Parental Attitudes Towards Sleep of Children in the United Kingdom and Iran - Literature review Example

Comparing Parental Attitudes towards Childrens Sleep in United Kingdom and Iran Introduction Sleep is important to every individual, including children and adults. However, there are differences in the understanding of the importance of quality sleep for children in different cultures. Previous studies on the nature of sleep among children, the quality and time of sleep has been found to be insufficient. For instance, a past survey of American parents revealed that 25 per cent of children had insufficient sleep based on the National Sleep Foundation recommendation (Jones, Owens & Pham, 2012). In yet another study of cross-cultural differences in children’s sleep patterns, Mindell et al., (2010) established that there were major differences in childrens sleep patterns between predominantly Asian countries and their counterparts from predominantly Caucasian countries. Such findings emphasize the fact that cultural factors and parental understanding of quality sleep affect the nature of children’s sleep. In a study to examine cultural differences in parental attitudes towards sleep patterns, some of the main cultural factors that determined the differences in childrens sleep patterns included parental perception of the need for sleep, attitudes towards sleep, and perception of homework (Biggs et al., 2010). There is evidence from research studies that show the correlation between children sleep patterns and cultural factors. Drawing from such evidence, this study seeks to examine how parental attitudes towards sleep affect the sleep patterns of children from the United Kingdom and Iran. The study will involve a quantitative quasi-experimental approach involving samples of parents from London and Tehran. There are several expectations of the study. First, it is expected that there will be notable differences in childrens sleep patterns between children from the UK and Iran. Previous studies have established these differences in terms of sleep duration, times, and patterns. Second, it is expected that parental attitudes towards sleep will be different in the two countries. These differences will be responsible for the differences between the children sleep patterns. Despite these expectations, the issue of education will also be important. Apparently, the level of education of the parents is expected to have an impact on the parental attitudes towards children sleep. This paper will provide a detailed and critical report of the study. The paper is organized into different sections. The first section is the introduction, which introduces the topic, purpose, and expectations of the study. The second section will provide a critical review of relevant literature. This section will provide the rationale and theoretical framework of the study. After the literature review, the next section will provide the study methodology. This will then be followed by the findings section, the discussion section, and the conclusion respectively. Literature Review Quality Sleep and Its Importance for Children Sleep is an important part of every child. Sleep has been associated with neuropsychological functioning of children. According to Sadeh, Raviv and Gruber (2000), sleep deprivation or insufficient sleep can cause ADHD, difficult temperament, attention problems, and poor learning outcomes. This implies that sleep determines the quality of cognitive, behavioural, and psychological development among children. Sufficient sleep is necessary to ensure proper growth and development in children. However, when children lack sufficient sleep because of various factors, they may show symptoms of development problems that may affect them even in their later years. The relationship between sufficient sleep and child development is emphasized in studies that have examined the relationship between children with ADHD and sleep disturbances. In one such study, Gruber, Sadeh and Raviv (2000) found out that children with ADHD tend to experience sleep disturbance, which affects their normal functioning. Children with sleep problems tended to show signs of inconsistent sleep routines, night wakings, and shorter sleep durations. Various factors determine sleep quality. One of the main factors of sleep quality is the duration of sleep. Although there is not standard sleep time for children, there are recommendations from various stakeholders regarding the duration of sleep for children in different age groups. For instance, in the UK, the National Health Services recommends an average of between 10 and 11 hours night time sleep for children between the ages of five and nine (NHS, 2013). Shorter or longer periods of sleep can be an indication of sleep problems. According to a study that sought to establish the link between shorter sleep patterns and obesity among children, Cappuccio et al., (2008) found out that shorter sleep duration increased the risk of obesity. Other studies have also established the link between short or long sleep duration with morbidity (Marshall, Glozier & Grunstein, 2008; National Sleep Foundation, 2014). However, sleep duration is only one factor that affects sleep quality among children. Another factor that affects sleep quality in children is sleep routine. According to The Sleep Council (n.d.), children need a regular sleep routine. This