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Wang Z, Tang Y, Ordway M, Cui N, Rong T, Deng Y, Li W, Liu J, Zhao M, Jiang F, Wang G. The time sensitive and dose-responsive association between parental corporal punishment and sleep disturbances in preschoolers: A prospective cohort study. CHILD ABUSE & NEGLECT 2024; 154:106866. [PMID: 38852431 DOI: 10.1016/j.chiabu.2024.106866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/03/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND To examine whether parental corporal punishment is associated with increased risk of concurrent and later sleep disturbances among preschoolers, and whether the association is time-sensitive or dose-responsive. METHODS This 3-year prospective cohort study used data from the Shanghai Children's Health, Education and Lifestyle Evaluation, Preschool(SCHEDULE-P). Participants were newly enrolled preschoolers in November 2016(wave 1) and followed up in April 2018(wave 2) and April 2019(wave 3). Parents reported the children's corporal punishment experiences and sleep disturbances at each wave survey. Children's risk of sleep disturbances in relation to corporal punishment was examined using logistic regression, adjusting for children's age, gender, emotional/behavioral problems, family annual income, and maternal educational level. RESULTS The participants of 19,668 children included 9436(47.98 %) females, with a mean age of 3.73(SD = 0.29) years at wave 1. Exposure to corporal punishment was associated with increased odds of concurrent sleep disturbances at wave 1, 2, and 3 (aOR,1.57; 95 % CI, 1.40-1.75; P < .001; aOR,1.60; 95 % CI, 1.43-1.80; P < .001; aOR,1.74; 95 % CI, 1.54-1.95; P < .001), respectively. Exposure to corporal punishment at any wave of preschool was associated with increased odds of sleep disturbances at wave 3, and the risks were greater for proximal and accumulative corporal punishment exposure. CONCLUSION There is a time-sensitive and dose-responsive association between corporal punishment and sleep disturbance among preschoolers, with greater risk of sleep disturbances for proximal and accumulative exposure of corporal punishment. Promoting positive parenting strategies and avoiding corporal punishment can be a promising strategy to prevent and intervene sleep disturbances in preschoolers.
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Affiliation(s)
- Zijing Wang
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yijia Tang
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Monica Ordway
- Yale School of Nursing, West Haven, CT., United States
| | - Naixue Cui
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Tingyu Rong
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou, China
| | - Yujiao Deng
- Department of Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wen Li
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jieqiong Liu
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China
| | - Fan Jiang
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
| | - Guanghai Wang
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
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Sun J, Lu R, Sun W, Deng Y, Liu J, Jiang Y, Zhu Q, Xu H, Wang G, Jiang F. Sleep problems and duration in school-aged children at different levels of giftedness. Sleep Med 2024; 122:8-13. [PMID: 39098120 DOI: 10.1016/j.sleep.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/27/2024] [Accepted: 07/24/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES Optimal sleep is crucial for developing and maintaining gifted children's cognitive abilities. However, only a few studies have explored the sleep profiles of gifted children and overlooked their internal variations. This study aimed to investigate subjective and object sleep profiles in school-aged gifted children with different levels of giftedness. METHODS This study included 80 school-aged children (50 % male) aged 6-11 years. Giftedness was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). Subjective and objective sleep were evaluated using the Children's Sleep Habits Questionnaire (CSHQ) and Actiwatch 2. RESULTS The sample was divided into three groups based on their full scale intelligence quotient (IQ): 16 typically developing children (IQ < 130), 38 moderately gifted children (IQ: 130-145), and 26 highly gifted children (IQ > 145). The highly gifted children had the mildest sleep problems, particularly in sleep duration and daytime sleepiness. Moderately gifted children had the shortest subjective average sleep duration, while the three groups had no significant differences in Actiwatch-measured sleep variables. Furthermore, CSHQ total and daytime sleepiness subscale scores were negatively associated with the full scale IQ in gifted children after controlling for confounders including emotional and behavioral problems. CONCLUSIONS Children with higher levels of giftedness experience fewer subjective sleep problems but have similar objective sleep parameters. It is imperative to implement tailored sleep strategies for fostering intellectual development and nurturing young talents.
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Affiliation(s)
- Jiumo Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ruping Lu
- Shanghai Experimental School, Shanghai, China; Faculty of Education, Beijing Normal University, Beijing, China
| | - Wanqi Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujiao Deng
- Department of Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jieqiong Liu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Xu
- Shanghai Experimental School, Shanghai, China.
| | - Guanghai Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
| | - Fan Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
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Kaur N, Vetter C, Konrad M, Kostev K. Investigation of the Association between Sleep Disorders with Subsequent Depression in Children and Adolescents-A Retrospective Cohort Study with 62,796 Patients. CHILDREN (BASEL, SWITZERLAND) 2024; 11:758. [PMID: 39062208 PMCID: PMC11275199 DOI: 10.3390/children11070758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/08/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Poor quality of sleep is a widespread issue in modern society, and even children are being diagnosed with sleep disorders nowadays. Sleep disruption in children can lead to poor mental health in the long term. The present study aimed to evaluate the association between sleep disorders and subsequent depression in children and adolescents. METHODS This retrospective cohort study used electronic medical records from the IQVIATM Disease Analyzer database. It included children and adolescents aged 6-16 with an initial diagnosis of a sleep disorder and age- and gender-matched patients without sleep disorders treated by one of 274 office-based pediatricians in Germany between January 2010 and December 2022. The five-year cumulative incidence of depression in the cohorts with and without sleep disorders was studied with Kaplan-Meier curves using the log-rank test. Multivariable Cox regression analyses were used to assess the association between sleep disorders and depression. RESULTS The present study included 10,466 children and adolescents with and 52,330 without sleep disorder diagnosis (mean age 10 ± 3 years, 48% female). Within five years after the index date, 5% of sleep disorder patients and 2% of the matched non-sleep disorder cohort had been diagnosed with depression. A strong and significant association was observed between sleep disorders and subsequent depression (HR: 2.34; 95% CI: 2.09-2.63). This association was stronger in adolescents (HR: 3.78; 95% CI: 3.13-4.56) than in children. Upon the exclusion of depression diagnoses in the first year after the index date, the association between sleep disorders and depression remained strong and significant (HR: 1.92; 95% CI: 1.68-2.19). CONCLUSIONS This study indicates a strong and significant association between sleep disorders and depression.
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Affiliation(s)
- Nimran Kaur
- Epidemiology, IQVIA, Bangalore 560 103, India
| | - Céline Vetter
- Epidemiology, IQVIA, 60549 Frankfurt am Main, Germany
| | - Marcel Konrad
- Health & Social, FOM University of Applied Sciences for Economics and Management, 60486 Frankfurt am Main, Germany
| | - Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt am Main, Germany
- University Clinic, Philipps-University, 35043 Marburg, Germany
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AlBishi L, Alkhuraisi LS, Alqahtani MM, Alatawi WL, Alghabban AT, Anazi MH, Aljohani HA, Asseiri RA. Obstructive Sleep Apnea Among Obese Children in Tabuk City, Saudi Arabia. Cureus 2024; 16:e58714. [PMID: 38779289 PMCID: PMC11110102 DOI: 10.7759/cureus.58714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Obstructive sleep apnea (OSA) is prevalent among children, impacting their well-being. Obesity and related morbidity may lead to serious health disorders. In obese children, OSA may be a risk factor for systemic diseases that negatively affect their quality of life. This study explored the correlation between obesity and OSA among children aged five to 14 years in Tabuk, Saudi Arabia. Methods This cross-sectional study employed an online questionnaire for the parents of 517 children, assessing sociodemographic variables, medical history, and OSA symptoms. The data analysis used Statistical Product and Service Solutions (SPSS; IBM SPSS Statistics for Windows, Armonk, NY) software, employing descriptive and inferential statistics. Results The children were predominantly male (281, 54.4%) and from Tabuk (405, 78.3%), with 158 (30.6%) classified as obese. Symptoms such as snoring (191, 36.9%), daytime fatigue (195, 37.7%), and impact on daily activities (79, 15.3%) were prevalent. OSA scores significantly correlated with BMI categories (p < 0.001), family history of OSA (p < 0.001), and medical conditions including diabetes, hypertension, and high cholesterol (p < 0.05). Correlations showed weak positive associations of age (ρ = 0.159) and height (ρ = 0.229) with OSA score, whereas a strong correlation existed between weight (ρ = 0.531) and OSA score (p < 0.001). Conclusion Obesity demonstrated a strong association with OSA severity among children in Tabuk. Higher BMI categories, a family history of OSA, and certain medical conditions correlated significantly with increased OSA scores. Although age and height displayed weaker associations, weight emerged as a major contributing factor to OSA severity. These findings emphasize the importance of addressing obesity in managing pediatric OSA, advocating for early interventions to mitigate its impact on children's health and well-being.
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Rojo-Wissar DM, Acosta J, DiMarzio K, Hare M, Dale CF, Sanders W, Parent JM. The role of sleep in prospective associations between parent reported youth screen media activity and behavioral health. Child Adolesc Ment Health 2024; 29:33-42. [PMID: 37431157 PMCID: PMC11184563 DOI: 10.1111/camh.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. METHOD Parents completed questions about their child (N = 564) ages 3-17 at Wave 1, Wave 2 (4-8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. RESULTS SMA was significantly associated with greater sleep disturbance, β = .11, 95% CI [.01, .21] and shorter sleep duration, β = -.16 [-.25, -.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, β = .14 [.04, .24], externalizing, B = .23 [.12, .33], attention, β = .24 [.15, .34], and peer problems, β = .25 [.15, .35]. Longer sleep duration was associated with more externalizing, β = .13 [.04, .21], and attention problems, β = .12 [.02, .22], and fewer peer problems, β = -.09 [-.17, -.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, β = -.15 [-.23, -.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. CONCLUSIONS Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use.
