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Chen P, Lam MI, Si TL, Zhang L, Balbuena L, Su Z, Cheung T, Ungvari GS, Sha S, Xiang YT. The prevalence of poor sleep quality in the general population in China: a meta-analysis of epidemiological studies. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01764-5. [PMID: 38429554 DOI: 10.1007/s00406-024-01764-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/13/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The high prevalence of poor sleep quality (PSQ) in the general population leads to negative health outcomes. Since estimates of PSQ prevalence in the Chinese general population vary widely, this meta-analysis aimed to refine these estimates and to identify moderating factors. METHODS A comprehensive literature search was undertaken in both international (PubMed, PsycINFO, Web of Science, and EMBASE) and Chinese (Wanfang, and the China National Knowledge Infrastructure databases) databases from inception to 23 November 2023. Studies were required to have used standard scales such as the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). The pooled prevalence of PSQ and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup and meta-regression analyses were performed to identify sources of heterogeneity. RESULTS In 32 studies with a combined 376,824 participants, the pooled prevalence of PSQ was 19.0% (95% CI 15.8-22.8%; range 6.6-43.6%). Across 22 studies that reported PSQI data, the pooled mean score was 4.32 (95%CI 3.82-4.81; SD = 0.502). The pooled mean sleep duration across 8 studies was 7.62 (95% CI 7.23-8.00; SD = 0.194) hours. Subgroup analyses showed that lower education (Q = 4.12, P = 0.042), living in less developed regions (Q = 60.28, P < 0.001), and lower PSQI cutoff values (Q = 9.80, P = 0.007) were significantly associated with PSQ. Meta-regression analyses showed that study quality was inversely associated with estimated PSQ prevalence (β = - 0.442, P = 0.004). LIMITATIONS Although measures such as subgroup and meta-regression analyses were performed, substantial heterogeneity remained. Information related to sleep quality, such as comorbid physical diseases or psychiatric disorders, substance use, occupational types, and employment status, were not reported in most studies. CONCLUSION One in five people in the general population of China may have PSQ and people with lower education or living in western regions may be more susceptible.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- Psychiatry Section, University of Notre Dame Australia, Fremantle, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Liu J, Ji X, Rovit E, Pitt S, Lipman T. Childhood sleep: assessments, risk factors, and potential mechanisms. World J Pediatr 2024; 20:105-121. [PMID: 36441394 PMCID: PMC9702880 DOI: 10.1007/s12519-022-00628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep problem is a highly prevalent health issue among pediatric populations across the world. In this review, we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in children. Potential biological, psychosocial, and environmental mechanisms as well as research gaps in the literature are also discussed. DATA SOURCES A comprehensive search for relevant English language full-text, peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed, SCOPUS, and Psych Info. Both relevant data based and systematic reviews are included. RESULTS This paper summarizes many risk factors for childhood sleep problems, including biological (e.g., genetics, gender, age and puberty, prenatal factors, postnatal factors); nutritional (e.g., macronutrients, micronutrients, omega-3 fatty acids, obesity); environmental (e.g., heavy metals, noise, light, air pollution); interpersonal (e.g., family, exposure to violence, screen media use, physical injury); and community/socioeconomic variables (e.g., racial/ethnicity and cultural factors, neighborhood conditions and socioeconomic status, school factors, public health disasters/emergencies), to better understand the development of sleep problems in children. CONCLUSIONS Poor childhood sleep is a multifactorial issue affected by a wide range of prenatal and early-life biological, environmental, and psychosocial risk factors and contributors. A better understanding of these risk factors and their mechanisms is an important first step to develop future research and prevention programs focusing on pediatric sleep problems.
