Objective To examine screening strategies for identifying problematic sleep in a diverse sample of infants. Methods Parents of infants (5–19 months; N = 3,271) presenting for a primary care visit responded to five screening items and the Infant Sleep Questionnaire (ISQ), a validated measure of problematic infant sleep. If parents responded affirmatively to any screening item, primary care providers received a prompt to evaluate. For each of the screening questions, we examined differences in item endorsement and criterion related validity with the ISQ. Using conceptual composites of night waking and sleep difficulty, prevalence, criterion-related validity, and concurrent demographic correlates were analyzed. Results Infants were primarily of Black race (50.1%) or Hispanic ethnicity (31.7%), with the majority (63.3%) living in economically distressed communities. Rates of problematic sleep ranged from 7.4%, for a single item assessing parental perception of an infant having a sleep problem, to 74.0%, for a single item assessing night wakings requiring adult intervention. Items assessing sleep difficulty had high (95.0–97.8%) agreement with the ISQ in identifying infants without problematic sleep, but low agreement (24.9–34.0%) in identifying those with problematic sleep. The opposite was true for items assessing night waking, which identified 91.0–94.6% of those with sleep problems but only 31.8–46.9% of those without. Conclusions Screening strategies for identifying problematic infant sleep yielded highly variable prevalence rates and associated factors, depending on whether the strategy emphasized parent-perceived sleep difficulty or night wakings. The strategy that is most appropriate will depend on the system’s goals.

中文翻译：

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在不同的婴儿样本中筛查有问题的睡眠

目的 研究筛查策略以识别不同婴儿样本中的睡眠问题。方法 参加初级保健就诊的婴儿（5-19 个月；N = 3,271）的父母对五个筛查项目和婴儿睡眠问卷 (ISQ) 做出了回应，该问卷是一种经过验证的婴儿睡眠问题测量方法。如果父母对任何筛查项目的回答是肯定的，初级保健提供者就会收到评估的提示。对于每个筛选问题，我们使用 ISQ 检查了项目认可和标准相关有效性的差异。使用夜间醒来和睡眠困难的概念复合材料，分析患病率、标准相关有效性和同时的人口统计学相关性。结果 婴儿主要为黑人（50.1%）或西班牙裔（31.7%），其中大多数（63. 3%）生活在经济困难的社区。有问题的睡眠发生率从 7.4%（评估父母对有睡眠问题的婴儿的看法）到 74.0%（评估需要成人干预的夜醒）不等。评估睡眠困难的项目在识别没有睡眠问题的婴儿方面与 ISQ 的一致性高（95.0-97.8%），但在识别有睡眠问题的婴儿方面一致性低（24.9-34.0%）。评估夜间醒来的项目则相反，它确定了 91.0-94.6% 的有睡眠问题的人，但只有 31.8-46.9% 的没有睡眠问题的人。结论 用于识别有问题的婴儿睡眠的筛查策略产生了高度可变的患病率和相关因素，这取决于该策略是强调父母感知的睡眠困难还是夜醒。