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Affiliation(s)
- Darlynn M Rojo-Wissar
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, Providence, RI, USA
- E.P. Bradley Hospital Sleep Research Laboratory, Providence, RI, USA
| | - Juliana Acosta
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Megan Hare
- Florida International University, Miami, FL, USA
| | | | - Wesley Sanders
- Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Justin M Parent
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, Providence, RI, USA
- E.P. Bradley Hospital Sleep Research Laboratory, Providence, RI, USA
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Fulfs T, Poulain T, Vogel M, Nenoff K, Kiess W. Associations between sleep problems and emotional/behavioural difficulties in healthy children and adolescents. BMC Pediatr 2024; 24:15. [PMID: 38183087 PMCID: PMC10768421 DOI: 10.1186/s12887-023-04487-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/14/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study aimed to (1) characterise sleep disturbances and emotional/behavioural difficulties among healthy German children and adolescents aged 3 to 13 years, (2) examine the association between parent-reported sleep problems and emotional/behavioural difficulties, (3) point out possible relations between specific kinds of sleep disturbances and different behavioural difficulties. METHODS Data were collected between 2011 and 2015 within the LIFE Child study in Germany. The sample included 1101 3- to 13-year-old children and adolescents. Information on sleep disturbances-assessed via the Children's Sleep Habits Questionnaire (CSHQ), emotional/behavioural difficulties-assessed via the Strengths and Difficulties Questionnaire (SDQ), and socioeconomic status was provided by participants' parents. Multiple regressions were applied to analyse the associations between general and specific sleep disturbances (independent variables) and emotional/behavioural difficulties (dependent variables). RESULTS The total CSHQ score was positively associated with the total SDQ score and all SDQ subscales (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems). Most of the CSHQ subscales were related to SDQ subscale scores, except for a few non-significant relations with hyperactivity/inattention and conduct problems. The CSHQ total score, daytime sleepiness, sleep duration and parasomnias showed the strongest associations with the SDQ total score. CONCLUSION This study confirms an association between children's and adolescents' sleep habits and psychological health. We were able to demonstrate the association between sleep problems and emotional/behavioural difficulties in a large sample of healthy participants. In particular, we observed a significant relation between parasomnias and hyperactive/inattentive behaviour as well as a significant association between emotional problems and sleep problems, especially daytime sleepiness, sleep anxiety and parasomnias.
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Affiliation(s)
- Theresa Fulfs
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.
| | - Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Kolja Nenoff
- Medical Department for Hematology, Cell Therapy and Hemostaseology, Leipzig University, Liebigstrasse. 20/22, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
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Leung TNH, Wong KL, Chan AKC, Li AM. Common Childhood Sleep Problems and Disorders. Curr Pediatr Rev 2024; 20:27-42. [PMID: 36043722 DOI: 10.2174/1573396318666220827102018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sleep insufficiency and disturbances affect the physical, cognitive, and emotional well-being of children. OBJECTIVE To perform a narrative review on common sleep problems and disorders encountered in primary care for children and adolescents. METHODS A search of English literature in the Pubmed and Google Scholar databases published from 1 January 2000 till 31 October 2021 was conducted with the keywords "sleep problem" or "sleep disorder" and "child" or "adolescent". Findings in the relevant articles and cross-references were compiled. RESULTS Sleep duration and habits of children vary widely across countries with different cultural backgrounds. There is robust evidence to support the promotion of positive bedtime routines and sleep hygiene as prevention and management of sleep problems. 15-70% of parents reported their children having sleep problems or disturbances. Common sleep complaints include difficulty in initiation or maintenance of sleep, abnormal behaviors or movements, snoring or abnormal breathing, and excessive daytime sleepiness. Comprehensive sleep history and a sleep diary are the first steps for evaluation. Home video and actigraphy may be used as preliminary tools to confirm the history. Referrals to a sleep specialist for polysomnography and other tests are needed, if suspecting specific sleep disorders, such as obstructive sleep apnea and narcolepsy, needs timely intervention. Common sleep disorders in different age groups encountered in primary care are reviewed with clinical features, indications for evaluation, and treatment options summarized. CONCLUSION Screening for sleep problems shall be an integral part of each child's health care visit. It is important to evaluate the impact of common sleep problems and identify specific sleep disorders for early intervention to prevent long-term adverse outcomes.
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Affiliation(s)
- Theresa Ngan Ho Leung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Kin Lok Wong
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Anthony Kam Chuen Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
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Bao R, Yang Z, Memon AR, Chen S, Wang L, Cai Y. Association between meeting the 24-h movement guidelines and psychosocial health in children: A cross-sectional study. Child Care Health Dev 2024; 50:e13191. [PMID: 37899718 DOI: 10.1111/cch.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/19/2023] [Accepted: 10/08/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE Emerging evidence suggests that meeting the 24-h movement guidelines is associated with optimal mental health. However, there remains some uncertainty regarding this association in children. Therefore, this study aimed to examine the association between meeting the 24-h movement guidelines and psychosocial health in children. METHODS A cross-sectional study design was employed to investigate 2005 children aged 9-12 years from four districts of Shanghai, China. The 24-h movement behaviours were assessed using selected items from the Health Behaviour in School-aged Children (HBSC) survey questionnaire. Children's self-rated psychosocial health was evaluated using the Strengths or Difficulties Questionnaire (SDQ). Generalised Linear Models with the ordinal logistic module were employed to analyse the association between meeting the 24-h movement guidelines and psychosocial health. RESULTS The overall prevalence of meeting all three 24-h movement recommendations was 10.2%. Among children, 7.9% of them exhibited abnormal total difficulties, with a notable difference between sex (boys: 11.2%, girls: 7.0%, p = 0.001). Meeting all three 24-h movement behaviour recommendations was associated with reduced total difficulties, emotional symptoms, conduct problems, hyperactivity and peer problems. Furthermore, a dose-response association was observed, indicating that meeting a greater number of 24-h movement behaviour recommendations was associated with enhanced psychosocial health, particularly in boys. CONCLUSION The findings of this study highlight the positive association between meeting the 24-h movement guidelines and psychosocial health in children. Notably, meeting more of these recommendations was associated with a lower likelihood of experiencing psychosocial problems, with greater benefits observed in boys compared with girls.
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Affiliation(s)
- Ran Bao
- Centre for Active Living and Learning, University of Newcastle, Callaghan, New South Wales, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, New South Wales, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Zhen Yang
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Aamir Raoof Memon
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Sitong Chen
- Centre for Mental Health, Shenzhen University, Shenzhen, China
| | - Lei Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Yujun Cai
- School of Physical Education, Shanghai University of Sport, Shanghai, China
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Chung WL, Kyriaki L, Arciuli J. Associations between sleep, reading, and mathematics in Taiwanese children. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2023; 93:694-711. [PMID: 36760081 DOI: 10.1111/bjep.12586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/26/2022] [Accepted: 01/06/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Some research shows a link between sleep behaviours and school achievement in English-speaking children and adolescents. AIMS The current study aimed to examine the relationship between children's sleep behaviours and aspects of their school achievement in Mandarin-speaking children who are living in Taiwan. SAMPLE The present study reports on 69 second-grade children (age range = 6.84-8.4 years) recruited in Taipei City, Taiwan. METHODS Children's sleep behaviours were assessed through two standardized parent self-report questionnaires: the Children's Sleep Habits Questionnaire (CSHQ) and the Sleep Disturbance Scale for Children (SDSC). Children undertook three standardized tests of word reading, reading comprehension and math. RESULTS Key findings include: (i) sleep disturbances are more prevalent when using the CSHQ scale than the SDSC scale, (ii) around half of second graders struggle with general sleep disturbances as observed by the CSHQ scale, (iii) children who go to bed before 22:00 and have at least 9-h sleep tend to exhibit fewer sleep disturbances, (iv) parasomnias as measured by the CSHQ are negatively correlated with reading comprehension after controlling age and nonverbal IQ, and (v) the amount of sleep (naps) during daytime is negatively correlated with Chinese character recognition, reading comprehension and math after controlling age and nonverbal IQ. CONCLUSIONS There is growing awareness of the value of research that spans culturally and linguistically diverse populations. Our study contributes to ongoing discussions about the relationship between sleep, and skills in reading and math in school-aged children in Taiwan.
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Affiliation(s)
- Wei-Lun Chung
- Department of Special Education, National Taipei University of Education, Taipei, Taiwan
| | - Louise Kyriaki
- Caring Futures Institute, College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Joanne Arciuli
- Caring Futures Institute, College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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Gao Y, Xu P, Aizetiguli M, Surong S, Zhu Z, Zhang J. Prevalence and influencing factors of sleep disorders among preschool children in Urumqi city: a cross-sectional survey. Ital J Pediatr 2023; 49:68. [PMID: 37287043 DOI: 10.1186/s13052-023-01477-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Sleep disorders refer to physiological and psychological states that cause adverse consequences due to the inability to fall asleep or poor sleep quality. The prevalence of sleep disorders varies greatly in different countries and regions due to different causes. This study aimed to investigate the prevalence and influencing factors of sleep disorders among preschool children in Urumqi city, China. METHODS A cross-sectional study was conducted with stratified random cluster sampling. Children aged 3-6 years old in one kindergarten randomly selected from each of the 8 districts of Urumqi from March to July 2022, and their parents were surveyed with a sleep quality questionnaire. RESULTS The prevalence of sleep disorders among preschool children in Urumqi was 14.29% (191/1336), and the prevalence of different symptoms was 42.81% for limb movements, 19.61% for snoring, 18.11% for bruxism, 16.39% for sleep talking, 12.57% for sweating, 11.60% for nocturnal awakening, 8.46% for nightmares, 6.89% for bed wetting, 3.74% for apnea, and 3.29% for sleepwalking. The prevalence of body movements, snoring, sweating, night-wake, nightmares, bed-wetting, apnea, and sleepwalking among different ethnicities were significantly different (P < 0.05). Multivariate analysis revealed that the major risk factors of sleep disorders were difficulty adapting to new environments, unwillingness to express emotions, inconsistent attitudes of the family toward children's education, running before bedtime, strict family education methods, etc. CONCLUSION: The prevalence of sleep disorders in preschool children in Urumqi is lower than the average level reported in other studies. Many factors affect the prevalence of sleep disorders in preschool children, but it is necessary to focus on the ability to adapt to new environments, psychological problems, and the impact of family education on sleep disorders. Further studies on the prevention and treatment of sleep disorders are needed for different ethnicities.
