Abstract
This study aimed to explore the prevalence of sleep disturbances among preschool children in rural areas of China and identify the underlying associated factors. A cross-sectional study was conducted in rural areas of Anhui Province, China, from September 2019 to January 2020. The caregivers of children from 26 kindergartens completed the demographic questionnaire, the Children's Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), the Self-rating Anxiety Scale (SAS), and the adapted Identification and Management of Feeding Difficulties (IMFeD) tool. One-way analysis of variance, independent-samples t-test, and hierarchical multiple linear regression were conducted to explore the potential influencing factors of sleep disturbances in preschool children. For the specific sleep disturbances based on each subscale of the CSHQ, bedtime resistance (54.9%) and sleep anxiety (47.9%) were the most common types of sleep disturbances, followed by daytime sleepiness (21.3%), sleep duration (20.8%), parasomnias (16.5%), sleep-onset delay (12.6%), night wakings (12.2%) and sleep-disordered breathing (10.3%). The ages of children, children's emotional/behavioral problems, children's feeding difficulties, inconsistent parenting attitudes of parents, poor parenting styles, non-parent caregivers, and caregiver anxiety contributed significantly to the CSHQ total score, accounting for approximately 27.1% (R(2) = 0.271) of the variance. Our study indicates that the prevalence of sleep disturbances among preschool children in rural areas of China is quite high. Furthermore, the potential risk factors are complicated, including factors related to both children and their caregivers.