Abstract：
BACKGROUND: To examine whether parental corporal punishment is associated with increased risk of concurrent and later sleep disturbances among preschoolers, and whether the association is time-sensitive or dose-responsive.
METHODS: This 3-year prospective cohort study used data from the Shanghai Children\'s Health, Education and Lifestyle Evaluation, Preschool(SCHEDULE-P). Participants were newly enrolled preschoolers in November 2016(wave 1) and followed up in April 2018(wave 2) and April 2019(wave 3). Parents reported the children\'s corporal punishment experiences and sleep disturbances at each wave survey. Children\'s risk of sleep disturbances in relation to corporal punishment was examined using logistic regression, adjusting for children\'s age, gender, emotional/behavioral problems, family annual income, and maternal educational level.
RESULTS: The participants of 19,668 children included 9436(47.98 %) females, with a mean age of 3.73(SD = 0.29) years at wave 1. Exposure to corporal punishment was associated with increased odds of concurrent sleep disturbances at wave 1, 2, and 3 (aOR,1.57; 95 % CI, 1.40-1.75; P < .001; aOR,1.60; 95 % CI, 1.43-1.80; P < .001; aOR,1.74; 95 % CI, 1.54-1.95; P < .001), respectively. Exposure to corporal punishment at any wave of preschool was associated with increased odds of sleep disturbances at wave 3, and the risks were greater for proximal and accumulative corporal punishment exposure.
CONCLUSIONS: There is a time-sensitive and dose-responsive association between corporal punishment and sleep disturbance among preschoolers, with greater risk of sleep disturbances for proximal and accumulative exposure of corporal punishment. Promoting positive parenting strategies and avoiding corporal punishment can be a promising strategy to prevent and intervene sleep disturbances in preschoolers.
METHODS: This 3-year prospective cohort study used data from the Shanghai Children\'s Health, Education and Lifestyle Evaluation, Preschool(SCHEDULE-P). Participants were newly enrolled preschoolers in November 2016(wave 1) and followed up in April 2018(wave 2) and April 2019(wave 3). Parents reported the children\'s corporal punishment experiences and sleep disturbances at each wave survey. Children\'s risk of sleep disturbances in relation to corporal punishment was examined using logistic regression, adjusting for children\'s age, gender, emotional/behavioral problems, family annual income, and maternal educational level.
RESULTS: The participants of 19,668 children included 9436(47.98 %) females, with a mean age of 3.73(SD = 0.29) years at wave 1. Exposure to corporal punishment was associated with increased odds of concurrent sleep disturbances at wave 1, 2, and 3 (aOR,1.57; 95 % CI, 1.40-1.75; P < .001; aOR,1.60; 95 % CI, 1.43-1.80; P < .001; aOR,1.74; 95 % CI, 1.54-1.95; P < .001), respectively. Exposure to corporal punishment at any wave of preschool was associated with increased odds of sleep disturbances at wave 3, and the risks were greater for proximal and accumulative corporal punishment exposure.
CONCLUSIONS: There is a time-sensitive and dose-responsive association between corporal punishment and sleep disturbance among preschoolers, with greater risk of sleep disturbances for proximal and accumulative exposure of corporal punishment. Promoting positive parenting strategies and avoiding corporal punishment can be a promising strategy to prevent and intervene sleep disturbances in preschoolers.
摘要：
背景：为了检查父母体罚是否与学龄前儿童并发和后期睡眠障碍的风险增加有关，以及这种关联是时间敏感还是剂量敏感。
方法：这项为期3年的前瞻性队列研究使用了来自上海儿童健康的数据，教育和生活方式评估，学龄前（附表-P）。参与者是2016年11月新入学的学龄前儿童（第1波），并在2018年4月（第2波）和2019年4月（第3波）进行随访。父母在每次调查中都报告了孩子的体罚经历和睡眠障碍。儿童睡眠障碍的风险与体罚的关系使用逻辑回归检查，适应儿童的年龄，性别,情绪/行为问题，家庭年收入,和母亲的教育水平。
结果：19,668名儿童的参与者包括9436名（47.98%）女性，在第1波时，平均年龄为3.73(SD=0.29)岁。暴露于体罚与第1、2和3波并发睡眠障碍的几率增加相关(aOR，1.57；95%CI，1.40-1.75；P<.001；aOR，1.60；95%CI，1.43-1.80；P<.001；aOR，1.74；95%CI，1.54-1.95；P<.001），分别。在任何学龄前波中遭受体罚都与第3波中睡眠障碍的几率增加有关，并且近端和累积体罚暴露的风险更大。
结论：在学龄前儿童中，体罚与睡眠障碍之间存在时间敏感和剂量敏感的关联，由于近端和累积的体罚暴露，睡眠障碍的风险更大。促进积极的育儿策略和避免体罚可能是预防和干预学龄前儿童睡眠障碍的有希望的策略。
方法：这项为期3年的前瞻性队列研究使用了来自上海儿童健康的数据，教育和生活方式评估，学龄前（附表-P）。参与者是2016年11月新入学的学龄前儿童（第1波），并在2018年4月（第2波）和2019年4月（第3波）进行随访。父母在每次调查中都报告了孩子的体罚经历和睡眠障碍。儿童睡眠障碍的风险与体罚的关系使用逻辑回归检查，适应儿童的年龄，性别,情绪/行为问题，家庭年收入,和母亲的教育水平。
结果：19,668名儿童的参与者包括9436名（47.98%）女性，在第1波时，平均年龄为3.73(SD=0.29)岁。暴露于体罚与第1、2和3波并发睡眠障碍的几率增加相关(aOR，1.57；95%CI，1.40-1.75；P<.001；aOR，1.60；95%CI，1.43-1.80；P<.001；aOR，1.74；95%CI，1.54-1.95；P<.001），分别。在任何学龄前波中遭受体罚都与第3波中睡眠障碍的几率增加有关，并且近端和累积体罚暴露的风险更大。
结论：在学龄前儿童中，体罚与睡眠障碍之间存在时间敏感和剂量敏感的关联，由于近端和累积的体罚暴露，睡眠障碍的风险更大。促进积极的育儿策略和避免体罚可能是预防和干预学龄前儿童睡眠障碍的有希望的策略。