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Affiliation(s)
- Yongwei Gao
- College of Pediatrics, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Peiru Xu
- College of Pediatrics, Xinjiang Medical University, Urumqi, Xinjiang, China.
| | - Maiming Aizetiguli
- College of Pediatrics, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Shan Surong
- College of Pediatrics, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zhaoxuan Zhu
- College of Pediatrics, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Jing Zhang
- College of Pediatrics, Xinjiang Medical University, Urumqi, Xinjiang, China
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11
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Cooper R, Di Biase MA, Bei B, Quach J, Cropley V. Associations of Changes in Sleep and Emotional and Behavioral Problems From Late Childhood to Early Adolescence. JAMA Psychiatry 2023; 80:585-596. [PMID: 37017952 PMCID: PMC10077137 DOI: 10.1001/jamapsychiatry.2023.0379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/29/2023] [Indexed: 04/06/2023]
Abstract
Importance Sleep problems and psychopathology symptoms are highly comorbid and bidirectionally correlated across childhood and adolescence. Whether these associations are specific to discrete profiles of sleep problems and specific internalizing and externalizing phenomena is currently unclear. Objective To characterize individual changes in profiles of sleep problems and their prospective associations with psychopathology symptoms across the transition from childhood to adolescence. Design, Setting, and Participants This observational cohort study used baseline data (participant age of 9 to 11 years) and 2-year follow-up data (participant age of 11 to 13 years) from the community-setting, multicenter Adolescent Brain Cognitive Development (ABCD) study. Individuals were assessed for a range of sleep problems at both waves and categorized into profiles via latent profile analysis. The stability and change in these profiles over time was assessed via latent transition analysis. Logistic regression models examined whether psychopathology symptoms were cross-sectionally associated with profile membership and whether transitions between profiles were associated with changes psychopathology symptoms over time. Data were collected from September 2016 to January 2020, and data were analyzed from August 2021 to July 2022. Exposures Sleep problems were assessed at both baseline and follow-up via the parent-reported Sleep Disturbance Scale for Children (SDSC). Main Outcomes and Measures Psychopathology symptoms at both baseline and follow-up were assessed using the internalizing and externalizing dimension scores derived from the parent-reported Child Behavior Checklist. Results A total of 10 313 individuals (4913 [47.6%] were female) were categorized into 4 latent profiles of sleep problems at both baseline and follow-up: a low disturbance profile, a sleep onset/maintenance problems profile, a moderate and nonspecific disturbance profile (termed mixed disturbance), and a high disturbance profile. Individuals in the 3 more severe problem profiles displayed greater risk of concurrent internalizing symptoms (sleep onset/maintenance problems: odds ratio [OR], 1.30; 95% CI, 1.25-1.35; P < .001; mixed disturbance: OR, 1.29; 95% CI, 1.25-1.33; P < .001; high disturbance: OR, 1.44; 95% CI, 1.40-1.49; P < .001) and externalizing symptoms (sleep onset/maintenance problems: OR, 1.20; 95% CI, 1.16-1.23; P < .001; mixed disturbance: OR, 1.17; 95% CI, 1.14-1.20; P < .001; high disturbance: OR, 1.24; 95% CI, 1.21-1.28; P < .001). Transitions between sleep profiles over time were associated with prospective internalizing and externalizing symptoms, but not vice versa. Conclusions and Relevance There are substantial changes in sleep problems across the transition to adolescence that are associated with later internalizing and externalizing symptoms. Sleep profiles could be targeted in future intervention and treatment programs to improve sleep-related and mental health-related outcomes across development.
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Affiliation(s)
- Rebecca Cooper
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Maria A. Di Biase
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, Australia
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jon Quach
- Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
- Learning Intervention, Melbourne Graduate School of Education, The University of Melbourne, Parkville, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia
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12
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Cai J, Shen Y, Zhao Y, Meng X, Niu Y, Chen R, Quan G, Li H, Groeger JA, Du W, Hua J, Kan H. Early-Life Exposure to PM 2.5 and Sleep Disturbances in Preschoolers from 551 Cities of China. Am J Respir Crit Care Med 2023; 207:602-612. [PMID: 36170612 DOI: 10.1164/rccm.202204-0740oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Air pollution has been linked with sleep disturbance in adults, but the association in children remains unclear. Objectives: To examine the associations of prenatal and postnatal exposure to fine particulate matter (particulate matter ⩽2.5 μm in aerodynamic diameter; PM2.5) with sleep quality and sleep disturbances among children in 551 Chinese cities. Methods: A total of 1,15,023 children aged 3-7 years from the Chinese National Cohort of Motor Development were included. Sleep quality was measured using the Children's Sleep Habits Questionnaire (CSHQ). PM2.5 exposure was estimated using a satellite-based model. Generalized additive mixed models with Gaussian and binomial distributions were used to examine the associations of PM2.5 exposure with CSHQ scores and risk of sleep disturbance, respectively, adjusting for demographic characteristics and temporal trends. Measurements and Main Results: Early-life PM2.5 exposure was associated with higher total CSHQ score, and the association was stronger for exposure at age 0-3 years (change of CSHQ score per interquartile range increase of PM2.5 = 0.46; 95% confidence interval [CI], 0.29-0.63) than during pregnancy (0.22; 95% CI, 0.12-0.32). The associations were more evident in sleep-disordered breathing and daytime sleepiness. Postnatal PM2.5 exposure was associated with increased risk of sleep disturbance (adjusted odds ratio for per-interquartile range increase of PM2.5 exposure at age 0-3 years, 1.10; 95% CI, 1.04-1.15), but no associations were found for prenatal exposure. Children who were exclusively breastfed for <6 months and had neonatal ICU admission may be more vulnerable to sleep disturbance related to PM2.5 exposure. Conclusions: PM2.5 exposure can impair sleep quality in preschool children.
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Affiliation(s)
- Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Yang Shen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Yan Zhao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Guangbin Quan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; and
| | - John A Groeger
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Wenchong Du
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Jing Hua
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Laboratory of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
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13
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Li DL, Nie XY, Li J, Tao YJ, Zhao CH, Zhong H, Pan CW. Factors associated with sleep disorders among adolescent students in rural areas of China. Front Public Health 2023; 11:1152151. [PMID: 37139399 PMCID: PMC10149705 DOI: 10.3389/fpubh.2023.1152151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/28/2023] [Indexed: 05/05/2023] Open
Abstract
Background This study aimed to determine sleep patterns and the prevalence and association factors of sleep disorders in a regionally representative sample in Mo Jiang, China. Methods A total of 2,346 (participation rate 93.5%) Grade 7 students (aged 13-14 years) from 10 middle schools, including 1,213 (51.7%) boys and 1,133 (48.3%) girls, participated in the study. All the participants were invited to complete questionnaires that acquired information on sleep patterns, academic performance, academic stress, and sociodemographic factors. Sleep disorders were assessed using the Chinese version of the Children's Sleep Habits Questionnaire. Logistic regression models were used to investigate factors associated with sleep disorders. Results The prevalence of sleep disorders among rural adolescents was 76.4%, which is higher than that among urban adolescents. Compared with previous findings in urban areas, our results indicate that sleep loss is much more severe in rural adolescents. Sleep disorders were positively associated with factors, such as watching TV [odds ratio (OR) = 1.22, p = 0.001], academic performance (OR = 1.80, p < 0.001), and academic stress (OR = 1.38, p = 0.04). In addition, girls were more likely to suffer from sleep disorders than boys (OR = 1.36, p = 0.01). Conclusion Insufficient sleep and sleep disorders have become common health problems in rural Chinese adolescents.
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Affiliation(s)
- Dan-Lin Li
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xin-Yi Nie
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jun Li
- Department of Ophthalmology, The Second People’s Hospital of Yunnan Province, Kunming, China
| | - Yi-Jin Tao
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chun-Hua Zhao
- Department of General Medicine, Big Data Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, China
- Chun-Hua Zhao,
| | - Hua Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
- Hua Zhong,
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
- *Correspondence: Chen-Wei Pan,
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14
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Manti F, Giovannone F, Aceti F, Giacchetti N, Fioriello F, Maugeri A, Sogos C. Unraveling the Relationship between Sleep Problems, Emotional Behavior Disorders, and Stressful Life Events in Preschool Children. J Clin Med 2022; 11:jcm11185419. [PMID: 36143065 PMCID: PMC9503080 DOI: 10.3390/jcm11185419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: The aims of this study were to: (1) explore sleep problems in preschool children with generalized anxiety disorder (GAD), selective mutism (SM), and oppositional defiant disorder (ODD) and (2) examine the relationship between stressful life events, sleep problems, and emotional behavior disorders in preschoolers. Methods: The parents of 213 preschool children with SM, GAD, ODD, and TD (typical development, age range 2–6 years) completed the Children’s Sleep Habits Questionnaire (CSHQ), the Coddington Life Events Scale, preschool version (CLES-P), and the CBCL 1½–5. Results: Eighty-three subjects reported sleep problems before the age of 2 years. Seventy-five children (86.14%) with a clinical diagnosis and eight children with TD (8.4%) exceeded the threshold level on the CSHQ. For the bedtime resistance (p = 0.042) and sleep duration subscales (p = 0.038), the SM group had significantly higher scores in comparison to the ODD group. The same pattern was also true for the sleep onset (p = 0.024) and sleep anxiety subscales (p = 0.019). The linear regression analysis model showed that the impact of stressful life events and internalizing problems could predict sleep habits in children. Conclusions: Emotional behavior disorders and stress factors should be regularly investigated in children who are referred to clinics for sleep problems. Clinicians should consider how these symptoms may exacerbate sleep problems and/or interfere with treatment.
