roosa MW. Agreement between parent and teacher reports on behavioral problems among Chinese children. J Dev Behav Pediatr. 2004;25(6):407–14.CrossRefPubMedGoogle Scholar
Liu J, et al. Community-based participatory research (CBPR) approach to study children's health in China: experiences and reflections. Int J Nurs Stud. 2011;48(7):904–13.CrossRefPubMedPubMedCentralGoogle Scholar
1.University of Pennsylvania Schools of Nursing and MedicinePhiladelphiaUSA
2.Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine InstituteShanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, MOE-Shanghai Key Laboratory of Children’s Environmental HealthShanghaiChina
3.University of Delaware School of NursingNewarkUSA
4.Shandong University School of NursingJinanChina
5.Shandong University School of Public HealthJinanChina