Objective To investigate sleep status of infants and toddlers in Changde, Hunan Province, so as to provide scientific evidence for promoting their sleep health.

Methods A total of 5 027 infants and toddlers aged 0 – 36 months who received routine health check from 8 maternal and child health care institutions at county level and 4 community health service centers in Wuling District, Changde, Hunan Province were recruited from May to October 2022. A questionnaire survey was conducted through caregiver to investigate sleep status among infants and toddlers.

Results A total of 5 027 questionnaires were distributed and 4 894 valid questionnaires were collected, including 2 498 males and 2 396 females, with an average age of 10.7 months. The biggest proportion of infants (75.6%) who slept with their parents fell was within the age range of 4 to 11 months, and supine position was predominant(49.5%). Infants aged 0 – 3 months and 4 – 11 months had longer daytime and full day sleep period than those of 12 – 23 months and 24 – 36 months toddlers (all P < 0.05). Among toddlers aged 24 to 36 months, 50.1% experienced a sleep latency greater than 20 minutes. After the development of the circadian rhythm, infants aged 4 – 11 months had more nocturnal awakenings times than those of infants and toddlers of other ages, with an average nocturnal awakening period of (20.7 ± 18.5) minutes. Infants and toddlers of different ages had different ways of initiating sleep. Sleep initiation patterns were different among infants and toddlers of various month-old. Infants of 0 – 3 and 4 – 11 month-old mainly relied on feeding to initiate sleep, while those aged 12 – 23 months and 24 – 36 months were predominantly accompanied by their parents. Bedtime tended to become progressively later with increasing age, with 80.0% of toddlers aged 24 to 36 months going to bed after 21∶ 00.

Conclusion The sleep habits of infants and toddlers aged 0 – 36 months in Changde, Hunan Province need to be improved. The main problems are long sleep latency at night, going to bed late at night, and insufficient total sleep time. It is necessary to raise caregivers’ awareness of fostering good sleeping habits among infants and toddlers in order to improve their sleep quality.