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Affiliation(s)
- Filippo Manti
- Department of Human Neuroscience, Unit of Child Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-06-4997-2972
| | - Federica Giovannone
- Department of Human Neuroscience, Unit of Child Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Franca Aceti
- Department of Human Neuroscience, Unit of Post-Partum Disorders, Sapienza University of Rome, 00185 Rome, Italy
| | - Nicoletta Giacchetti
- Department of Human Neuroscience, Unit of Post-Partum Disorders, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesca Fioriello
- Department of Human Neuroscience, Unit of Child Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Maugeri
- Department of Human Neuroscience, Unit of Child Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Carla Sogos
- Department of Human Neuroscience, Unit of Child Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
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15
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Teti DM, Fronberg KM, Fanton H, Crosby B. Infant sleep arrangements, infant-parent sleep, and parenting during the first six months post-partum. Infant Behav Dev 2022; 69:101756. [PMID: 36027627 DOI: 10.1016/j.infbeh.2022.101756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
The present study of 124 families examined linkages between patterns of sleep arrangement use across the first 6 months post-partum and (a) family socio-demographics, (b) nighttime sleep of infants, mothers, and fathers, and (c) coparenting distress, and mothers' emotional availability with infants and bedtime. Families were recruited when infants were 1-month-old, and infants were classified, from video data available at 3 and 6 months post-partum, into one of three sleep arrangement pattern groups: Solitary sleep, cosleeping, and cosleeping (at 3 months)-to-solitary sleep (at 6 months). Mothers in cosleeping arrangements were more likely to be at higher socioeconomic risk, non-White, unemployed, and to have completed fewer years of education. Controlling for these variables and for duration of breast feeding and parental depressive and anxiety symptoms, subsequent 3 (sleep arrangement pattern) X 2 (infant age: 3 and 6 months) mixed-model analyses of covariance revealed that sleep arrangement patterns were more robustly linked with maternal sleep than with infant and father sleep. Mothers in cosleeping arrangements experienced more fragmented sleep and greater variability in fragmented sleep relative to mothers of infants in solitary sleep, and fathers in cosleeping arrangements showed greater variability across the week in the number of minutes of nighttime sleep. Cosleeping was associated with mother reports of less positive and more negative coparenting, and mothers in cosleeping arrangements were independently observed to be less emotionally available with their infants at bedtime compared to mothers in the other two sleep arrangement groups. These linkages were largely upheld after statistically controlling for mothers' stated preference for sleep arrangements they were using.
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Affiliation(s)
- Douglas M Teti
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, United States.
| | - Kaitlin M Fronberg
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, United States
| | - Heidi Fanton
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, United States
| | - Brian Crosby
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, United States
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16
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Lyu J, Groeger JA, Barnett AL, Li H, Wang L, Zhang J, Du W, Hua J. Associations between gestational age and childhood sleep: a national retrospective cohort study. BMC Med 2022; 20:253. [PMID: 35934710 PMCID: PMC9358861 DOI: 10.1186/s12916-022-02443-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/16/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Both sleep quality and quantity are essential for normal brain development throughout childhood; however, the association between preterm birth and sleep problems in preschoolers is not yet clear, and the effects of gestational age across the full range from preterm to post-term have not been examined. Our study investigated the sleep outcomes of children born at very-preterm (<31 weeks), moderate-preterm (32-33 weeks), late-preterm (34-36 weeks), early-term (37-38 weeks), full-term (39-40 weeks), late-term (41 weeks) and post-term (>41 weeks). METHODS A national retrospective cohort study was conducted with 114,311 children aged 3-5 years old in China. Children's daily sleep hours and pediatric sleep disorders defined by the Children's Sleep Habits Questionnaire (CSHQ) were reported by parents. Linear regressions and logistic regression models were applied to examine gestational age at birth with the sleep outcomes of children. RESULTS Compared with full-term children, a significantly higher CSHQ score, and hence worse sleep, was observed in very-preterm (β = 1.827), moderate-preterm (β = 1.409), late-preterm (β = 0.832), early-term (β = 0.233) and post-term (β = 0.831) children, all p<0.001. The association of pediatric sleep disorder (i.e. CSHQ scores>41) was also seen in very-preterm (adjusted odds ratio [AOR] = 1.287 95% confidence interval [CI] (1.157, 1.433)), moderate-preterm (AOR = 1.249 95% CI (1.110, 1.405)), late-preterm (AOR = 1.111 95% CI (1.052, 1.174)) and post-term (AOR = 1.139 95% CI (1.061, 1.222)), all p<0.001. Shorter sleep duration was also found in very-preterm (β = -0.303), moderate-preterm (β = -0.282), late-preterm (β = -0.201), early-term (β = -0.068) and post-term (β = -0.110) compared with full-term children, all p<0.01. Preterm and post-term-born children had different sleep profiles as suggested by subscales of the CSHQ. CONCLUSIONS Every degree of premature, early-term and post-term birth, compared to full-term, has an association with sleep disorders and shortened daily sleep duration. Preterm, early-term, and post-term should therefore all be monitored with an increased threat of sleep disorder that requires long-term monitoring for adverse sleep outcomes in preschoolers.
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Affiliation(s)
- Jiajun Lyu
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, 2699 Gaoke Road, Shanghai, China
| | - John A Groeger
- NTU Psychology, Nottingham Trent University, Burton Street, Nottingham, NG1 4BU, UK
| | - Anna L Barnett
- Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Haifeng Li
- Department of Rehabilitation, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Zhejiang, China
| | - Lei Wang
- Maternal and Child Health Care Hospital of Yangzhou, Affiliated Hospital of Medical College Yangzhou University, Jiangsu, China
| | - Jiajia Zhang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, 2699 Gaoke Road, Shanghai, China
| | - Wenchong Du
- NTU Psychology, Nottingham Trent University, Burton Street, Nottingham, NG1 4BU, UK.
| | - Jing Hua
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, 2699 Gaoke Road, Shanghai, China.
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17
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Yang YT, Zou JJ, Wei Q, Shi YY, Zhang YH, Shi HJ. A Longitudinal Study of the Effects of Bed-Sharing Experience in Infancy on Sleep Outcomes at 2 Years Old. J Pediatr 2022; 245:142-148.e2. [PMID: 35120991 DOI: 10.1016/j.jpeds.2022.01.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 12/29/2021] [Accepted: 01/26/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the effects of bed-sharing experiences in infancy on sleep patterns and sleep problems at 2 years of age. STUDY DESIGN A total of 1564 children from an ongoing Shanghai Maternal-Child Pairs Cohort were included. Bed-sharing experiences were collected when children were 2, 6, and 24 months old via caregiver-completed questionnaires (whether caregivers shared a bed with children during the night), and children's bed-sharing experiences were classified as follows: no bed-sharing, early-only bed-sharing, late-onset bed-sharing, and persistent bed-sharing. Sleep outcomes at month 24 were assessed using the Brief Infant Sleep Questionnaire. Sleep patterns and problems were compared among the 4 types of bed-sharing experiences. RESULTS Of the 1564 infants, 10.10% had no bed-sharing, 18.35% had early-only, 27.94% had late-onset, and 43.61% had persistent bed-sharing. Compared with children with no bed-sharing, children with late-onset and persistent bed-sharing had shorter nighttime sleep durations and longer daytime sleep durations (P < .05) and were more likely to snore (aOR 1.87 [95% CI 1.25-2.79]; aOR 1.68 [95% CI 1.14-2.47]) and have sleep onset difficulty (aOR 2.06 [95% CI 1.37-3.09]; aOR 2.07 [95% CI 1.41-3.05]). However, caregivers of infants in the late-onset and persistent bed-sharing groups perceived less problematic sleep (aOR 0.38 [95% CI 0.26-0.56] and aOR 0.40 [95% CI 0.28-0.58]). CONCLUSIONS Bed-sharing is a common experience among Chinese children. Although bed-sharing may reduce caregivers' perception of children's problematic sleep, late-onset or persistent bed-sharing in infancy is associated with sleep problems at 2 years of age.
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Affiliation(s)
- Yan-Ting Yang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jiao-Jiao Zou
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Qian Wei
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yu-Yang Shi
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yun-Hui Zhang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Hui-Jing Shi
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
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18
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Chang FC, Chiu CH, Chen PH, Chiang JT, Miao NF, Chuang HY, Huang WQ, Tseng CC. Smartphone addiction and victimization predicts sleep problems and depression among children. J Pediatr Nurs 2022; 64:e24-e31. [PMID: 35101352 DOI: 10.1016/j.pedn.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND In this study we examined the phenomena of smartphone addiction, online harassment, and school bullying/victimization to predict the prospective influence these could have on the onset and persistence of sleep problems and depression among children. METHODS Responses from 2155 fifth-grade children recruited from 30 primary schools in Taipei were assessed, and a follow-up was performed in the 6th grade. Self-administered questionnaires were collected for each year. FINDINGS Children who reported smartphone addictions, online harassment, and school bullying/victimization coupled with an increase in those factors were more likely to experience the onset and persistence of sleep problems. In addition, children who reported smartphone addiction, online harassment, school bullying/victimization, and poor sleep quality were more likely to experience the onset and persistence of depression. IMPLICATIONS School nurses or pediatric nurses should be able to assess children's Internet use and risks to understand potential influences on sleep quality and mental status and provide recommendations for children, parents and schools.
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Affiliation(s)
- Fong-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan.
| | - Chiung-Hui Chiu
- Graduate Institute of Information and Computer Education, National Taiwan Normal University, Taiwan.
| | - Ping-Hung Chen
- The Graduate Institute of Mass Communication, National Taiwan Normal University, Taiwan.
| | | | - Nae-Fang Miao
- College of Nursing, Taipei Medical University, Taiwan.
| | - Hung-Yi Chuang
- Department of Public Health, Kaohsiung Medical University, Taiwan.
| | - Wei-Quan Huang
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan.
| | - Chie-Chien Tseng
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan.
