Differences in Sleep Patterns are Related to Behavior, Emotional Problems,Attention and Academic Performance in Elementary School Studentsof a South Korean Metropolitan City

Abstract

Objectives : The aim of this study was to investigate the sleep patterns of South Korean elementary school children andwhether the differences in sleep patterns were related to behavior, emotional problems, attention and academic performance.Method : This study included a community sample of 268 boys and girls from fourth-, fifth- and sixth-grade classes in a SouthKorean metropolitan city from November to December 2010. The primary caregivers completed a questionnaire that includedinformation on demographic characteristics, as well as the Child’s Sleep Habit Questionnaire (CSHQ), the Korean version ofChild Behavior Checklist (K-CBCL), the Korean version of the Learning Disability Evaluation Scale (K-LDES), the Koreanversion of ADHD Rating Scale (K-ARS) and the Disruptive Behavior Disorder Scale (DBDS). We conducted analyses on theCSHQ individual items, between the subscales, on the total scores and on the K-CBCL, the K-LEDS, the K-ARS and the DBDS.Results : Based on the findings from the CHSQ, the subjects had significantly higher scores for bedtime resistance (9.18±2.17), delayed sleep onset (1.32±0.62), the sleep duration (4.19±1.52) and daytime sleepiness (14.10±3.55) than the scoresfrom the previous reports on children from western countries. The total CHSQ score showed positive correlations to all subscalesof the K-CBCL : withdrawn (r=0.24, p＜.005), somatic complaint (r=0.24, p＜.005) and anxious/depressive (r=0.38, p＜.005).Bedtime resistance was associated with oppositional defiant disorder (r=0.15, p＜.05) and a positive correlation was demonstratedbetween sleep anxiety and the oppositional defiant disorder score (r=0.13, p＜.05), night waking and the conduct disorderscore (r=0.16, p＜.05). Delayed sleep onset was related with low performance on the K-LDES with respect to thinking (r=-0.17,p＜.05) and mathematical calculation (r=-0.17, p＜.05).Conclusion : The results of this study reconfirm Korean children’s problematic sleep patterns. Taken together the results provide that the reduced sleep duration and disruption of sleep pattern can have a significant impact on emotion, behavior, performanceof learning in children. Further studies concerning more diverse psychosocial factors affecting sleep pattern will be helpful tounderstanding of the sleep health in Korean children