Health  Vol.7 No.11 , November 2015
Sleep Duration and Sleep Problems in a Representative Sample of German Children and Adolescents
Abstract: Objective: The main purpose of the present study was to evaluate sleep duration for nighttime sleep from early infancy to late adolescence in a German sample to illustrate the developmental course and age-specific variability of these variables among subjects. Methods: A total of 17,641 subjects from the KiGGS study were evaluated. The questionnaires contained questions about physical health, living circumstances, health behavior and risks, health supply, mental health, health-related quality of life and sleep. KiGGS assessed sleep by using parent questionnaire of children aged 0 to 10 years (n = 9944) and self-reports of adolescents (n = 7697) aged 11 to 17 years. Results: Total sleep duration decreased from 14.28 hours (SD = 2.33) at the ages 0 - 0.5 to 9.50 hours (SD = 0.82) at the ages of 10.5 - 11. Above the age of 11 adolescents report a decrease of sleep at night from 9.41 hours (SD = 1.33) at the age of 11 - 11.5 to 7.42 (SD = 1.73) at the age of 17.5 - 18 years. Unspecified sleep problems were reported of 19.5%, 13.0% of the children had difficulties falling asleep, difficulties sleeping through the night showed 8.8% of the children, whereas 3.0% report both symptoms—difficulties falling asleep and difficulties sleeping through the night. Conclusions: Age-specific variability of sleep duration is reported as well as sleep difficulties from infancy to adolescence. This is important knowledge for the health care professional who deals with sleep problems in pediatric practice.
Cite this paper: Schlarb, A. , Gulewitsch, M. , Weltzer, V. , Ellert, U. and Enck, P. (2015) Sleep Duration and Sleep Problems in a Representative Sample of German Children and Adolescents. Health, 7, 1397-1408. doi: 10.4236/health.2015.711154.

[1]   Laberge, L., Petit, D., Simard, C., Vitaro, F., Tremblay, R.E. and Montplaisir, J. (2001) Development of Sleep Patterns in Early Adolescence. Journal of Sleep Research, 10, 59-67.

[2]   Gulliford, M.C., Price, C.E., Rona, R.J. and Chinn, S. (1990) Sleep Habits and Height at Ages 5 to 11. Archives of Disease in Childhood, 65, 119-122.

[3]   Jacklin, C.N., Snow, M.E., Gahart, M. and Maccoby, E.E. (1980) Sleep Pattern Development from 6 through 33 Months. Journal of Pediatric Psychology, 5, 295-303.

[4]   Bamford, F.N., Bannister, R.P., Benjamin, C.M., Hillier, V.F., Ward, B.S. and Moore, W.M. (1990) Sleep in the First Year of Life. Developmental Medicine and Child Neurology, 32, 718-724.

[5]   Klackenberg, G. (1968) The Development of Children in a Swedish Urban Community. A Prospective Longitudinal Study. Acta Paediatrica, 57, 105-121.

[6]   Seo, W.S., Sung, H.-M., Lee, J.H., Koo, B.H., Kim, M.J., Kim, S.Y., Choi, S.-J. and Im Shin, H. (2010) Sleep Patterns and Their Age-Related Changes in Elementary-School Children. Sleep Medicine, 11, 569-575.

[7]   Liu, X., Liu, L., Owens, J.A. and Kaplan, D.L. (2005) Sleep Patterns and Sleep Problems among Schoolchildren in the United States and China. Pediatrics, 115, 241-249.

[8]   Liu, X., Ma, Y., Wang, Y., Jiang, Q., Rao, X., Lu, X. and Teng, H. (2005) Brief Report: An Epidemiologic Survey of the Prevalence of Sleep Disorders among Children 2 to 12 Years Old in Beijing, China. Pediatrics, 115, 266-268.

[9]   Iglowstein, I., Jenni, O.G., Molinari, L. and Largo, R.H. (2003) Sleep Duration from Infancy to Adolescence: Reference Values and Generational Trends. Pediatrics, 111, 302-307.

[10]   Thorleifsdottir, B., Bjornsson, J.K., Benediktsdottir, B., Gislason, T. and Kristbjarnarson, H. (2002) Sleep and Sleep Habits from Childhood to Young Adulthood over a 10-Year Period. Journal of Psychosomatic Research, 53, 529-537.

[11]   Nixon, G.M., Thompson, J.M.D., Han, D.Y., Becroft, D.M., Clark, P.M., Robinson, E., Waldie, K.E., Wild, C.J., Black, P.N. and Mitchell, E.A. (2008) Short Sleep Duration in Middle Childhood: Risk Factors and Consequences. Sleep, 31, 71-78.

[12]   García-Jiménez, M.A., Salcedo-Aguilar, F., Rodríguez-Almonacid, F.M., Redondo-Martínez, M.P., Monterde-Aznar, M.L., Marcos-Navarro, A.I. and Torrijos-Martínez, M.P. (2004) Prevalencia de los trastornos del sueno en adolescentes de Cuenca, Espana. Revista de Neurologia, 39, 18-24.

[13]   Dollman, J., Ridley, K., Olds, T. and Lowe, E. (2007) Trends in the Duration of School-Day Sleep among 10- to 15- Year-Old South Australians between 1985 and 2004. Acta Paediatrica, 96, 1011-1014.

