Children Sleeping Habits in Preschool Age, Their Behavior during the Wake Up Night and Strategies Adopted by Parents

Introduction\n\nSleep is a psychobiological need that requires a completely satisfaction. The sleep-wake fluctuation allows for cell recovery in its protective function and maintenance of homeostasis, regulating the functions of the brain and the body in general. Vyazovskiy and Harris (2013, p 450-451) suggested that " a key function of NREM sleep is to allow individual neurons to experience a substantial lowering of synaptic and metabolic activity, preventing cellular damage and favouring processes of cellular maintenance after sustained synaptic activity during waking. Because of the extensive recurrent circuitry of the cortex, this requires off periods of coordinated silence in a local population" and sustained also that the neurons restoration involve a state of functional sensory disconnection from the environment and behavioural immobility. Therefore, we need to be globally and behaviourally in order to rest the neurons.\nSo, the sleep is essential for a child´s health, wellbeing and development. The maturation of sleep in childhood requires evolution and adaptive, connected to multiple factors, like temperament, level of development, and socio-cultural environment of the family. \nNevertheless we can identify more and more sleep problems in childhood, associated with unhealthy habits. According to National Sleep Foundation, in 2004, surveys conducted by the NSF (1999-2004) revealed 69 percent of children experience one or more sleep problems a few nights or more during a week. The preschoolers most often stall about going to bed at bedtime (52%), resist going to bed at bedtime (30%), seem sleepy or overtired during the day (26%), snore (19%) and/or have difficulty waking in the morning (19%) at least a few days or nights a week.\nThe problematic night-waking occur frequently of preschool-aged children and are most often associated with poor parenting behaviors.\n\nObjectives\nAs part of broader research and with the awareness that the sleep habits of children are changing, not always in the right direction, and that sleep problems in early childhood are resultant from inefficient routines, we have defined this main objective:\nIdentify the sleep habits of children in pre-school age, including the daily duration of sleep, the practice of co-sleeping, the behaviors of preschool-aged children during night-waking and the strategies adopted by parents to help their child to sleep autonomously , as well as the factors that are associated with them.\n\nMethodology\nA quantitative, descriptive correlational study was developed in a sample by convenience of 158 parents/mothers of preschool-aged children. We have translated and validated culturally to Portuguese the CNBS and NSS, developed by Coulombe and Reid (2010). As well, we have selected the "Sleep Habits Inventory for Preschool Children developed and validated by Croewell and colleagues at the University of Maine - USA, in 1987, translated and validated for the Portuguese language (Batista & Nunes, 2006). It allows evaluating the changes in sleep habits in children from 2-6 years of age, in the week previous the data collection. It must be completed by parents\nResults\nOnly half of the children retained a routine time to go to bed and fell asleep in their own bed. The average sleep duration was of 9,62hours per night. However there are children in this age group who sleep an inadequate number of hours. This finding is is important The practice of "co-sleeping", were common, 65.2% slept alone in own room, while 14.0% usually shared a bed with at least one parent. It was also found that 10.1% slept with brothers; while 9.5% did in own bed in shared room; 7.6% slept with one of his parents; \nA little over half of the children (53,2%) called their parents during night-waking at least once a week, expressing comfort requests followed by those of escape, loss of control, activity and fear. The behaviors regularly adopted were "Asking parents to stay close to him" "asks for a hug, a caress on the back, a touch, etc." "Asks to stay in bed of parents" "get out of bed or crib and leave the room."\nAbout 25% screamed by parents from bed or the cradle and/or didn't sleep again without help. There were even more comfort requests followed the escape of the environment requests of sleep and behavior indicative of loss of control\nThe strategy most commonly used by parents to help their child to sleep autonomously was keeping bedtime routine, and in opposition to co-sleeping, this was the most associated to the decreasing in inadequate sleeping habits - IHSCP and to requests for escape.\nConclusions\nWhile indicating a duration of nocturnal sleep of children of preschool age (= 9.62 hours) similar to that obtained in other studies with children in this age group, we deduce that there is a significant number to sleep much less than what is required. This is problematic, because unhealthy habits will harm these children soon as they enter the school with other requirements. \nGiven the emergence of these sleep problems through the first childhood, it is a good practice in the infant health consultations to discuss and guide the parents to lead with this activity of life. The acquisition of appropriate sleeping habits should be approached with the same relevance of practice of physical exercise or eat healthily. In addition to the maintenance of the bedtime routine, it should be fostered the development of self-esteem/self-control, the settlement of limits and development of autonomy, instead of punishment strategies , the reinforcement of self-esteem/self-control and reward, that revealed the increase of some of the inappropriate behavior during night-waking.\nBibliografia\nBatista, B. & Nunes, M. L. (2006). Validação para a Língua Portuguesa de duas Escalas de Avaliação de Hábitos e Qualidade do Sono em Crianças. Journal of Epilepsy and Clinical Neurophysiology. 12 (3): 143-148.\nCoulombe, Aimee J. (2010). Parenting at midnight: measuring parents' thoughts and strategies to help young children sleep through the night. [Em linha]. Universidade de Western Ontario. [Consult. 2 de Fev. 2011]. Disponível em: <http://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=1128&context=etd>\n National Sleep Fundation. (2014) [Consult. 8 de dez. 2014]. Disponível em http://sleepfoundation.org/sites/default/files/FINAL%20SOF%202004.pdf\nVyazovskiy, Vladyslav V. & Harris, Kenneth D. (2013). Sleep and the single neuron: the role of global slow oscillations in individual cell rest. Nat Rev Neurosci. 14(6): 443-451.

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