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19
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Wang Z, Li W, Cui N, Sun X, Rong T, Deng Y, Meng M, Shan W, Zhang Y, Ordway M, Jiang F, Wang G. The association between child maltreatment and sleep disturbances among preschoolers. CHILD ABUSE & NEGLECT 2022; 127:105525. [PMID: 35168067 DOI: 10.1016/j.chiabu.2022.105525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Child maltreatment (CM) can result in lifelong detrimental consequences, but its association with sleep disturbances in young children remains unclear. OBJECTIVE This study aimed to investigate the association of CM with sleep disturbances and short sleep duration among Chinese preschoolers. PARTICIPANTS AND SETTING Data were from a representative sample of 17,023 children (6.17 ± 0.29 years old, 51.96% boys) at their graduation year of preschool in September 2019, as a subset of the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) study. METHODS Parents reported children's CM of different types and the Children's Sleep Habits Questionnaire (CSHQ). Logistic regression was used to evaluate the risk of sleep disturbances and short sleep duration linked to CM. RESULTS Of the children, 12,583(73.92%) demonstrated sleep disturbances (CSHQ total score > 41) and 3017(17.72%) demonstrated short sleep duration (<9 h/night). After adjusting covariates, physical abuse (aOR = 1.16, 95%CI = 1.05-1.28) and emotional abuse (aOR = 1.50, 95% CI = 1.39-1.62) were associated with global sleep disturbances. Physical abuse (aOR = 1.16, 95% CI = 1.06-1.28), physical neglect (aOR = 1.29, 95%CI = 1.12-1.49), and emotional abuse (aOR = 1.19, 95% CI = 1.09-1.30) were associated with short sleep duration. Sexual abuse was not significantly associated with global sleep disturbances or short sleep duration. A cumulative association was noted that more CM types were associated with increased global sleep disturbances and short sleep duration. CONCLUSIONS CM is associated with sleep disturbances and short sleep duration in young children. This highlights the efforts to prevent and reduce CM in favor of optimal sleep and whole health in young children.
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Affiliation(s)
- Zijing Wang
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Wen Li
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Naixue Cui
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xiaoning Sun
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Tingyu Rong
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Yujiao Deng
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Min Meng
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Wenjie Shan
- Department of VIP Clinic, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunting Zhang
- Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Monica Ordway
- Yale University School of Nursing, West Haven, CT, USA
| | - Fan Jiang
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
| | - Guanghai Wang
- Pediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
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20
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Li M, Tan CS, Xu L, Foo LL, Yap F, Sun CH, Tham EKH, Cai S, Ang M, Saw SM, Sabanayagam C. Sleep Patterns and Myopia Among School-Aged Children in Singapore. Front Public Health 2022; 10:828298. [PMID: 35400064 PMCID: PMC8990958 DOI: 10.3389/fpubh.2022.828298] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/28/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the associations of sleep factors with myopia, spherical equivalent (SE), and axial length (AL) in elementary school-aged children from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort. Methods This cross-sectional study included multi-ethnic children who participated in the GUSTO prospective birth cohort and were delivered in two major tertiary hospitals in Singapore (2009–2010). Sleep factors and myopia outcomes were assessed at the 8- and 9-year study visits, respectively. Parent-reported sleep quality was assessed with the Children's Sleep Habits Questionnaire (CSHQ) total scores. Additionally, each child's sleep duration, timing (bedtime; waketime), and the consistency of sleep duration or timing (i.e., the difference between weekends and weekdays) were parent-reported. Outcomes included cycloplegic SE, myopia (SE ≤ −0.5 D) and AL. Eye measurements from both eyes were included in the analyses. Multivariable linear or logistic regression with Generalized Estimating Equations were used to account for the correlation between paired eyes and confounders in the associations of sleep factors at age 8 and myopia at age 9. Results A total of 572 multi-ethnic children (49.5% boys; 56.1% Chinese) aged 9 years were included in the analyses. Overall, 37.3% of eyes were myopic. Children reported a mean total CSHQ score of 46 [standard deviation (SD) = 6]. The mean duration of sleep was 9.2 (SD = 1.0) hours per day (h/day), with 59.9% of children reporting sufficient sleep (≥9 h/day) based on guidelines recommended by the National Sleep Foundation, USA. The mean bedtime and wake time were 22:00 (SD = 00:53) and 07:08 (SD = 00:55), respectively. In multivariable regression models, total CSHQ scores, the duration of sleep, bedtime and wake time were not significantly associated with myopia, SE, or AL (p ≥ 0.05 for all), adjusting for gender, ethnicity, time outdoors, near-work, parental myopia, maternal education levels (and additionally the child's height when the outcome was AL). Similarly, the consistency of both the duration and timing of sleep (across weekends and weekdays) were not significantly associated with myopia, SE, or AL (p ≥ 0.05 for all). Conclusion In this cross-sectional study, sleep quality, duration, timing, and the consistency of specific sleep factors were not independently associated with myopia, SE, or AL among elementary school-aged children in Singapore. Large longitudinal studies are warranted to corroborate these results.
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Affiliation(s)
- Mijie Li
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Chuen-Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Lingqian Xu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Li-Lian Foo
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS (National University of Singapore) Medical School, Singapore, Singapore
| | - Fabian Yap
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Chen-Hsin Sun
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Elaine K. H. Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Shirong Cai
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS (National University of Singapore) Medical School, Singapore, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS (National University of Singapore) Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS (National University of Singapore) Medical School, Singapore, Singapore
- *Correspondence: Charumathi Sabanayagam
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21
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Rea-Sandin G, Breitenstein RS, Doane LD, Vakulskas E, Valiente C, Lemery-Chalfant K. Early Life Socioeconomic Differences in Associations between Childhood Sleep and Academic Performance. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022; 79. [PMID: 35250138 PMCID: PMC8896821 DOI: 10.1016/j.appdev.2022.101392] [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] [Indexed: 11/16/2022]
Abstract
Poor sleep can negatively impact children's academic performance. However, it is unknown whether early-life socioeconomic status (SES) moderates later sleep and academics. We tested associations between actigraphy-based sleep duration and midpoint time, and parent-reported sleep problems with objective and subjective measures of academic performance. We also examined whether relations varied by early and concurrent SES. Children (n=707; 52% female; M age=8.44 years; 28.7% Hispanic/Latinx; 29.7% at/below poverty line) were assessed at 12 months for SES and eight years for SES, sleep, and academics. There were no main effects of sleep on academics. More sleep problems predicted lower Applied Problems performance for low SES children (b=-.73, p<.05) and better performance for high SES children (b=.69, p<.05). For high SES children, greater sleep problems (b=-.11, p<.05) and longer sleep duration (b=-.11, p<.05) predicted lower academic achievement. However, most associations were consistent across SES, illustrating the complex interplay between sleep, academic outcomes, and SES.
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Affiliation(s)
- Gianna Rea-Sandin
- Department of Psychology, Arizona State University, Tempe, AZ, United States of America
| | - Reagan S Breitenstein
- Department of Psychology, Arizona State University, Tempe, AZ, United States of America.,Department of Psychology, Appalachian State University, Boone, NC, United States of America
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ, United States of America
| | - Emily Vakulskas
- Department of Psychology, Arizona State University, Tempe, AZ, United States of America.,School of Medicine, Wake Forest University, Winston-Salem, NC, United States of America
| | - Carlos Valiente
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, United States of America
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22
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Liang X, Zhang X, Wang Y, van IJzendoorn MH, Wang Z. Sleep problems and infant motor and cognitive development across the first two years of life: The Beijing Longitudinal Study. Infant Behav Dev 2022; 66:101686. [PMID: 35007866 DOI: 10.1016/j.infbeh.2021.101686] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 11/05/2022]
Abstract
The present study examined bidirectional effects between sleep problems (nocturnal awakenings and insufficient nocturnal sleep) and infant development (gross motor, fine motor, and cognition) in a sample of 182 infants (89 girls) and their parents living in Beijing (China). Using 3 waves of longitudinal data (at 6 months, 1 year, and 2 years of age), this study (a) explored the differences in sleep patterns and developmental outcomes between infants in the current sample and infants from other cultures; and primarily examined (b) whether nocturnal awakenings and insufficient nocturnal sleep prospectively predicted infant development; (c) or whether infant development predicted sleep problems. Mothers reported their children's sleep problems, and infant development was assessed with Bayley III. Sleep patterns of Beijing infants were slightly different from those from Finland and Singapore, and most scores on Bayley III in this Beijing sample were higher than those in Danish, Dutch and Sri Lankan samples. Sleep problems and developmental measures were stable across the 3 times of assessments, but cross-lagged associations were limited in number and strength. High scores on the Bayley at 6 months predicted less nocturnal awakenings at 1 year of age. Insufficient nocturnal sleep at 1 year predicted poor fine motor development at 2 years. Thus, findings suggest some bidirectional associations between infant development and sleep problems and further highlight the need to understand these relations within specific cultural contexts.
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Affiliation(s)
- Xi Liang
- Research Center for Child Development, Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China.
| | - Xin Zhang
- Research Center for Child Development, Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China.
| | - Ying Wang
- Research Center for Child Development, Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China.
| | - Marinus H van IJzendoorn
- Research Center for Child Development, Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China; School of Clinical Medicine, University of Cambridge, UK.
| | - Zhengyan Wang
- Research Center for Child Development, Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China.
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23
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Wang R, Chen J, Tao L, Qiang Y, Yang Q, Li B. Prevalence of Sleep Problems and Its Association With Preterm Birth Among Kindergarten Children in a Rural Area of Shanghai, China. Front Pediatr 2022; 10:863241. [PMID: 35547534 PMCID: PMC9082307 DOI: 10.3389/fped.2022.863241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/16/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Healthy sleep in children is critical for their physical and mental health. Although growing evidence indicates the linkage between preterm birth and neural network that regulates sleep architecture, findings on the association between preterm birth and sleep problems among children are still contradictory. In this study, we aimed to understand the prevalence of sleep problems in children aged 3-6 years and to explore the association between sleep problems and preterm birth among children in Shanghai, China. METHODS We selected 8,586 kindergarten children aged 3-6 years and their mothers in a rural area of Shanghai. Data were collected by questionnaire interview among mothers with informed consent that was signed ahead. Six types of sleep problems (i.e., insufficient sleep, sleepwalk, nightmare, snore, grind teeth, and cry in sleep) were selected in this study. SAS 9.4 was used for data analysis, and p < 0.05 was considered statistically significant. RESULTS In this study, the prevalence of preterm birth was 9.88% (848/8,586), with a higher prevalence in boys (10.62%) than girls (9.01%). The prevalence of sleep problems was 89.81% among kindergarten children, with 62.50% for snore, 50.35% for grind teeth, 49.20% for cry in sleep, 41.18% for nightmare, 11.67% for insufficient sleep, and 4.44% for sleepwalk. The age of children, family income, and mother's education were associated with the prevalence of sleep problems in children. Logistic regression indicated that sleep problems in preterm children were comparable with the full-term children [odds ratio = 1.13, 95% confidence interval (0.89-1.45)]. CONCLUSION Sleep problems were prevalent among children aged 3-6 years in the rural area of Shanghai, and preterm birth was not associated with sleep problems in kindergarten children. We recommend that parents should create limit setting in the home, cultivate similar child-rearing attitudes and beliefs among family members, and encourage children to go to bed earlier.
