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Sleep Med. 2013 Dec;14(12):1283-9. doi: 10.1016/j.sleep.2013.09.002. Epub 2013 Sep 21.

Cross-cultural differences in the sleep of preschool children.

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The Children's Hospital of Philadelphia, Saint Joseph's University, United States. Electronic address:

Erratum in

  • Sleep Med. 2014 Dec;15(12):1595-6.



The aim of our study was to characterize cross-cultural sleep patterns and sleep problems in a large sample of preschool children ages 3-6years in multiple predominantly Asian (P-A) and predominantly Caucasian (P-C) countries/regions.


Parents of 2590 preschool-aged children (P-A countries/regions: China, Hong Kong, India, Japan, Korea, Malaysia, Philippines, Singapore, Thailand; P-C countries: Australia-New Zealand, Canada, United Kingdom, United States) completed an Internet-based expanded version of the Brief Child Sleep Questionnaire (BCSQ).


Overall, children from P-A countries had significantly later bedtimes, shorter nighttime sleep, and increased parental perception of sleep problems compared with those from P-C countries. Bedtimes varied from as early as 7:43pm in Australia and New Zealand to as late as 10:26pm in India, a span of almost 3h. There also were significant differences in daytime sleep with the majority of children in P-A countries continuing to nap, resulting in no differences in 24-h total sleep times (TST) across culture and minimal differences across specific countries. Bed sharing and room sharing are common in P-A countries, with no change across the preschool years. There also were a significant percentage of parents who perceived that their child had a sleep problem (15% in Korea to 44% in China).


Overall, our results indicate significant cross-cultural differences in sleep patterns, sleeping arrangements, and parent-reported sleep problems in preschool-aged children. Further studies are needed to understand the underlying bases for these differences and especially for contributors to parents' perceptions of sleep problems.


Child; Cross-cultural; Preschool; Sleep; Sleep patterns; Sleep problems

[Indexed for MEDLINE]

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