implies that children ought to go to bed and wake up following a regular pattern such that their bodies can adopt this routine. The regular sleep routine is especially important for children in the preschool ages. Other factors that may determine the quality of sleep include sharing of bed and disruptions of sleep. Relationship between Culture and Sleep in Children The above factors that determine quality of sleep are subject to cultural influences. Multiple studies have show the relationship between culture aspects and sleep quality among children (Jones, Owens & Pham, 2012; Biggs et al., 2010; Mindell et al., 2010). It is important to note that culture alone is not the influencing factor in sleep behaviour. According to Jenni and OConnor (2005), sleep is primarily a biological process that is influenced by cultural beliefs and values of parents. Therefore, it is important to note that culture plays an influential role in determining children sleep. However, this influence is indirect in the sense that it is the parents’ cultural beliefs and values that affect their children’s sleep. Various studies have shown the parental role in children’s sleep. In a study of sleep habits of school-aged children in China, Liu, Liu and Wang (2003) found out that bed sharing was quite prevalent in China. This was linked to various factors, including young age, crowded housing, and poor physical health of the children. This finding is supported by the findings of another study that linked Asian cultures with room-sharing (Mindell et al., 2010). Compared to European or Caucasian cultures, children from Asian cultures are more likely to share a bed with their siblings or parents, which also affects their sleep patterns and quality. For instance, Mindell et al., (2010) noted that Asian parents had a higher level of perception regarding sleep problems. This suggests that children from such Asian families may experience better sleep patterns because of their parents increased perception of their sleep problems. However, in another study of differences in sleep attitudes between South East Asian and Caucasian parents, Biggs et al., (2010) established Caucasian parents had greater belief that their children need more sleep than their South East Asian counterparts. The study also established that South East Asian parents tended to prioritize their children’s homework over sleep, which led to a tendency for such parents to let the children to go to bed late. This would seem to suggest that the tendency of Asian parents to share a bed with their young children does not have a major beneficial impact on the sleep duration of the children. This notion is also supported by Sadeh, Tikotzky and Scher (2010) who note that parental involvement in child sleep causes children to experience longer and more night wakings because they do not develop effective self-regulation for their sleep. The relationship between parental involvement and child sleep is conceptualized by the transactional model proposed by Sadeh and Anders. This model suggests that infant sleep is affected by multiple factors including culture, environment, family, parenting, and intrinsic infant factors. These factors work together to influence the interactive context between the parent and the child with regard to sleep. Specifically, these factors influence the attachment, emotional availability, care, limit setting, bedtime interactions, and soothing methods of parents. In turn, these factors affect the sleep pattern, duration, schedule, and overall sleep quality of the child (see diagram 1 below). Diagram 1: Transactional Model in Parental Involvement in Child Sleep Source: Sadeh & Anders (1993). Although there have been multiple studies on the parenting factors and child sleep, most of these studies have focused on major European and Asian countries. There have been limited studies focusing on Iran. However, several studies present important insights regarding child sleep and parental attitudes in Iran. One such study provides a comprehensive analysis of sleep quality and patterns among preschool and school-aged children in Iran. From the study, there were major differences in the sleep patterns and characteristics of preschool and school-aged children. One of the main differences was the school-aged children woke up earlier than preschool children. This study linked this to the fact that school-aged children were involved with home chores and school work, which meant that their sleep practices were affected. For instance, the school aged children had to wake up early to attend school (Mohammadi et al., 2007).This finding could be linked to the observation that Asia parents in general emphasize the importance of homework. Therefore, the parents are more likely to wake up their school-aged children. However, the study also linked parental involvement in child sleep. The study findings showed that preschool children were more likely to share rooms or bed with their parents as compared to school-aged children (Mohammadi et al., 2007). This sharing of bed or room with parents affected the sleep patterns including later bedtimes, more time in bed before sleeping, and difficulty going to sleep. Apparently, the children who share bed or rooms with their parents were more likely to be affected by their parents’ sleeping habits. In another study that was based in Qazvin, Iran,Shoghy (2005) found out a considerably high prevalence (44.3 per cent) of sleep disorders among the children involved in the study whose ages ranged from seven to eleven years. The specific sleep disorders among the sampled children included sleep talking, sleep walking, nightmares, daytime drowsiness, night terrors, sleep bruxism, and restless legs syndrome. The study also linked parental involvement in the sleep quality of the children. One major finding was that only a limited number of parents knew about their children’s sleep disorders and recommended the use of public educational programs for parents (p. 18). In yet another study of sleeping problems among four to five year olds in Oxford, Ali, Pitson and Stradling (1993) noted that sleep disorders were also common among the children.The sleeping problems were also related to maternal behaviour. For instance, only a small number of parents (30 per cent) knew about their children’s sleeping disorders. This finding supports the observation that parental involvement in child sleep is important. Apart from this, the study also established that mothers who smoked tobacco placed their children at greater risk of sleep disorders (p. 363). Maternal smoking can be perceived a culturally based behaviour. Apparently, tobacco smoking behaviour is influenced by cultural values of a society (Nichter, 2003). The relationship between parental smoking and child sleep disorders suggests that culture is a major factor influencing parental attitudes and behaviours and how these affect their involvement in their children’s sleep. In another study conducted on English preschool children, Jones and Ball (2012) noted that the children’s napping behaviour was partly influence by parental attitudes and preferences. Children with parents who encouraged napping were found to have nap duration and frequency than those whose parents did not encourage napping. This finding emphasizes the link between positive parental attitude and children sleep. Iran and the UK have several cultural differences, which may partly account for the different parental attitudes towards children’s sleep. According to Hofstede’s cultural dimensions, Iran and the UK are different in all the six cultural elements of the model including power distance, uncertainty avoidance, indulgence, individualism, masculinity, and pragmatism (see diagram 2 below). Diagram 2: Hofstede Country Comparison between Iran and the UK Source: The Hofstede Centre (2015). From the diagram above, Iran has a lower score on individualism than the UK, which implies that Iranians have a collectivist culture. The collectivist culture supports closer family ties. This could explain the fact that parental bed and or room sharing is higher in Iran and than in the UK. Additionally, the lower score of Iran in the indulgence element compared to the UK means that Iran is a restrained society while the UK is an indulgent society. Therefore, the observation that parental smoking affected child sleep in the Oxford study could be explained by the indulgent culture, which allows women to smoke tobacco. This is not the case in Iran. Prevalence of tobacco smoking among women is low (Meysamie et al., 2012; Halimi, Haghdoost & Alizadeh, 2013). These cultural differences provide support for the parenting attitudes towards children’s sleep and how these differ in the two countries. The parental attitudes towards children’s sleep are also influenced by their education levels. Apparently, children from families with parents with higher levels of education are likely to have better sleep quality than those whose parents have lower levels of education (Wolfson & Montgomery-Downs, 2013). Education is considered an effective tool for social transformation (Dominic, 2011; New & Ghafar, 2012). Therefore, educated parents are empowered and informed about the importance of sleep to their children and are likely to adopt positive attitudes and behaviours towards children’s sleep. Overall, a review of previous studies and literature support the view that parental attitudes affect children sleep. Based on the analysis of the literature, this dissertation hypothesizes that there are differences in parental attitudes towards children’s sleep in Iran and the UK. These differences affect the sleep characteristics of children from the two societies. References Ali, N. J., Pitson, D. J., & Stradling, J. R. (1993). Snoring, sleep disturbance, and behaviour in 4-5 year olds. Archives of disease in childhood, 68(3), 360-366. Biggs, S., N., Pizzorno, V., A., Heuvel, C., Kennedy , J., D., Martin, A., J., & Lushington, K. (2010). Differences in Parental Attitudes Towards Sleep and Associations With Sleep–Wake Patterns in Caucasian and Southeast Asian School-Aged Children in Australia.Behavioral Sleep Medicine, 8(4), 207-218, DOI: 10.1080/15402002.2010.509197 Cappuccio F., P., Taggart, F., M., Kandala, N., B., Currie, A., Peile, E., Stranges, S., Miller, M., A. (2008). Meta-analysis of short sleep duration and obesity in children and adults. SLEEP, 31(5):619-626. Chen, X., Gelaye, B., Velez, J., C., Pepper, M., Gorman, S., Barbosa, C. et al. (2014). Attitudes, beliefs, and perceptions of caregivers and rehabilitation providers about disabled children’s sleep health: A qualitative study. BMC Pediatrics, 14, 245. Dickson, D. M. (2014). Parental perceptions of sleep hygiene practices of urban, minority