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Affiliation(s)
- Ruiping Wang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Jun Chen
- Clinical Research Center, Shanghai Eye Disease Hospital, Shanghai, China
| | - Liqun Tao
- Lishui Hospital of Traditional Chinese Medicine, Lishui, China
| | - Yan Qiang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Qing Yang
- Songjiang Maternal and Child Health-Care Hospital, Shanghai, China
| | - Bin Li
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
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24
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Zhao T, Xuan K, Liu H, Chen X, Qu G, Wu Y, Zhang J, Sun Y. Sleep disturbances and correlates among a sample of preschool children in rural China. Sleep Biol Rhythms 2022; 20:123-136. [PMID: 38469069 PMCID: PMC10900050 DOI: 10.1007/s41105-021-00348-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 09/20/2021] [Indexed: 01/07/2023]
Abstract
This study aimed to explore the prevalence of sleep disturbances among preschool children in rural areas of China and identify the underlying associated factors. A cross-sectional study was conducted in rural areas of Anhui Province, China, from September 2019 to January 2020. The caregivers of children from 26 kindergartens completed the demographic questionnaire, the Children's Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), the Self-rating Anxiety Scale (SAS), and the adapted Identification and Management of Feeding Difficulties (IMFeD) tool. One-way analysis of variance, independent-samples t-test, and hierarchical multiple linear regression were conducted to explore the potential influencing factors of sleep disturbances in preschool children. For the specific sleep disturbances based on each subscale of the CSHQ, bedtime resistance (54.9%) and sleep anxiety (47.9%) were the most common types of sleep disturbances, followed by daytime sleepiness (21.3%), sleep duration (20.8%), parasomnias (16.5%), sleep-onset delay (12.6%), night wakings (12.2%) and sleep-disordered breathing (10.3%). The ages of children, children's emotional/behavioral problems, children's feeding difficulties, inconsistent parenting attitudes of parents, poor parenting styles, non-parent caregivers, and caregiver anxiety contributed significantly to the CSHQ total score, accounting for approximately 27.1% (R2 = 0.271) of the variance. Our study indicates that the prevalence of sleep disturbances among preschool children in rural areas of China is quite high. Furthermore, the potential risk factors are complicated, including factors related to both children and their caregivers.
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Affiliation(s)
- Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China
| | - Kun Xuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China
| | - Xin Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China
| | - Yile Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China
- Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601 Anhui China
| | - Jian Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China
- Department of Neonatology, Anhui Provincial Children’s Hospital/Children’s Hospital of Anhui Medical University, Hefei, 230051 Anhui China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China
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25
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Mi Y, Zhao R, Sun X, Yu P, Wang W, Li J, Liang Z, Wang H, Wang G, Sun K. Sleep disturbances and sleep patterns in children with tic disorder: A case-control study. Front Pediatr 2022; 10:911343. [PMID: 35979406 PMCID: PMC9376246 DOI: 10.3389/fped.2022.911343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022] Open
Abstract
STUDY OBJECTIVES To characterize sleep disturbances and sleep patterns in children with Tic disorder (TD), and explore their association with TD severity and types. METHODS A case-control study was conducted in 271 children with TD recruited from a clinical setting and 271 non-TD children recruited from a primary school, matched by age (mean = 8.47 years, SD = 1.53 years) and gender (15.1% female). The Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep patterns and sleep disturbances. The TD types and severity were assessed with the Yale Global Tic Severity Scale (YGTSS). RESULTS The TD children scored higher on CSHQ total score than non-TD group (t = 29.50, p < 0.001) and demonstrated severer global sleep disturbance. Compared to non-TD children, TD children presented with increased risks for global sleep disturbance (aOR: 1.95; 95% CI = 1.20-3.06), and most specific sleep disturbances, including bedtime resistance (aOR: 3.15; 95% CI = 1.96-5.06), sleep onset delay (aOR: 3.43; 95% CI = 1.58-7.46), sleep anxiety (aOR: 2.83; 95%CI = 1.83-4.38), parasomnias (aOR: 3.68; 95% CI = 2.02-6.62), night waking (aOR: 9.29; 95% CI = 2.64-32.65), sleep disordered breathing (aOR: 1.72; 95% CI = 1.03-2.90) and daytime sleepiness (aOR: 1.72; 95% CI = 1.09-2.74). Children with mild and moderate tics, Provisional Tic Disorder (PTD), Chronic Tic Disorder (CTD) and Tourette Syndrome (TS) presented with more global and more specific sleep disturbances. In addition, combined ADHD, etc. CONCLUSION Children with TD are major risks for increased sleep disturbances, especially for those with severe and chronic symptoms. Furthermore, comorbid ADHD increases risk in certain areas of sleep. These findings highlight the importance to consider sleep outcomes in the assessment and treatment for children with TD.
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Affiliation(s)
- Yunhui Mi
- Department of Traditional Chinese Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Runzhi Zhao
- Shanghai Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoning Sun
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Pediatric Translational Medicine Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Pingbo Yu
- Department of Traditional Chinese Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenqin Wang
- Traditional Chinese Medicine, Children's Hospital of Fudan University, Shanghai, China
| | - Jijun Li
- Department of Traditional Chinese Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhenwen Liang
- Shanghai University of Medicine and Health Sciences, College of Rehabilitation Sciences, Shanghai, China
| | - Hui Wang
- Psychology Teaching and Research Section, Zhabei No.1 Central Primary School, Shanghai, China
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Pediatric Translational Medicine Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Kexing Sun
- Department of Traditional Chinese Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Matsuoka M, Matsuishi T, Nagamitsu S, Iwasaki M, Iemura A, Obara H, Yamashita Y, Maeda M, Kakuma T, Uchimura N. Sleep disturbance has the largest impact on children's behavior and emotions. Front Pediatr 2022; 10:1034057. [PMID: 36518780 PMCID: PMC9744255 DOI: 10.3389/fped.2022.1034057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Children's behavior and emotions are affected by sleep disturbances, the parent-child relationship, media viewing time, and the social status of parents and caregivers. We conducted a questionnaire survey to identify the factors that have the greatest impact on children's behavior and emotions and how these factors relate to each other. METHODS A parental questionnaire survey was performed at a public elementary school. The questionnaire comprised questions on the family environment (e.g., family structure, media and game exposure, after-school lessons, and caregiver's work schedule) and physical information, the Strengths and Difficulties Questionnaire (SDQ), the Children's Sleep Habits Questionnaire (CSHQ), and the Pittsburgh Sleep Quality Index (PSQI) for parents' sleep condition. A path diagram was drawn to hypothesize the complex interrelationships among factors, and structural equation modeling was used to estimate the path coefficients. RESULT We identified several factors that significantly affected the SDQ score. The CSHQ total score had the largest impact, followed by after-school lessons, single-mother families, and children's sex. In addition, several indirect pathways that led to the CSHQ score (i.e., a pathway from time spent watching television to CSHQ score via children's bedtime and a pathway from single-mother family to CSHQ score via PSQI total score) significantly affected the SDQ score. CONCLUSION Children's sleep habits that were influenced by several environmental factors had the greatest impact on children's behavior and emotions, which suggested that children's behavioral problems can be improved by interventions focused on sleep habits, such as sleep hygiene instructions.
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Affiliation(s)
- Michiko Matsuoka
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, School of Medicine, Kurume University, Kurume, Japan
| | - Toyojiro Matsuishi
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan.,Research Center for Children and Research Center for Rett Syndrome, St. Mary's Hospital, Kurume, Japan
| | - Shinichiro Nagamitsu
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan.,Department of Pediatrics, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Mizue Iwasaki
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan
| | - Akiko Iemura
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan
| | - Hitoshi Obara
- Biostatistics Center, School of Medicine, Kurume University, Kurume, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan
| | - Masaharu Maeda
- Department of Neuropsychiatry, School of Medicine, Kurume University, Kurume, Japan.,Department of Disaster Psychiatry, Fukushima Medical University, Fukushima, Japan
| | - Tatsuyuki Kakuma
- Biostatistics Center, School of Medicine, Kurume University, Kurume, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, School of Medicine, Kurume University, Kurume, Japan
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27
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Zhao F, Sun X, Wang Y, Zhou Y, He Y, Wang C, Han F, Liu J, Tsai SY, Wang G, Wang J. Sleep Disturbances in Chinese Children with Epilepsy: Associations with Behavioral Problems and Quality of Life. Nat Sci Sleep 2022; 14:1225-1236. [PMID: 35814490 PMCID: PMC9258772 DOI: 10.2147/nss.s367900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the association between sleep disturbances and behavioral problems as well as quality of life (QOL) in Chinese children with epilepsy. METHODS Caregivers of 167 epileptic children aged 3 to 12 years completed the Child Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), and the Pediatric Quality of Life Inventory (PedsQL™, 4.0 Core). RESULTS The prevalence of sleep disturbances (CSHQ total score >41) in epileptic children was 73.7% [95% CI (66.9%.80.4%)]. Epileptic children with sleep disturbances demonstrated more behavioral problems and lower QOL compared to those without sleep disturbances. Sleep disturbances such as sleep anxiety and daytime sleepiness were associated with more behavioral problems and lower QOL (p <0.05). Linear regression analyses showed that higher disturbance in sleep duration domain were associated with more behavioral problems, while higher sleep disordered breathing domains was associated with lower QOL (p <0.05). The interaction between sleep disturbances and behavioral problems in predicting QOL was not significant. The sensitivity analysis using 48 as an alternative cutoff for CSHQ total score obtained consistent results. CONCLUSION Sleep disturbances occur frequently among Chinese children with epilepsy, and are associated with more behavioral problems and lower QOL. The sleep disturbance-QOL association is unlikely contingent on behavioral problems. This study highlights the necessity of evaluating and treating sleep disturbances multidimensionally among children with epilepsy to promote their whole health and wellbeing.
