Family and dietary risk factors associated with childhood sleep disorders: Evidence from a cross-sectional study in China

BACKGROUND: Childhood sleep disorders are common and are associated with familyand diet-related factors, such as parental snoring and unhealthy eating habits. However, culturally relevant studies remain limited, and existing research often overlooks weak correlations in large populations. OBJECTIVES: This study aimed to identify familyand diet-related risk factors for childhood sleep disorders in a Chinese population and to provide insights for prevention. MATERIAL AND METHODS: A cross-sectional study was conducted in Jinan, China, between January 2022 and December 2023, enrolling 845 children aged 1-7 years through convenience sampling. Sleep disorders were defined based on parent-reported symptoms (mouth breathing, habitual snoring, apnea, or gasping) using a validated questionnaire. Demographic, family, and dietary factors were collected. Associations were analyzed using multivariable logistic regression with stepwise selection based on the Akaike information criterion (AIC), adjusted for age, with subgroup analyses according to age (1-3, 4-5, and 6-7 years). Statistical significance was set at p < 0.05. RESULTS: Among the 845 children (mean age: 5.2 years), 192 (22.7%) had sleep disorders. Multivariable analysis showed that parental snoring (father: odds ratio (OR) = 2.20, 95% confidence interval (95% CI): 1.44-3.41; mother: OR = 1.76, 95% CI: 1.15-2.66), maternal education at the associate degree level (OR = 2.58, 95% CI: 1.27-5.66) or bachelor's degree level (OR = 2.44, 95% CI: 1.21-5.29), and children's preferences for fried foods (OR = 6.49, 95% CI: 2.51-17.40), meat (OR = 2.19, 95% CI: 1.43-3.35), and sweets (OR = 2.15, 95% CI: 1.31-3.51) were significant risk factors. Moderate sweet consumption (1-2 times/week: OR = 0.53, 95% CI: 0.29-0.95; 3-5 times/week: OR = 0.51, 95% CI: 0.27-0.94) was associated with a protective effect compared with daily consumption. CONCLUSIONS: Childhood sleep disorders were significantly associated with parental snoring, higher maternal educational attainment, and children's preferences for fried foods, meat, and sweets, whereas moderate sweet consumption appeared to have a protective effect.