school-aged children: A descriptive qualitative study (Order No. 3580067). Available from ProQuest Dissertations & Theses Full Text. (1521257323). Retrieved from http://search.proquest.com/docview/1521257323?accountid=458 Dominic, B. (2011). ‘Women’s education a tool of social transformation’ – A historical study based on Kerala society. International Journal of Scientific & Engineering Research, 2(10), 1-7. Firouzi, S., Bee Koon, P., Noor, M. I., & Sadeghilar, A. (2013). Sleep pattern and sleep disorders among a sample of Malaysian children. Sleep & Biological Rhythms, 11(3), 185-193. doi:10.1111/sbr.12020 Gruber, R., Sadeh, A., & Raviv, A. (2000). Instability of sleep patterns in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 39(4), 495-501. Halimi, L., Haghdoost, A., A., & Alizadeh, S., M. (2013). Prevalence of cigarette smoking among Iranian women: A systematic review and meta-analysis. Medical Journal of the Islamic Republic of Iran, 27(3), 132-140. Javadzadeh, M., Hashemi, Z., Roudbari, M., Mahvelati, F., & Jalilolghadr, S. (2008). Sleep patterns and sleep disorders in primary school children in Qazvin, Iran. Iranian Journal of Child Neurology (IJCN), 2(4), 15-19. Jenni, O. G., & OConnor, B. B. (2005). Childrens sleep: An interplay between culture and biology. Pediatrics, 115(Supplement 1), 204-216. Jones, C., H., & Ball., H., L. (2013). Napping in English preschool children and the association with parents’ attitudes. Sleep Medicine, 14(4), 352-358. Jones, C.,. Owens, J., A., & Pham, B. (2012). Can a brief educational intervention improve parents’ knowledge of healthy children’s sleep? A pilot test. Health Education Journal, 72(5), 601-610. Liu, X., Liu, L., & Wang, R. (2003). Bed sharing, sleep habits, and sleep problems among Chinese school-aged children. SLEEP-NEW YORK THEN WESTCHESTER-, 26(7), 839-844. Marshall, N., S., Glozier, N., & Grunstein, R., R. (2008). Is sleep duration related to obesity? A critical review of the epidemiological evidence. Sleep Medicine Reviews, 12, 289-298. Meijer, A. M., Habekothé, R. T., & Van Den Wittenboer, G. L. (2001). Mental health, parental rules and sleep in pre-adolescents. Journal Of Sleep Research, 10(4), 297-302. doi:10.1046/j.1365-2869.2001.00265.x Meysamie, A., Ghaletaki, R., Zhand, N., & Abbasi, M. (2013). Cigarette smoking in Iran. Iran Journal of Public Health, 41(2), 1-14. Mindell, J,. A., Sadeh, A., Wiegand, B., How, T., H., & Goh, D. (2010). Cross-cultural differences in infant and toddler sleep. Sleep Medicine, 11, 274-280. Mohammadi, M., Ghalebaghi, B., Bandi, M. G., Amintehrani, E., Khodaie, S., Shoaee, S., & Ashrafi, M. R. (2007). Sleep patterns and sleep problems among preschool and school-aged group children in a primary care setting. Iranian Journal of Pediatrics, 17(3), 213-221. National Sleep Foundation. (2014). How much sleep do we really need? Retrieved from http://sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need/page/0,1/ New, K., H., & Ghafar, M., N. (2012). The role of education in transforming the potential social skills of college students. Excellence in Higher Education, 3(2), 95-103. Ng, A. S., Dodd, H. F., Gamble, A. L., & Hudson, J. L. (2013). The relationship between parent and child dysfunctional beliefs about sleep and child sleep. Journal of Child and Family Studies, 22(6), 827-835. doi:http://dx.doi.org/10.1007/s10826-012-9637-6 NHS. (2013). How much sleep do kids need? Retrieved from http://www.nhs.uk/Livewell/Childrenssleep/Pages/howmuchsleep.aspx Nichter, M. (2003). Smoking: What does culture have to do with it? Addiction, 98(1), 139-145. Oka, Y., Suzuki, S., & Inoue, Y. (2008). Bedtime Activities, Sleep Environment, and Sleep/Wake Patterns of Japanese Elementary School Children. Behavioral Sleep Medicine, 6(4), 220-233. doi:10.1080/15402000802371338 Robinson, A. M., & Richdale, A. L. (2004). Sleep problems in children with an intellectual disability: parental perceptions of sleep problems, and views of treatment effectiveness. Child: Care, Health & Development, 30(2), 139-150. doi:10.1111/j.1365-2214.2004.00395.x Sadeh, A., & Anders, T. F. (1993). Infant sleep problems: Origins, assessment, interventions. Infant Mental Health Journal, 14(1), 17-34. Sadeh, A., Flint-Ofir, E., Tirosh, T., & Tikotzky, L. (2007). Infant sleep and parental sleep-related cognitions. Journal of Family Psychology, 21(1), 74-87. Sadeh, A., Mindell, J., & Rivera, L. (2011). “My child has a sleep problem”: A cross-cultural comparison of parental definitions. Sleep Medicine, 12(5), 478-482. Sadeh, A., Raviv, A., & Gruber, R. (2000). Sleep patterns and sleep disruptions in school-age children. Developmental psychology, 36(3), 291. Sadeh, A., Tikotzky, L., & Scher, A. (2010). Parenting and infant sleep. Sleep Medicine Reviews, 14, 89-96. Shoghy, M., Khanjari, S., Farmany, F., & Hossaini, F. (2005). Sleep pattern in school-age children, residents of the West Area in Tehran. Iran Journal of Nursing, 18(43), 83-89. The Hofstede Centre. (2015). Iran in comparison with United Kingdom. Retrieved from http://geert-hofstede.com/iran.html The Sleep Council. (n.d.). The good-night guide for children. Retrieved from http://www.sleepcouncil.org.uk/pdf-downloads/the_good_night_guide_for_children.pdf Wolfson, A., R., & Montgomery-Downs, H., E. eds. (2013). The Oxford handbook of infant, child, and adolescent sleep and behaviour. Oxford University Press. Read More