Objective To analyze the associations between paternal and maternal emotional symptoms and sleep disturbances in Chinese preschoolers, providing evidence for the prevention and control of childhood sleep disturbances.

Methods From September to October 2024, a multi-stage random sampling method was used to recruit 3 749 children from 12 kindergartens in Hefei city, Anhui province. Parents completed emotional self-rating scales, while mothers provided information on household characteristics and children′s sleep disturbances. Parent-child data were linked, and multivariate logistic regression models were established to examine the associations between paternal and maternal emotional symptoms and sleep disturbances in preschoolers.

Results The prevalence of sleep disturbances among preschoolers was 4.11%. Paternal and maternal symptoms of anxiety, depression, and stress were all associated with an increased risk of sleep disturbances in preschoolers (P < 0.001 for all). Co-exposure to paternal and maternal negative emotional symptoms further elevated the risk of sleep disturbances (P < 0.001). With no paternal or maternal anxiety as the reference group, regression analysis suggested increased risk of sleep disturbances for boys in the groups of no paternal anxiety and maternal anxiety (OR = 6.87, 95%CI: 4.07–11.59) and both paternal anxiety and maternal anxiety (OR=8.80, 95%CI: 3.87–20.01). For girls, elevated risks were observed in the groups of paternal anxiety and no maternal anxiety (OR = 5.01, 95%CI: 2.44–10.29), no paternal anxiety and maternal anxiety (OR = 7.57, 95%CI: 4.21–13.61), and both paternal anxiety and maternal anxiety (OR = 12.56, 95%CI: 5.11–30.90). With no paternal or maternal depression as reference, boys demonstrated higher risk of sleep disturbances in the groups of no paternal depression and maternal depression (OR = 5.26, 95%CI: 3.03–9.11) and both paternal depression and maternal depression (OR = 8.39, 95%CI: 3.17-22.22). Among girls, increased risks were found in the groups of paternal depression and no maternal depression (OR = 2.52, 95%CI: 1.02-6.22), no paternal depression and maternal depression (OR = 3.30, 95%CI: 1.74–6.27), and both paternal depression and maternal depression (OR = 19.99, 95%CI: 8.68–46.05). With no paternal or maternal stress as reference, regression analysis indicated elevated risk of sleep disturbances for boys in the groups of no paternal stress and maternal stress (OR = 5.75, 95%CI: 3.19–10.36) and both paternal stress and maternal stress (OR = 12.19, 95%CI: 3.05–48.65). For girls, higher risks were observed in the groups of paternal stress and no maternal stress (OR = 4.28, 95%CI: 2.04–8.96), no paternal stress and maternal stress (OR = 2.78, 95%CI: 1.35–5.69), and both paternal stress and maternal stress (OR = 14.09, 95%CI: 3.89–51.10).

Conclusions Paternal and maternal negative emotional symptoms are associated with an increased risk of sleep disturbances in preschoolers. Special attention should be paid to children whose mothers exhibit negative emotional symptoms and those with both parents affected, particularly to girls.