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The Children's Sleep Habits Questionnaire in Toddlers and Preschool Children

Goodlin-Jones, Beth L. PhD*; Sitnick, Stephanie L. MS†; Tang, Karen BS*; Liu, Jingyi MS‡; Anders, Thomas F. MD*

Journal of Developmental & Behavioral Pediatrics: April 2008 - Volume 29 - Issue 2 - pp 82-88
doi: 10.1097/DBP.0b013e318163c39a
Original Article

Objective: Twenty to 40% of young children are reported to have behavioral insomnias of childhood. Concerns about sleep at these ages are the most common problem expressed to pediatricians at the time of well child visits. A screening questionnaire, the Children's Sleep Habits Questionnaire (CSHQ), has been used in clinical settings and in research studies to assess children ages 4 to 10 for the presence of sleep problems. A CSHQ total score has distinguished clinical populations from community samples.

Methods: The current study assesses the CSHQ in a younger age group than previously reported and in a diverse population. A total of 194 children, ages 2 to 5½ years, were recruited into 3 diagnostic groups: 68 children with autism, 57 children with developmental delay without autism, and 69 typically developing children. All children's parents completed the CSHQ and a sleep log, and all children were studied for 7 days and nights with actigraphy. The children were divided into problem sleep and non-problem sleep groups on the basis of a parent report of a generic sleep problem at the time of entry into the study. The CSHQ responses for the problem and non-problem sleep groups were then compared.

Results: The results suggest that the CSHQ is clinically useful for screening of sleep problems in typically developing children at these young ages as well as in children with diverse neurodevelopmental diagnoses.

Conclusions: The somewhat higher subscale scores than previously reported for older children appear to be consistent with more sleep problems in younger children.

From *M.I.N.D. Institute and Department of Psychiatry and Behavioral Sciences, U.C. Davis, †Department of Human and Community Development, U.C. Davis, and ‡Department of Statistics, U.C. Davis.

Received June 2007; accepted November 2007.

Address for reprints: Thomas F. Anders, MD, UC Davis M.I.N.D., 2825 50th Street, Sacramento, CA 95817; e-mail:

Note: Specific questions on the CSHQ correspond directly with variables derived from the actigraph and parent sleep diary. For example, the CSHQ item “Child's Bedtime” corresponds with actigraph and diary bedtimes. Similarly, night waking duration compares the CSHQ items related to “number of minutes a night waking lasts” × “number of night wakings”, etc. All three methods utilize a 1-week average for comparison.

© 2008 Lippincott Williams & Wilkins, Inc.