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Affiliation(s)
- Fen Zhao
- Department of Pediatric Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xiaoning Sun
- Paediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yingyan Wang
- Department of Pediatric Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yunqing Zhou
- Department of Pediatric Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yingzhong He
- Department of Pediatric Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Cuijin Wang
- Department of Pediatric Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Feng Han
- Department of Pediatric Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Jie Liu
- Department of Pediatric Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Shao-Yu Tsai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Guanghai Wang
- Paediatric Translational Medicine Institute, Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Jiwen Wang
- Department of Pediatric Neurology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Hyunshik K, Jiameng M, Sunkyoung L, Ying G. Change in Japanese children's 24-hour movement guidelines and mental health during the COVID-19 pandemic. Sci Rep 2021; 11:22972. [PMID: 34836992 PMCID: PMC8626449 DOI: 10.1038/s41598-021-01803-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022] Open
Abstract
Specialized guidelines are required for the health behaviors of vulnerable populations such as children. This is especially true during the COVID-19 pandemic, wherein major lifestyle changes have occurred, especially among young children. The present study aims to use longitudinal data to understand changes in the physical activity, screen time, sleep, and mental health of preschoolers in Japan during the COVID-19 pandemic, compared to pre-pandemic period. Subjective and objective measures were used to assess the variables of interest longitudinally. It was found that physical activity, adherence to WHO-recommended screen time, and prosocial behaviors decreased significantly. On the other hand, sedentary time and hyperactivity increased. Our results are consistent with findings from other countries. The implications with respect to outdoor playtime, screen-time in the context of online learning during the pandemic, and the effects of parents' mental health on preschool-aged children are discussed.
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Affiliation(s)
- Kim Hyunshik
- Faculty of Sports Education, Sendai University, 2-2-18 Funaokaminami, Shibata-machi, Miyagi-ken, 9891693, Japan
| | - Ma Jiameng
- Faculty of Sports Education, Sendai University, 2-2-18 Funaokaminami, Shibata-machi, Miyagi-ken, 9891693, Japan
| | - Lee Sunkyoung
- Department of Life Physical Education, Myongji University, 34 Geobukgol-ro, Seodaemun-gu, Seoul, 03674, Republic of Korea
| | - Gu Ying
- College of Sports Science, Shenyang Normal University, No. 253, Huanghe North Street, Huanggu District, Shenyang City, Liaoning Province, China.
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Amaerjiang N, Xiao H, Zunong J, Shu W, Li M, Pérez-Escamilla R, Hu Y. Sleep disturbances in children newly enrolled in elementary school are associated with parenting stress in China. Sleep Med 2021; 88:247-255. [PMID: 34798441 DOI: 10.1016/j.sleep.2021.10.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to investigate the prevalence of children's sleep disturbances among students newly enrolled in elementary school, and explored the association between the two during the child's transition from kindergarten to elementary school. METHODS In 2019, a cross-sectional study was conducted among 1,510 newly enrolled school kids and their parents in Beijing. Children's sleep characteristics were evaluated using the Children's Sleep Habits Questionnaire (CSHQ), and parenting stress characteristics were assessed with the Parenting Stress Index-Short Form (PSI-SF). Logistic regression models were used to analyze the association between children's sleep and parenting stress. RESULTS A total of 77.9% of children newly enrolled in elementary school had sleep disturbances and 15.6% of parents had experienced parenting stress. When examining the relationship between children's sleep disturbances and parenting stress, monthly family income over US$1,550 was a protective factor and children with sleep disturbances were associated with higher risk of parenting stress. Two subscales from the CSHQ were associated with higher parenting stress risk: sleep duration and daytime sleepiness. Similarly, parents experiencing parenting stress had children with higher risk of sleep disturbances. This risk was also higher for children from parents screening positive in the PSI-SF subscales for parental distress and difficult child. CONCLUSIONS We found that children's sleep disturbances and parenting stress were common and there was a bidirectional association between the two during this transition time. Schools and communities need to provide timely psychological support for children and parents to address major stressors.
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Affiliation(s)
- Nubiya Amaerjiang
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Huidi Xiao
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Jiawulan Zunong
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Wen Shu
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Menglong Li
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, 100069, China
| | | | - Yifei Hu
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, 100069, China.
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30
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Sun W, Kwok NTT, Chan NY, Chan JWY, Zhang J, Chan KCC, Li SX. Associations of circadian factors with insomnia symptoms and emotional and behavioral problems among school-age children. J Clin Sleep Med 2021; 17:2107-2114. [PMID: 34606443 DOI: 10.5664/jcsm.9346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To examine the associations of circadian characteristics (ie, chronotype and social jetlag) with insomnia symptoms and emotional and behavioral problems among school-age children. METHODS A total of 620 primary school children (medianage = 10.06, standard deviation = 1.16, 58.7% boys) were recruited and assessed by a set of parent-report questionnaires, including Children's Sleep Habit Questionnaire for measuring sleep-wake patterns and insomnia symptoms (bedtime resistance, sleep onset delay, and night waking), Children's Chronotype Questionnaire for assessing the child's chronotype preference, and Strength and Difficulties Questionnaire for assessing emotional and behavioral problems. Linear regression models were applied to examine the associations of chronotype and social jetlag with insomnia symptoms and mental health outcomes, in which age, sex, family income, and average sleep duration were entered as covariates. RESULTS Evening chronotype was significantly associated with bedtime resistance and sleep onset delay, while social jetlag was not related to insomnia symptoms. Evening chronotype was also significantly associated with externalizing symptoms after controlling for potential confounders. CONCLUSIONS Evening chronotype, but not social jetlag, was the risk factor for insomnia symptoms, and evening chronotype was further associated with increased behavioral problems in school-age children. Our findings underscored the roles of circadian factors in relation to sleep and mental health problems in this young population. CITATION Sun W, Kwok NTT, Chan NY, et al. Associations of circadian factors with insomnia symptoms and emotional and behavioral problems among school-age children. J Clin Sleep Med. 2021;17(10):2107-2114.
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Affiliation(s)
- Wanqi Sun
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,Department of Psychiatry, Shanghai Mental Health Center, People's Republic of China
| | - Natasha Tung Ting Kwok
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR)
| | - Ngan Yin Chan
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR
| | - Joey Wing Yan Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR
| | - Jihui Zhang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR.,Guang Dong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kate Ching-Ching Chan
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR
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31
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Tomasiello M, Temcheff CE, Martin-Storey A, Bégin V, Poirier M, Déry M. Self and parent-reported sleep problems of adolescents with childhood conduct problems and comorbid psychological problems. J Adolesc 2021; 92:165-176. [PMID: 34547674 DOI: 10.1016/j.adolescence.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/07/2021] [Accepted: 09/11/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Childhood conduct problems (CP) are characterized by maladaptive externalizing behaviors and are linked with poor sleep. CP are highly comorbid with other psychological problems, including attention deficit/hyperactivity disorder and depression, which are also associated with disturbed sleep. The present study examined if childhood CP and comorbid depressive and/or attentional-hyperactivity problems were prospectively associated with parent and self-reported sleep difficulties in adolescence. METHODS Participants (N = 744; 53% boys) from an ongoing longitudinal study in Québec, Canada were assessed for CP and comorbidities when they were between 6 and 9 years old. Participants were classified as without CP, CP only, CP and depressive symptoms, CP and attention-hyperactivity problems, or CP, depressive symptoms, and attention-hyperactivity problems. Regressions were conducted to examine the associations between comorbidity groups, parent, and self-reported sleep problems 7 years later (Median age = 15.33 years), controlling for sex, age, family income, primary caregiver education and medication. RESULTS Adolescents in all CP groups had higher self and parent-reported sleep problems compared to adolescents without histories of CP. Adolescents with histories of CP, depressive symptoms and attention-hyperactivity problems had more sleep problems than all other groups according to self-reports, but not parent-reports. CONCLUSION Childhood CP was prospectively linked to sleep problems in adolescence, and comorbid conditions exacerbated these problems, according to youth but not parents.
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Affiliation(s)
- Melina Tomasiello
- Department of Educational and Counselling Psychology, McGill University, Education Building, 3700 McTavish Street, Montreal, Québec, Canada.
| | - Caroline Elizabeth Temcheff
- Department of Educational and Counselling Psychology, McGill University, Education Building, 3700 McTavish Street, Montreal, Québec, Canada.
| | - Alexa Martin-Storey
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance, Département de Psychoéducation, Université de Sherbrooke, Pavillon A7, 2500 Boul. de L'Université, Sherbrooke, Québec, Canada.
| | - Vincent Bégin
- Research group on psychosocial maladjustment in children, School of Criminology, Université de Montréal, 3150 Jean-Brillant, Montréal, Québec, Canada.
| | - Martine Poirier
- Département de Secteur Disciplinaire des Sciences de L'éducation, Université Du Québec à Rimouski, 300 Allée des Ursulines, Rimouski, Québec, Canada.
| | - Michèle Déry
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance, Département de Psychoéducation, Université de Sherbrooke, Pavillon A7, 2500 Boul. de L'Université, Sherbrooke, Québec, Canada.
