Correlation between sleep problems and manual dexterity ability in a national multicenter study of preschool children

ZHOU Ji, CHENG Tong, XU Mengjie, ZHENG Yingnan, XU Mengxue, JIA Ni, GUAN Hongyan

Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (2) : 122-127.

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (2) : 122-127. DOI: 10.11852/zgetbjzz2025-1437
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Correlation between sleep problems and manual dexterity ability in a national multicenter study of preschool children

  • ZHOU Ji, CHENG Tong, XU Mengjie, ZHENG Yingnan, XU Mengxue, JIA Ni, GUAN Hongyan
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Abstract

Objective To describe sleep problems and manual dexterity among preschool children, and to examine their correlation, so as to provide reference for improving preschool children's sleep problems and manual dexterity ability in China. Methods From April to July 2023 and in January 2024, a multistage stratified cluster sampling strategy was applied to select cities with medium or above economic level in representative provinces across four major economic regions in China (eastern, central, western and northeastern China).A total of 49 kindergartens were recruited, including 26 urban kindergartens and 23 rural kindergartens.Within each kindergarten, children were enrolled with a 1:1 allocation by sex and by age group (3-year-olds vs. 4-year-olds), with 25–30 children recruited per kindergarten, for a total of 1 316 participants.Children's Sleep Habits Questionnaire (CSHQ) was used to obtain the detection rate of children's sleep problems, and the 9-hole pegboard test in the National Institutes of Health Neurological and Behavioral Function Assessment Toolbox (NIH Toolbox) was used to measure children's manual dexterity ability.Multiple linear regression models were constructed to analyze the relationship between children's sleep problems and manual dexterity ability. Results A total of 1 255 children were included (50.04% were boys), with a mean age of (4.10±0.45) years.The mean CSHQ total score was 47.05±6.14, and the overall detection rate of sleep problems was 78.6%.The mean 9-hole pegboard completion time was (36.30±8.45) seconds, with a pass rate of 93.8%.After adjustment for confounders, the CSHQ total score was not significantly associated with 9-hole pegboard time (P>0.05).For each 1-point increase in the sleep onset delay and sleep-disordered breathing domain scores, the 9-hole pegboard completion time increased by 0.808 s (95% CI: 0.203–1.413) and 1.003 s (95% CI: 0.183–1.822), respectively (P<0.05). Conclusions Reduced manual dexterity was associated with prolonged sleep latency and the presence of sleep-disordered breathing in preschool children, suggesting that targeted manual dexterity ability training should be integrated into sleep intervention and prevention to optimize strategy comprehensiveness and efficacy.

Key words

sleep problem / manual dexterity / hand / preschool children

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ZHOU Ji, CHENG Tong, XU Mengjie, ZHENG Yingnan, XU Mengxue, JIA Ni, GUAN Hongyan. Correlation between sleep problems and manual dexterity ability in a national multicenter study of preschool children[J]. Chinese Journal of Child Health Care. 2026, 34(2): 122-127 https://doi.org/10.11852/zgetbjzz2025-1437

References

[1] Uchitel J, Vanhatalo S, Austin T.Early development of sleep and brain functional connectivity in term-born and preterm infants[J].Pediatr Res,2022,91(4):771-786.
[2] Albertini ML, Spoto G, Ceraolo G, et al.Sleep disorders in children with autism spectrum disorder: Developmental impact and intervention strategies[J].Brain Sci,2025,15(9):983.
[3] Tamir S, Dye TJ, Witt RM.Sleep and circadian disturbances in children with neurodevelopmental disorders[J].Semin Pe-diatr Neurol,2023,48:101090.
[4] Gopal A, Hsu WY, Allen DD, et al.Remote assessments of hand function in neurological disorders: Systematic review[J].JMIR Rehabil Assist Technol,2022,9(1):e33157.
[5] Prado EL, Sebayang SK, Apriatni M, et al.Maternal multiple micronutrient supplementation and other biomedical and socioenvironmental influences on children's cognition at age 9-12 years in Indonesia: Follow-up of the SUMMIT randomised trial[J].Lancet Glob Health,2017,5(2):e217-e228.
[6] Jatnika R, Agustiani H, Abidin FA, et al.Child Development Card (KKA) as a discriminant tool for the growth and development of stunted and normal children in Indonesia[J].J Public Health Res,2024,13(1):22799036241231790.
[7] Smirni D, Tabacchi G, Cottone R, et al.Cognitive performance, sleep quality and physical activity as predictors of functional mobility in older adults[J].Front Aging Neurosci,2025,17:1649682.
[8] Merín L, Nieto M, Sánchez-Arias L, et al.Actigraphy-assessed sleep duration and quality and executive function in a sample of typically developing preschoolers[J].Eur Child Adolesc Psychiatry,2025,34(4):1379-1390.
[9] Owens JA, Spirito A, Mcguinn M.The Children's Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children[J].Sleep,2000,23(8):1043-1051.
[10] 李生慧,金星明,沈晓明,等.儿童睡眠习惯问卷中文版制定及测量性能考核[J].中华儿科杂志,2007,45(3):176-180.
Li SH, Jin XM, Shen XM, et al.Development and psychometric properties of the Chinese version of Children's Sleep Habits Questionnaire[J].Chin J Pediatr,2007,45(3):176-180.(in Chinese)
[11] Reuben DB, Magasi S, Mccreath HE, et al.Motor assessment using the NIH Toolbox[J].Neurology,2013,80(11 Suppl 3):65-75.
[12] Wang YC, Bohannon RW, Kapellusch J, et al.Dexterity as measured with the 9-Hole Peg Test (9-HPT) across the age span[J].J Hand Ther,2015,28(1):53-60.
[13] Leung TNH, Wong KL, Chan AKC, et al.Common childhood sleep problems and disorders[J].Curr Pediatr Rev,2024,20(1):27-42.
[14] Zhao T, Xuan K, Liu H, et al.The association between family function and sleep disturbances of preschool children in rural areas of China: A cross-sectional study[J].Psychol Health Med,2023,28(4):895-907.
[15] Hua J, Lyu J, Du W.Prevalence of sleep disorder in chinese preschoolers: A national population-based study[J].Nat Sci Sleep,2022,14:2091-2095.
[16] Liu Y, Zhang J, Li SX, et al.Excessive daytime sleepiness among children and adolescents: Prevalence, correlates, and pubertal effects[J].Sleep Med,2019,53:1-8.
[17] Izadi M, Thomas E, Thomas AC, et al.The effect of time-of-day and sleep deprivation on postural control: A systematic review[J].Gait Posture,2022,97:94-103.
[18] Ameen RW, Warshawski A, Fu L, et al.Early life circadian rhythm disruption in mice alters brain and behavior in adulthood[J].Sci Rep,2022,12(1):7366.
[19] Goto A, Bota A, Miya K, et al.Stepwise synaptic plasticity events drive the early phase of memory consolidation[J].Science,2021,374(6569):857-863.
[20] Tse Cya, Lee Hp, Chan Ksk,et al.Examining the impact of physical activity on sleep quality and executive functions in children with autism spectrum disorder: A randomized controlled trial[J].Autism,2019,23(7):1699-1710.
[21] Torres-Lopez LV, Cadenasa-Sanchez C, Migueles JH, et al.Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?[J].Eur J Pediatr,2022,181(5):2055-2065.
[22] Mezzofranco L, Agostini L, Boutarbouche A, et al.Sleep habits and disorders in school-aged children: A cross-sectional study based on parental questionnaires[J].Children (Basel),2025,12(4):489.
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