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Affiliation(s)
- Jianghong Liu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA.
| | - Xiaopeng Ji
- School of Nursing, College of Health Sciences, University of Delaware, Newark, DE, 19716, USA
| | - Elizabeth Rovit
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
| | - Susannah Pitt
- Geisinger Commonwealth School of Medicine, Scranton, PA, 18510, USA
| | - Terri Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
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Pham C, Desmarais E, Jones V, French BF, Wang Z, Putnam S, Casalin S, Linhares MBM, Lecannelier F, Tuovinen S, Heinonen K, Raikkonen K, Montirosso R, Giusti L, Park SY, Han SY, Lee EG, Huitron B, de Weerth C, Beijers R, Majdandžić M, Gonzalez-Salinas C, Acar I, Slobodskaya H, Kozlova E, Ahmetoglu E, Benga O, Gartstein MA. Relations between bedtime parenting behaviors and temperament across 14 cultures. Front Psychol 2022; 13:1004082. [PMID: 36507001 PMCID: PMC9731114 DOI: 10.3389/fpsyg.2022.1004082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives The present study examined parental sleep-supporting practices during toddlerhood in relation to temperament across 14 cultures. We hypothesized that passive sleep-supporting techniques (e.g., talking, cuddling), but not active techniques (e.g., walking, doing an activity together), would be associated with less challenging temperament profiles: higher Surgency (SUR) and Effortful Control (EC) and lower Negative Emotionality (NE), with fine-grained dimensions exhibiting relationships consistent with their overarching factors (e.g., parallel passive sleep-supporting approach effects for dimensions of NE). Methods Caregivers (N = 841) across 14 cultures (M = 61 families per site) reported toddler (between 17 and 40 months of age; 52% male) temperament and sleep-supporting activities. Utilizing linear multilevel regression models and group-mean centering procedures, we assessed the role of between- and within-cultural variance in sleep-supporting practices in relation to temperament. Results Both within-and between-culture differences in passive sleep-supporting techniques were associated with temperament attributes, (e.g., lower NE at the between-culture level; higher within-culture EC). For active techniques only within-culture effects were significant (e.g., demonstrating a positive association with NE). Adding sleep-supporting behaviors to the regression models accounted for significantly more between-culture temperament variance than child age and gender alone. Conclusion Hypotheses were largely supported. Findings suggest parental sleep practices could be potential targets for interventions to mitigate risk posed by challenging temperament profiles (e.g., reducing active techniques that are associated with greater distress proneness and NE).
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Affiliation(s)
- Christie Pham
- Department of Psychology, Washington State University, Pullman, WA, United States,*Correspondence: Christie Pham,
| | - Eric Desmarais
- Department of Psychology, Washington State University, Pullman, WA, United States
| | - Victoria Jones
- Department of Psychology, Washington State University, Pullman, WA, United States
| | - Brian F. French
- College of Education, Washington State University, Pullman, WA, United States
| | - Zhengyan Wang
- College of Psychology, Capital Normal University, Beijing, China
| | | | - Sara Casalin
- Department of Psychology, University of Leuven, Leuven, Belgium
| | | | | | - Soile Tuovinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland,Department of Social Sciences, University of Tampere, Tampere, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland,Department of Social Sciences, University of Tampere, Tampere, Finland
| | - Katri Raikkonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Rosario Montirosso
- 0-3 Centre for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Lorenzo Giusti
- 0-3 Centre for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Seong-Yeon Park
- Department of Child Development, Ewha Woman’s University, Seoul, South Korea
| | - Sae-Young Han
- Department of Child Development, Ewha Woman’s University, Seoul, South Korea
| | - Eun Gyoung Lee
- Department of Child Development, Ewha Woman’s University, Seoul, South Korea,Ewha Social Science Research Institute, Seoul, South Korea
| | - Blanca Huitron
- Department of Psychology, National Autonomous University of Mexico, México City, Mexico
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Roseriet Beijers
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands,Department of Developmental Psychology, Radboud University, Nijmegen, Netherlands
| | - Mirjana Majdandžić
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | | | - Ibrahim Acar
- Department of Psychology, Özyeğin University, Istanbul, Turkey
| | - Helena Slobodskaya
- Research Institute of Neuroscience and Medicine, Novosibirsk State University, Novosibirsk, Russia
| | - Elena Kozlova
- Research Institute of Neuroscience and Medicine, Novosibirsk State University, Novosibirsk, Russia
| | - Emine Ahmetoglu
- Department of Early Childhood Education, Trakya University in Edirne, Edirne, Turkey
| | - Oana Benga
- Department of Psychology, Babes Bolyai University, Cluj-Napoca, Romania
| | - Maria A. Gartstein
- Department of Psychology, Washington State University, Pullman, WA, United States
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