Predictors of Nighttime Fears and Sleep Problems in Young Children

Objectives This study had two major aims: (1) to explore the relationship between sleep related difficulties and behavioral and emotional problems in young children, and (2) to identify predictors of child fear and problematic sleep behaviors. Methods Sixty-eight children (34 boys), ages 4–6 years ( M = 4.9, SD = 0.9) who experienced nighttime fears and who co-slept with their parents were evaluated using parental reports of internalizing and externalizing behavioral problems, sleep difficulties and related anxiety, as well as child and parental reports of fear. Results Child-reported fear was significantly predicted by internalizing problems when controlling for other variables whereas parent-reported fear was primarily related to child endorsed fears on a preschool fear questionnaire when controlling for the other variables. In contrast, sleep-related problems were primarily related to externalizing behavior problems whereas the number of nights slept alone was primarily related to separation anxiety on a preschool anxiety questionnaire. Conclusions Findings from the present study point to the multiplicity of factors that account for nighttime fears and sleep difficulties in young children. Child fear and separation anxiety were related to co-sleeping. Moreover, internalizing symptoms in young children predicted child fear whereas, externalizing symptoms predicted sleep problems. Based on the reciprocal relationship between emotional/behavior problems and sleep, frequent co-sleeping and nighttime fears might serve as a risk and/or maintaining factor of disrupted sleep practices. When treating nighttime fears in young children, co-sleeping should be targeted for intervention as well.