Objectives: To determine the range of sleep behaviour of normal children to age 38 months and to ascertain the level of parents' problems associated with their child's sleep behaviour.
Design and setting: A cross-sectional survey by questionnaire of parents presenting with their children for routine well-child checks at child health centres, mobile clinics, flying doctor clinics and home visits throughout Queensland. Of 3383 questionnaires distributed 3269 (96.5%) were returned.
Main outcome measures: 1. Sleep frequency and duration, settling procedures, time taken to settle at night, age when child first slept through the night and number of night-time wakenings requiring parental intervention. 2. Parents' problems with their child's sleep behaviour.
Results: There is a wide range of normal childhood sleep behaviour. Circadian rhythm is not well established until four months of age. Daytime sleep becomes less regular with increasing age. Frequent night-time wakening is common from four to 12 months. Night-time settling requires more parental input from 18 months. A large proportion of parents (28.6%) have a problem with their child's sleep behaviour.
Conclusions: Parents require information from health care providers about the wide range of normal childhood sleep patterns. This information can help prevent misdiagnosis, inappropriate medication use, child abuse and parental depression when children's sleep patterns are a problem.