• Jihui Zhang, Albert Martin Li, Tai Fai Fok, and Yun Kwok Wing.
• Department of Psychiatry, The Chinese University of Hong Kong, Shatin Hospital, Shatin, Hong Kong SAR, China.
• J. Pediatr. 2010 Apr 1;156(4):606-12.e5.

ObjectivesTo determine sleep/wake patterns of primary school children and their correlates.Study DesignA total of 4470 sets of mother-father-child community-based trios were recruited in this study. We constructed 3 integrated models with structural equation modeling to predict sleep/wake patterns of children (bedtime, wakeup time, and time in bed [TIB]).ResultsOur best-fitting models explained 40% to 71% variances of various sleep/wake patterns of the children, which were influenced by a web of interactive factors including school start time, parental sleep/wake patterns, sociodemographics, and daytime activities. The strongest predictor of various sleep/wake patterns was school start time. Higher socioeconomic status would shorten TIB of both children and parents, but through different pathways (by advancing wakeup time and delaying bedtime in children but by delaying bedtime in parents). Media use and homework shortened TIB of children, while leisure extracurricular activities and later school start time lengthened it. The age and sex effects on sleep/wake patterns, at least in part, were mediated by daytime activities. Daytime activities of children also influenced their parental sleep/wake patterns, especially their maternal one. A consistent pattern of stronger mother-child than father-child associations were found in various sleep/wake patterns.ConclusionsThere was a complex and interactive relationship among school schedule, parental sleep/wake patterns, socioeconomic status, and daytime activities in determining the sleep/wake patterns of children. These findings have important clinical implications for the management of childhood sleep/wake habits and problems.Copyright 2010 Mosby, Inc. All rights reserved.

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