Caregiver health literacy, sleep practices, and child sleep outcomes in Thai children aged 3-12 years: a cross-sectional study.

Health literacy (HL) enables individuals to make informed decisions and manage their well-being. Although studies have examined caregiver HL and child outcomes, research in Thailand is limited, particularly regarding its impact on child sleep. This study investigates the associations among caregiver HL, their expectations of child sleep, and sleep hygiene in relation to child sleep outcomes. From January 2024 to October 2024, a cross-sectional study was conducted among caregivers of children aged 3-12 years. Data on caregiver HL, expectations of child sleep, sleep quality, sleep hygiene, and child sleep outcomes were collected using the Thai Health Literacy Scales (Thai-HLS), Pittsburgh Sleep Quality Index, Sleep Hygiene Index, and Children's Sleep Habits Questionnaire (CSHQ). Multiple linear regression analysis examined these associations. Among 215 participants (182 mothers), 89.8% had at least a bachelor's degree. Although caregiver HL was not associated with total sleep disturbances on the CSHQ, the communication and social support domain of the Thai-HLS was negatively correlated with child sleep duration problems (β = -0.17, p = 0.003). Caregiver's expectations of appropriate sleep duration for their child's age were associated with fewer total sleep disturbances. Poor caregiver sleep hygiene was associated with poorer sleep quality (β = 0.430, p < 0.001), while better self-management of health, another HL component, was related to better caregiver sleep quality.

conclusionsHigher caregiver HL, particularly in communication, social support, and self-management, was associated with fewer child sleep duration problems and better caregiver sleep quality. Higher levels of these HL components may be associated with more favorable family sleep health. WHAT IS KNOWN: • Main caregiver health literacy is a key determinant of children's health outcomes, including sleep patterns. • Research indicates that lower main caregiver health literacy is associated with greater difficulties in children's sleep habits, such as increased sleep disturbances and shorter sleep durations. WHAT IS NEW: • Higher main caregiver health literacy, particularly in communication, social support, and self-management, was associated with fewer child sleep duration problems and better main caregiver sleep quality. • Main caregivers who had accurate expectations of appropriate sleep duration for their child's age reported fewer total sleep disturbances. • These findings emphasize the need to integrate health literacy into child healthcare programs, with a strong focus on sleep education, to support family sleep health.