SLEEP - Frequent Nightmares in Children: Familial Aggregation and Associations with Parent-Reported Behavioral and Mood Problems

VOLUME 34, ISSUE 04

FREQUENT NIGHTMARES IN CHILDREN
Frequent Nightmares in Children: Familial Aggregation and Associations with Parent-Reported Behavioral and Mood Problems

Shirley Xin Li, MA¹; Mandy Wai Man Yu, MPH, RPSGT¹; Siu Ping Lam, MRCPsych, FHKAM (Psych)¹; Jihui Zhang, MD¹; Albert Martin Li, MRCP, MD²; Kelly Yee Ching Lai, MRCPsych, FHKAM (Psych)¹; Yun Kwok Wing, FRCPsych, FHKAM (Psych)¹

¹Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; ²Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR

Table of Contents

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Study Objectives:

To conduct a systematic investigation on the prevalence, correlates, and familial aggregation of frequent nightmares in children, and to scrutinize the associations between frequent nightmares and parent-reported behavioral and mood problems in children.

Design:

A cross-sectional study was conducted by collecting the data on sociodemographic, sleep, behavioral, and family-related information from a total of 6359 children (age: mean [SD] = 9.2 [1.8] years; girls: 49.9%) and their reported biological parents.

Setting:

Community.

Interventions:

N/A

Measurements and Results:

Prevalence of frequent nightmares with a criterion of at least once per week was 5.2%. Multinomial regression analysis indicated that monthly family income, paternal and maternal nightmares, insomnia symptoms, parasomniac symptoms, and daytime consequences were significantly associated with nightmares in children. Frequent nightmares in children were significantly associated with hyper-activity (odds ratio [OR] = 1.68, 95% CI 1.16-2.44), frequent temper outbursts/mood disturbance (OR = 1.76, 95%CI 1.27-2.44), and poor academic performance (OR = 1.62, 95% CI 1.11-2.36), after controlling for potential confounding factors. Approximately 20% of children with frequent nightmares experienced comorbid frequent insomnia. Comorbid nightmares and insomnia were associated with increased odds of hyperactivity (OR = 4.13, 95% CI 2.13-8.00) and frequent temper outbursts/mood disturbance (OR = 2.41, 95%CI 1.27-4.60).

Conclusions:

Frequent nightmares in children are associated with a constellation of child-, sleep-, and family-related factors, including comorbid sleep problems, such as insomnia and parasomnia, family economic status, and parental predisposition. Frequent nightmares are independently associated with emotional and behavioral problems in children.

Citation:

Li SX; Yu MWM; Lam SP; Zhang J; Li AM; Lai KYC; Wing YK. Frequent nightmares in children: familial aggregation and associations with parent-reported behavioral and mood problems. SLEEP 2011;34(4):487-493.