[14]   Tynjala, J., Kannas, L. and Valimaa, R. (1993) How Young Europeans Sleep. Health Education Research, 8, 69-80.

[15]   Roberts, R.E., Roberts, C.R. and Chen, I.G. (2002) Impact of Insomnia on Future Functioning of Adolescents. Journal of Psychosomatic Research, 53, 561-569.

[16]   Roberts, R.E., Roberts, C.R. and Chan, W. (2006) Ethnic Differences in Symptoms of Insomnia among Adolescents. Sleep, 29, 359-365.

[17]   Ohayon, M.M., Roberts, R.E., Zulley, J., Smirne, S. and Priest, R.G. (2000) Prevalence and Patterns of Problematic Sleep among Older Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1549-1556.

[18]   Liu, X., Uchiyama, M., Okawa, M. and Kurita, H. (2000) Prevalence and Correlates of Self-Reported Sleep Problems among Chinese Adolescents. Sleep, 23, 27-34.

[19]   Johnson, E.O., Roth, T., Schultz, L. and Breslau, N. (2006) Epidemiology of DSM-IV Insomnia in Adolescence: Lifetime Prevalence, Chronicity, and an Emergent Gender Difference. Pediatrics, 117, e247-e256.

[20]   Li, S., Zhu, S., Jin, X., Yan, C., Wu, S., Jiang, F. and Shen, X. (2010) Risk Factors Associated with Short Sleep Duration among Chinese School-Aged Children. Sleep Medicine, 11, 907-916.

[21]   Shi, Z., Taylor, A.W., Gill, T.K., Tuckerman, J., Adams, R. and Martin, J. (2010) Short Sleep Duration and Obesity among Australian Children. BMC Public Health, 10, 609.

[22]   Padez, C., Mourao, I., Moreira, P. and Rosado, V. (2009) Long Sleep Duration and Childhood Overweight/Obesity and Body Fat. American Journal of Human Biology: The Official Journal of the Human Biology Council, 21, 371-376.

[23]   Wolfson, A.R. and Carskadon, M.A. (1998) Sleep Schedules and Daytime Functioning in Adolescents. Child Development, 69, 875-887.

[24]   Loessl, B., Valerius, G., Kopasz, M., Hornyak, M., Riemann, D. and Voderholzer, U. (2008) Are Adolescents Chronically Sleep-Deprived? An Investigation of Sleep Habits of Adolescents in the Southwest of Germany. Child: Care, Health and Development, 34, 549-556.

[25]   Patel, S.R., Malhotra, A., Gottlieb, D.J., White, D.P. and Hu, F.B. (2006) Correlates of Long Sleep Duration. Sleep, 29, 881-889.

[26]   Owens, J. (2008) Classification and Epidemiology of Childhood Sleep Disorders. Primary Care, 35, 533-546.

[27]   Ferber, R. (1996) Clinical Assessment of Child and Adolescent Sleep Disorders. Child and Adolescent Psychiatric Clinics of North America, 5, 569-579.

[28]   Lehmkuhl, G., Fricke-Oerkermann, L., Wiater, A. and Mitschke, A. (2008) Sleep Disorders in Children Beginning School: Their Causes and Effects. Deutsches Arzteblatt International, 105, 809-814.

[29]   Krishnan, V. and Collop, N.A. (2006) Gender Differences in Sleep Disorders. Current Opinion in Pulmonary Medicine, 12, 383-389.

[30]   Johnson, E.O., Roth, T., Schultz, L. and Breslau, N. (2006) Epidemiology of DSM-IV Insomnia in Adolescence: Lifetime Prevalence, Chronicity, and an Emergent Gender Difference. Pediatrics, 117, e247-e256.

[31]   Kurth, B.-M. (2007) Der Kinder-und Jugendgesundheitssurvey (KiGGS): Ein Uberblick über Planung, Durchführung und Ergebnisse unter Berücksichtigung von Aspekten eines Qualit?tsmanagements. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 50, 533-546.

[32]   Kamtsiuris, P., Lange, M. and Schaffrath Rosario, A. (2007) Der Kinder-und Jugendgesundheitssurvey (KiGGS): Stichprobendesign, Response und Nonresponse-Analyse. Bun-desgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 50, 547-556.

[33]   Holling, H., Kamtsiuris, P., Lange, M., Thierfelder, W., Thamm, M. and Schlack, R. (2007) Der Kinder-und Jugendgesundheitssurvey (KiGGS): Studienmanagement und Durchführung der Feldarbeit. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 50, 557-566.

[34]   Kurth, B.M., Bergmann, K.E., Holling, H., Kahl, H., Kamtsiuris, P. and Thefeld, W. (2002) Der bundesweite Kinderund Jugendgesundheitssurvey. Das Gesundheitswesen, 64, S3-S11.

[35]   American Academy of Sleep Medicine (2005) International Classification of Sleep Disorders. 2nd Edition, Diagnostic and Coding Manual, American Academy of Sleep Medicine, Westchester.

[36]   Carskadon, M.A., Acebo, C. and Jenni, O.G. (2004) Regulation of Adolescent Sleep: Implications for Behavior. Annals of the New York Academy of Sciences, 1021, 276-291.