Variables in Child Sleep Habit Questionnaire (CSHQ) |
Question# |
Question |
Field name |
Response nature |
Response options |
1 |
Participant
ID |
PID |
### |
|
2 |
Child
ID |
csq_A |
9### |
|
3 |
Initials
of the child |
csq_B |
XX |
|
4 |
Researcher's
code |
csq_C |
## |
|
5 |
Date
of interview |
csq_D |
##-XXX-## |
dd-mmm-yy |
6 |
Age
of the child |
csq_E |
## |
|
|
Bedtime |
|
|
|
7 |
Weeknights…………../………am/pm |
|
##:## |
hh:mm |
8 |
Weekends…………../………
am/pm |
|
##:## |
hh:mm |
9 |
Child goes to bed at
the same time at night. |
csq_1 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
10 |
Child falls asleep
within 20 minutes after going to bed. |
csq_2 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
11 |
Child falls asleep
alone in own bed. |
csq_3 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
12 |
Child falls asleep
in parent’s or sibling’s bed |
csq_4 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
13 |
Child falls asleep
with rocking or rhythmic movements. |
csq_5 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
14 |
Child needs special
objects to fall asleep (doll, special blanket, stuffed animals, etc). |
csq_6 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
15 |
Child needs parent
in the room to fall asleep. |
csq_7 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
16 |
Child resists going
to bed at bedtime. |
csq_8 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
17 |
Child is afraid of
sleeping in the dark. |
csq_9 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
|
Sleep behavior |
|
|
|
18 |
Write in your
child’s usual amount of sleep each day (combining nighttime sleep and naps)
……..hours and…….minutes |
|
##:## |
hh:mm |
19 |
Child sleeps about
the same amount each day. |
csq_10 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
20 |
Child is restless
and moves a lot during sleep. |
csq_11 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
21 |
Child moves to
someone else’s bed during the night (parents, siblings, etc). |
csq_12 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
22 |
Child grinds teeth
during sleep (your dentist may have
told you this). |
csq_13 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
23 |
Child snores
loudly. |
csq_14 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
24 |
Child awakens during
night screaming, sweating, and inconsolable. |
csq_15 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
25 |
Child naps during
the day. |
csq_16 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
|
|
|
|
|
26 |
Child wakes up once
during the night. |
csq_17 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
27 |
Child wakes up more
than once during the night. |
csq_18 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
|
Morning wakeup time |
|
|
|
|
Write in the time
child usually wakes up in the morning : |
|
|
|
28 |
Weekdays……../………am/pm |
|
##:## |
hh:mm |
29 |
Weekends……./………am/pm |
|
##:## |
hh:mm |
30 |
Child wakes up by
him/herself. |
csq_19 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
31 |
Child wakes up very
early in the morning (or, earlier than necessary or desired). |
csq_20 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
32 |
Child seems tired
during day time. |
csq_21 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
33 |
Child falls asleep
while involved in activities. |
csq_22 |
# |
1=Always,
2=Usually, 3=Sometimes, 4=Rarely, 5=Never |
34 |
Remarks: |
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TXT |
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