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Preschool-age Adopted Chinese Children’s Sleep Problems and Family Sleep Arrangement by Dr. Tony Xing Tan and Dr. Kofi Marfo 2008

[Although I usually only reviewed research that has been published in a peer reviewed journal, I made an exception with this one because I get so many sleep questions. This paper is currently under peer review and was presented at a conference in Germany on July 13, 2008.]

This study on preschool aged children adopted from China was designed to determine the methods parents used to improve their children’s sleep and examine the relationship between children’s sleep problems and their sleep arrangement. Almost 95% of the children studies were girls, as you would expect with Chinese adoptions, and 85% of them were adopted before the age of 18 months. Their average age at the time of the study was 52 months (4.3 years).

On typical weekdays, the children’s wake-up time for the day ranged from 5:15 to 10 am (most at 7:00-8:30 am). Their bedtime ranged from 7 to 11pm (most at 8:00-9:00 pm). Most children slept for about 10 hours.

Sleep problems are common with internationally adopted children. In an earlier study of 240 children adopted from China, 52% of families reported that their children had “some degree of sleep problems”, although only 9% reported that their children had “significant sleep difficulties”. Another study on 707 preschool-age adopted Chinese girls, reported that sleep problems were the only area in which the adopted girls fared more poorly than the comparison group of non-adopted children.

In this study, parents were asked how many places their child usually slept in throughout the night. 71.3% had a single sleep location, 21.4% had two, 4.6% had three, and 2.1% had four or five sleep locations. Of the kids who slept in only one place, 55.4% slept by themselves in their own room, 26.2% shared a room with a sibling, 3.5% shared a bed with a sibling, 6.4% slept in their parents bedroom, and 8.5% slept with their parents in the parent’s bed. In about half of the co-sleeping cases, the parent initiated this sleeping arrangement to facilitate bonding and apparently not as the result of sleep problems.

This study found that children that had more than one sleep location, co-slept with parents, or shared a bedroom with parents had more sleep problems than children that slept alone. Also, solitary sleepers and children who shared bed with a sibling slept longer than children who co-slept or who shared a bedroom with parents. However, this study also found that co-sleeping and room-sharing with parents did help to improve children’s sleep if the child was having problems. It also found that adhering to a strict bedtime routine was the most effective technique for improving children’s sleep habits.

This study seems to beg the classic chicken and egg question: does sleeping in one place (most often their own bed) lead to fewer sleep problems, or does the absence of sleep problems lead to comfort in sleeping by yourself? Alas, the answer to that question must await another study.


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