Children's Sleep Habits Questionnaire (CSHQ)

Original Editor - Romy Hageman Top Contributors - {{Special:Contributors/Children's Sleep Habits Questionnaire (CSHQ)}}

Purpose[edit | edit source]

The Children's Sleep Habits Questionnaire (CSHQ) is one of the most commonly used assessment tools for paediatric sleep[1]. It is used both in research and in the clinical field. The CSHQ is a 45-item questionnaire completed by parents, aimed at assessing the frequency of behaviours associated with common sleep difficulties in children. This retrospective measure requires parents to indicate how often their child has exhibited various sleep behaviours over the past week. The responses are used to generate eight subscales that correspond to typical sleep issues experienced by children: bedtime resistance, sleep onset delay, sleep duration, sleep anxiety, night wakings, parasomnias, sleep disordered breathing, and daytime sleepiness.

Intended population[edit | edit source]

Technique[edit | edit source]

This video gives an example of the use of the Children's Sleep Habits Questionnaire.[6]

Scoring[edit | edit source]

Each question on the questionnaire is rated on a 3-point scale based on the frequency of occurrence within the past week[7]. Responses are categorized as ''usually'' (5-7 times within the past week), ''sometimes'' (2-4 times within the past week), or ''rarely (never of 1 time within the past week). Some items on the questionnaire are reverse-scored, ensuring that higher scores consistently indicate problem behaviours[7].

All responses are totaled to create a Total Sleep Disturbance index (range from 33-99), with a score exceeding 41 suggesting the presence of a paediatric sleep disorder[1].

Psychometric values[edit | edit source]

  • The CSHQ had an acceptable internal consistency of 0.68 and 0.78[1]
  • Test-retest of the subscales range from 0.62 - 0.79[1]
  • Sensitivity: 0.80[1]
  • Specificity: 0.72[1]
  • Validation in other countries:
    • Brazil: satisfactory equivalence for the original English form[8]
    • China: basically acceptable reliability, except for night-time awakenings and sleep duration subscales[9]
    • Portugal: comparable to the versions of other countries[10]
    • The Netherlands: adequate reliability and moderate internal consistency[11]
    • Spain: adequate psychometric properties[12]
    • Greece: moderate internal consistency and moderate intraclass correlation[13]
    • Indonesia: good internal consistency[14]
    • Italy: good internal consistency[15]
    • Iran: good reliability and validity[16]
    • Japan: adequate internal consistency[17]
  • The psychometric values for the infant version are[3]:
    • Good test-retest reliability
    • Good internal consistency
    • Good concurrent validity

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Owens JA, Spirito A, McGuinn M. The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep. 2000; 23(8): 1043–51
  2. Goodlin-Jones BL, Sitnick SL, Tang K, Liu J, Anders TF. The Children's Sleep Habits Questionnaire in Toddlers and Preschool Children. Journal of Developmental & Behavioral Pediatrics. 2008; 29(2): 82-88
  3. 3.0 3.1 Dias CC, Figueiredo B, Pinto TM. Children's Sleep Habits Questionnaire - Infant Version. Jornal de Pediatrica. 2018; 94(2): 146-154
  4. Johnson CR, DeMand A, Lecavalier L, Smith T, Aman M, Foldes E, Scahill L. Psychometric properties of the children's sleep habits questionnaire in children with autism spectrum disorder. Sleep Medicine. 2016; 20: 5-11
  5. Parreira AF, Martins A, Ribeiro F, Silva FG. Clinical Validation of the Portuguese Version of the Children Sleep Habits Questionnaire (CSHQ-PT) in Children with Sleep Disorder and ADHD. Acta Med Port. 2019; 32(3): 195-201
  6. Kinsey Johnson. Children's Sleep Habits Questionnaire. Available from: [Last accessed 25-03-2024]
  7. 7.0 7.1 Markovich AN, Gendron MA, Corkum PV. Validation the Children's Sleep Habits Questionnaire Against Polysomnography and Actigrahpy in School-Aged Children. Frontiers in Psychiatry. 2015; 5
  8. Silva Gios T, Owens J, Pontrelli Mecca T, Uchida RR, Ferreira Belisario Filho J, Lowenthal R. Translation and adaptation into Brazilian Portuguese and investigation of the psychometric properties of the Children's Sleep Habits Questionnaire (CSHQ-BR). Sleep Medicine. 2022; 100: 550-557
  9. Lia Z, Wang G, Tang H. Reliability and validity of the Children's Sleep Habits Questionnaire in preschool-aged Chinese children. Sleep and Biological Rhythms. 2014; 12(3): 187-193
  10. Silva FG, Silva CR, Braga LB, Neto AS. Portuguese Children's Sleep Habits Questionnaire - validation and cross-cultural comparison. Jornal de Pediatria. 2014; 90(1): 79-84
  11. Waumans RC, Terwee CB, Van den Berg G, Knol DL, Van Litsenburg RRL, Gemke RJBJ. Sleep and Sleep Disturbance in Children: Reliability and Validity of the Dutch Version of the Child Sleep Habits Questionnaire. Sleep. 2010; 33(6): 841-845
  12. Lucas-de la Cruz L, Martínez-Vizcaino V, Álvarez-Bueno C, Arias-Palencia N, Sánchez-López M, Notario-Pacheco B. Reliability and validity of the Spanish version of the Children's Sleep Habits Questionnaire (CSHQ-SP) in school-age children. Child: Care, Health and Development. 2016; 42: 675–682
  13. Mavroudi A, Chrysochoou E-A, Boyle RJ, Trypsianis G, Xinias I, Cassimos D, Imvrios G, Katatomichelakis M, Karagiannidou A, Karantaglis N, Kourentas G, Warner JO. Validation of the Children's Sleep Habits Questionnaire in a sample of Greek children with allergic rhinitis. Allergologia et Immunopathologia. 2018; 46(4): 389-393
  14. Hartini S, Sunartini HSE. Item analysis and internal consistency of children's sleep habits questionnaire (CSHQ) in Indonesion version. Belitung Nursing Journal. 2017; 3(6): 645-655
  15. Lionetti F, Dellagiulia A, Verderame C, Sperati A, Bodale G, Spinelli M, Fasolo M. The Children's Sleep Habits Questionnaire: Identification of sleep dimensions, normative values, and associations with behavioral problems in Italian preschoolers. Sleep Health. 2021; 7(3): 390-396
  16. Fallahzadeh H, Etesam F, Asgarian FS. Validity and reliability related to the Persian version of the Children's Sleep Habits Questionnaire. Sleep Bilogical Rhythms. 2015; 13: 271-278
  17. Ishii R, Obara H, Nagamitsu S, Matsuoka M, Suda M, Yuge K, Inoue T, Sakuta R, Oka Y, Kakuma T, Matsuishi T, Yamashita Y. The Japanese version of the children's sleep habits questionnaire (CSHQ-J): A validation study and influencing factors. Brain and Development. 2022; 44(9): 595-604