Psychometric properties and Dutch norm values of the Children's Sleep Habits Questionnaire in toddlers.

OBJECTIVE: The Children's Sleep Habits Questionnaire (CSHQ) was developed in the USA for children aged 4-10 years. The Dutch CSHQ has been validated for this age group, but not yet for toddlers. Furthermore, Dutch norm values for toddlers are unavailable. This study aimed to investigate the psychometric properties and collect norm values of the Dutch CSHQ in toddlers. METHODS: Data collection was conducted by Taylor Nelson Sofres Netherlands Institute for Public Opinion (TNS-NIPO), a Dutch market research agency. The TNS-NIPO provided access to the TNS-NIPO base, which comprises a panel of respondents who have indicated that they are willing to regularly participate in research. Parents of children aged 2-3 years were invited to complete the CSHQ. The CSHQ is a multidimensional questionnaire to detect sleep problems in children. It is a 33-item, one-week retrospective (parent-)proxy survey. A higher score indicates more sleep problems. RESULTS: The response rate was 61% (n = 201). The original eight-factor structure did not fit well in this population and a more appropriate structure could not be achieved with explorative factor analyses. The mean total score was 41.9 (SD 5.6), and was higher (indicating more sleep problems) compared to Dutch school-aged children. CONCLUSIONS: The one-dimensionality of the subscales of the CSHQ could not be confirmed in Dutch toddlers. Clinicians and researcher should be aware of the difficulty of reliably measuring sleep in this age group when using the CSHQ. For research purposes, it is therefore recommended to only use the total score.

Sleep habits and sleep disturbances in Dutch children: a population-based study.

Sleep disorders can lead to significant morbidity. Information on sleep in healthy children is necessary to evaluate sleep disorders in clinical practice, but data from different societies cannot be simply generalized. The aims of this study were to (1) assess the prevalence of sleep disturbances in Dutch healthy children, (2) describe sleep habits and problems in this population, (3) collect Dutch norm data for future reference, and (4) compare sleep in children from different cultural backgrounds. A population-based descriptive study was conducted using the Children's sleep habits questionnaire and the sleep self-report. One thousand five hundred seven proxy-reports and 262 self-reports were analyzed. Mean age was 8.5 years (95% confidence interval, 8.4-8.6), 52% were boys. Sleep problems in Dutch children were present in 25%, i.e., comparable to other populations. Sleep habits were age-related. Problem sleepers scored significantly higher on all scales. Correlations between parental and self-assessments were low to moderate. Dutch children had significantly more sleep disturbances than children from the USA and less than Chinese children. Cognitions and attitudes towards what is considered normal sleep seem to affect the appraisal of sleep, this probably accounts partly for cultural differences. For a better understanding of cultural influences on sleep, more information on these determinants and the establishment of cultural norms are mandatory.