Cross-cultural differences in infant and toddler sleep

Mindell, Jodi A.; Sadeh, Avi; Wiegand, Benjamin; How, Ti Hwei; Goh, Daniel Y.T.

doi:10.1016/j.sleep.2009.04.012

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Volume 11, Issue 3 , Pages 274-280, March 2010

Cross-cultural differences in infant and toddler sleep

Jodi A. Mindell
- The Children’s Hospital of Philadelphia, Saint Joseph’s University, USA
- Corresponding author. Address: Saint Joseph’s University, Department of Psychology, Philadelphia, PA 19131, USA. Tel.: +1 610 660 1806.
Avi Sadeh
- Avi Sadeh, Department of Psychology, Tel Aviv University, Tel Aviv 69978, Israel
Benjamin Wiegand
- Johnson & Johnson, 420 Delaware Avenue, Ft. Washington, PA 19034, USA
Ti Hwei How
- Johnson & Johnson Asia Pacific, Division of Johnson & Johnson Pte. Ltd., No. 2, International Business Park, #07-01, Tower One, The Strategy, Singapore 609930, Singapore
Daniel Y.T. Goh
- Department of Paediatrics, University Children’s Medical Institute, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore

Received 24 February 2009; received in revised form 17 April 2009; accepted 26 April 2009.

Abstract

Background

To characterize cross-cultural sleep patterns and sleep problems in a large sample of children ages birth to 36months in multiple predominantly-Asian (P-A) and predominantly-Caucasian (P-C) countries.

Methods

Parents of 29,287 infants and toddlers (predominantly-Asian countries/regions: China, Hong Kong, India, Indonesia, Korea, Japan, Malaysia, Philippines, Singapore, Taiwan, Thailand, Vietnam; predominantly-Caucasian countries: Australia, Canada, New Zealand, United Kingdom, United States) completed an internet-based expanded version of the Brief Infant Sleep Questionnaire.

Results

Overall, children from P-A countries had significantly later bedtimes, shorter total sleep times, increased parental perception of sleep problems, and were more likely to both bed-share and room-share than children from P-C countries, p<.001. Bedtimes ranged from 19:27 (New Zealand) to 22:17 (Hong Kong) and total sleep time from 11.6 (Japan) to 13.3 (New Zealand) hours, p<.0001. There were limited differences in daytime sleep. Bed-sharing with parents ranged from 5.8% in New Zealand to 83.2% in Vietnam. There was also a wide range in the percentage of parents who perceived that their child had a sleep problem (11% in Thailand to 76% in China).

Conclusions

Overall, children from predominantly-Asian countries had significantly later bedtimes, shorter total sleep times, increased parental perception of sleep problems, and were more likely to room-share than children from predominantly-Caucasian countries/regions. These results indicate substantial differences in sleep patterns in young children across culturally diverse countries/regions. Further studies are needed to understand the basis for and impact of these interesting differences.

Abbreviations: SD, standard deviation, BISQ, Brief Infant Sleep Questionnaire, P-A, predominantly-Asian, P-C, predominantly-Caucasian, AU, Australia, CA, Canada, CN, China, HK, Hong Kong, ID, Indonesia, IN, India, JP, Japan, KR, Korea, MY, Malaysia, NZ, New Zealand, PH, Philippines, SG, Singapore, TH, Thailand, TW, Taiwan, UK, United Kingdom, US, United States, VN, Vietnam