{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:51:30Z","timestamp":1788259890965,"version":"build-2803163510"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Children's behavior and emotions are affected by sleep disturbances, the parent-child relationship, media viewing time, and the social status of parents and caregivers. We conducted a questionnaire survey to identify the factors that have the greatest impact on children's behavior and emotions and how these factors relate to each other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A parental questionnaire survey was performed at a public elementary school. The questionnaire comprised questions on the family environment (e.g., family structure, media and game exposure, after-school lessons, and caregiver's work schedule) and physical information, the Strengths and Difficulties Questionnaire (SDQ), the Children's Sleep Habits Questionnaire (CSHQ), and the Pittsburgh Sleep Quality Index (PSQI) for parents' sleep condition. A path diagram was drawn to hypothesize the complex interrelationships among factors, and structural equation modeling was used to estimate the path coefficients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>We identified several factors that significantly affected the SDQ score. The CSHQ total score had the largest impact, followed by after-school lessons, single-mother families, and children's sex. In addition, several indirect pathways that led to the CSHQ score (i.e., a pathway from time spent watching television to CSHQ score <jats:italic>via<\/jats:italic> children's bedtime and a pathway from single-mother family to CSHQ score <jats:italic>via<\/jats:italic> PSQI total score) significantly affected the SDQ score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Children's sleep habits that were influenced by several environmental factors had the greatest impact on children's behavior and emotions, which suggested that children's behavioral problems can be improved by interventions focused on sleep habits, such as sleep hygiene instructions.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.1034057","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T07:52:23Z","timestamp":1669621943000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Sleep disturbance has the largest impact on children's behavior and emotions"],"prefix":"10.3389","volume":"10","author":[{"given":"Michiko","family":"Matsuoka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyojiro","family":"Matsuishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Nagamitsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizue","family":"Iwasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Iemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Obara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushiro","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuyuki","family":"Kakuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohisa","family":"Uchimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1111\/j.1469-7610.2012.02608.x","article-title":"Resilient functioning in maltreated children-past, present, and future perspectives","volume":"54","author":"Cicchetti","year":"2013","journal-title":"J Child Psychol Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40609-016-0042-8","article-title":"Familial and contextual influences on children\u2019s prosocial behavior: south African caregivers as adult protective shields in enhancing child mental health","volume":"3","author":"Parchment","year":"2016","journal-title":"Glob Soc Welf"},{"key":"B3","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.ijporl.2016.09.002","article-title":"Associations between childhood hearing loss and behavioural and academic difficulties: a danish cohort study","volume":"90","author":"Niclasen","year":"2016","journal-title":"Int J of Pediatr Otorhinolaryngol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s007870170041","article-title":"Associations between disturbed sleep and behavioural difficulties in 635 children aged six to eight years: a study based on Parents\u2019 perceptions","volume":"10","author":"Smedje","year":"2001","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1186\/s12889-019-6832-z","article-title":"Associations between overweight and mental health problems among adolescents, and the mediating role of victimization","volume":"19","author":"van Vuuren","year":"2019","journal-title":"BMC Public Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1111\/all.12241","article-title":"Externalizing and internalizing behavioural problems related to asthma in school children","volume":"68","author":"Annesi-Maesano","year":"2013","journal-title":"Allergy"},{"key":"B7","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1186\/1477-7525-11-115","article-title":"Is the impact of atopic disease on children and adolescents\u2019 health related quality of life modified by mental health? 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