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32
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Chen H, Yang T, Chen J, Chen L, Dai Y, Zhang J, Li L, Jia F, Wu L, Hao Y, Ke X, Yi M, Hong Q, Chen J, Fang S, Wang Y, Wang Q, Jin C, Li T. Sleep problems in children with autism spectrum disorder: a multicenter survey. BMC Psychiatry 2021; 21:406. [PMID: 34399715 PMCID: PMC8365936 DOI: 10.1186/s12888-021-03405-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/26/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND High prevalence of sleep problems have been reported in children with Autism Spectrum Disorder (ASD). This study aims to investigate the sleep conditions of ASD children in China, and explore the relationship between the common sleep problems and core symptoms and developmental levels. METHODS Using a cross-sectional design, we included 2 to 7-year-old children from 13 cities in China: 1310 with ASD and 1158 with typically-developing (TD) children. The neurodevelopmental level was evaluated with the revised Children Neuropsychological and Behavior Scale (CNBS-R2016). ASD were diagnosed with DSM-5 and Child Autism Rating Scale (CARS). the Social Responsiveness Scale (SRS), the Autism Behavior Checklist (ABC) and the communication warning behavior sub-scale in CNBS-R2016 valued autism behaviors. The children' s sleep habits questionnaire (CSHQ) assessed sleep conditions. RESULTS The prevalence of sleep disorders in ASD children was significantly higher than that in TD (67.4% vs. 51%, p < 0.01), and among them the four dimensions with the highest prevalence of sleep problems were bedtime resistance (25.6%), sleep anxiety (22.7%), sleep onset delay (17.9%) and daytime sleepiness (14.7%). ASD children with sleep onset delay or sleep anxiety had higher ABC, SRS scores and higher scores on communication warning behavior with sleep anxiety, with daytime sleepiness had higher ABC, SRS and CARS scores, and with bedtime resistance had higher SRS total scores. Differences in the neurodevelopmental level were not significant. CONCLUSION Children with ASD have a higher prevalence of sleep problems. Bedtime resistance, anxiety, sleep onset delay and daytime sleepiness may be related to the core symptoms, but not be related to the developmental level in ASD children. In the clinic, sleep assessment should be included in the routine of ASD visits, and during the intervention, sleep hygiene education is as important as the treatment of biological factors. TRIAL REGISTRATION The study was approved by the ethics committee of the Children's Hospital of Chongqing Medical University, Approval Number: (2018) IRB (STUDY) NO. 121, and registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000031194 ).
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Affiliation(s)
- Hongyu Chen
- grid.419897.a0000 0004 0369 313XChildren’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China
| | - Ting Yang
- grid.419897.a0000 0004 0369 313XChildren’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China
| | - Jie Chen
- grid.419897.a0000 0004 0369 313XChildren’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China
| | - Li Chen
- grid.419897.a0000 0004 0369 313XChildren’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China
| | - Ying Dai
- grid.419897.a0000 0004 0369 313XChildren’s Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014 China
| | - Jie Zhang
- grid.452902.8Xi’an Children’s Hospital, Xi’an, 710003 China
| | - Ling Li
- grid.502812.cDepartment of Children Rehabilitation, Hainan Women and Children’s Medical Center, Haikou, 570100 China
| | - Feiyong Jia
- grid.430605.4Department of Developmental and Behavioral Pediatric, the First Hospital of Jilin University, Changchun, 130021 China
| | - Lijie Wu
- grid.410736.70000 0001 2204 9268Department of Children’s and Adolescent Health, Public Health College of Harbin Medical University, Harbin, 150081 China
| | - Yan Hao
- grid.33199.310000 0004 0368 7223Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Xiaoyan Ke
- grid.452645.40000 0004 1798 8369Child mental health research center of Nanjing Brain Hospital, Nanjing, 210013 China
| | - Mingji Yi
- grid.412521.1Department of Child Health Care, the Affiliated Hospital of Qingdao University, Qingdao, 266003 China
| | - Qi Hong
- Maternal and Child Health Hospital of Baoan, Shenzhen, 518133 China
| | - Jinjin Chen
- grid.16821.3c0000 0004 0368 8293Department of Child Healthcare, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, 200040 China
| | - Shuanfeng Fang
- grid.207374.50000 0001 2189 3846Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, 450053 China
| | - Yichao Wang
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008 China
| | - Qi Wang
- Deyang Maternity & Child Healthcare Hospital, Deyang, 618000 Sichuan China
| | - Chunhua Jin
- grid.418633.b0000 0004 1771 7032Department of Children Health Care, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Tingyu Li
- Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.
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Wen J, Yang T, Zhu J, Guo M, Lai X, Tang T, Chen L, Chen J, Xue M, Li T. Vitamin a deficiency and sleep disturbances related to autism symptoms in children with autism spectrum disorder: a cross-sectional study. BMC Pediatr 2021; 21:299. [PMID: 34217246 PMCID: PMC8254303 DOI: 10.1186/s12887-021-02775-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 06/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background Vitamin A deficiency (VAD) and sleep disturbances have been reported in children with autism spectrum disorder (ASD). The influence of vitamin A (VA) levels on sleep regulation and sleep disturbances in ASD has garnered concern. The present study aimed to characterize the association of VA levels with sleep disturbances in children with ASD. Methods This cross-sectional study compared children with ASD (n = 856) to typically developing children (TDC; n = 316). We used the Children’s Sleep Habits Questionnaire to assess sleep disturbances, Childhood Autism Rating Scale to evaluate the severity of autism symptoms, and Autism Behavior Checklist and Social Responsiveness Scale to assess autism behaviors. Serum VA levels were estimated using high-performance liquid chromatography. Multivariable linear regression and two-way analysis of variance were performed to investigate if VAD was related to sleep disturbances in children with ASD. Results Children with ASD had lower serum VA levels and a higher prevalence of sleep disturbances than TDC did. The incidence of VAD in ASD children with sleep disturbances was higher, and the symptoms more severe than those without sleep disturbances and TDC. Interestingly, the interaction between VAD and sleep disturbances was associated with the severity of autism symptoms. Conclusion VAD and sleep disturbances are associated with the core symptoms of ASD in children. Regular monitoring of sleep and VA levels may be beneficial for children with ASD. Trial registration Chinese Clinical Trial Registry, registration number: ChiCTR-ROC-14005442, registration date: December 9th 2014.
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Affiliation(s)
- Jing Wen
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China
| | - Ting Yang
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China
| | - Jiang Zhu
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China
| | - Min Guo
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China
| | - Xi Lai
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China
| | - Ting Tang
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China
| | - Li Chen
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China
| | - Jie Chen
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China
| | - Ming Xue
- Department of Neurosciences and Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Tingyu Li
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, PR China. .,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China. .,National Clinical Research Center for Child Health and Disorder, Chongqing, PR China. .,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, PR China.
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Association between sleep habits/disorders and emotional/behavioral problems among Japanese children. Sci Rep 2021; 11:11438. [PMID: 34075151 PMCID: PMC8169700 DOI: 10.1038/s41598-021-91050-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/20/2021] [Indexed: 02/04/2023] Open
Abstract
Actual sleep status and the association between sleep habits/disorders and emotional/behavioral problems among children in the development stage have not been fully clarified. A questionnaire survey was conducted on the sleep habits/disorders (Brief Child Sleep Questionnaire; BCSQ) and emotional/behavioral problems (Strengths and Difficulties Questionnaire; SDQ) of 87,548 children enrolled in ordinary classes in nine grade levels from the first grade of elementary school to the third grade of junior high school from December 2009 to April 2010. As school grade increased, children's bedtimes were delayed and sleep duration was reduced by 2.0 h over the nine grade levels. Based on the BCSQ, 18.3% of children were judged to have some type of sleep disorder, and about 30% to 40% of children had sleep symptoms at bedtime, during sleep, and at wake time. Multiple regression analysis showed that emotional and behavioral problems were associated with presence of any sleep symptom, longer sleep latency, and longer awake time after sleep onset, whereas total sleep time was not. Sleep symptoms at wake time were most strongly associated with emotional and behavioral problems. Status of sleep habits/disorders should be considered when interpreting emotional/behavioral problems in school-age children.
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35
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Mohammadi MR, Salmanian M, Keshavarzi Z. The Global Prevalence of Conduct Disorder: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:205-225. [PMID: 34221047 PMCID: PMC8233559 DOI: 10.18502/ijps.v16i2.5822] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: There has been little effort to conduct systematic reviews or meta-analyses of the available literature to find global prevalence rates of conduct disorder and analyze the sources of heterogeneity. Method : We searched multiple databases, including Web of Science, PubMed, Scopus, and Google Scholar to identify cross-sectional studies with random or nonrandom sampling to assess the global prevalence of conduct disorder in children and adolescents aged under 18 in the general or school-based populations. Quality assessment and data extraction were independently carried out by two authors. Subgroup analysis was used to find the potential sources of heterogeneity. Results: We reached 50 studies, incorporating 186,056 children and adolescents from 35 countries. The total prevalence of conduct disorder was 8% (CI: 7-9%; I2: 99.77%), including 7% in females (CI: 4-9%; I2: 99.56%) and 11% in males (CI: 7-15%; I2: 99.74%). The results of subgroup analysis showed that total heterogeneity could be explained by measurement tools. When diagnostic interviews such as the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) and Development and Well-Being Assessment (DAWBA) were employed, the pooled prevalence rates for conduct disorder were 0.4% and 0.7%, respectively, and heterogeneity decreased. However, the use of the screening tools such as the Strengths and Difficulties Questionnaire (SDQ)-parent or teacher report and SDQ-self report increased the pooled prevalence of conduct disorder to 10% and 16% respectively. Conclusion: The prevalence of conduct disorder in the epidemiological studies should be estimated by employing the diagnostic interviews to reach accurately assessments.
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Affiliation(s)
- Mohammad-Reza Mohammadi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Salmanian
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Keshavarzi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
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36
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Shen S, Li X, Li R, Huang D, Zhao X, Zhang X, Hao Q, Sun Q, Tong H, Zheng X, Cao Y, Liu S, Zhu H, Liu H. Association of sleep disorders with subfoveal choroidal thickness in preschool children. Eye (Lond) 2021; 36:448-456. [PMID: 33707765 PMCID: PMC8807704 DOI: 10.1038/s41433-021-01489-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 01/29/2021] [Accepted: 02/22/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To explore the association between sleep disorders and subfoveal choroidal thickness (SFCT) in preschool children. METHODS In this population-based cross-sectional study, children aged 60-72 months were measured for SFCT using spectral-domain optical coherence tomography (SD-OCT) and for sleep disorders using the Chinese version of Children's Sleep Habits Questionnaire (CSHQ). Multiple linear regression analyses were performed to assess the association between sleep disorders and SFCT. RESULTS A total of 1337 children (mean (SD) age: 66.88 (3.41) months) were included in the analyses. In multivariable linear analysis, a higher total CSHQ score (indicating higher likelihood of sleep disorders) was associated with a thinner subfoveal choroid (beta, -0.070; 95% CI, -0.141 to -0.001; P = 0.046). When each of eight CSHQ subscale scores was analysed by the multivariable model, only the Daytime Sleepiness subscale score was negatively associated with the SFCT (beta, -0.115; 95% CI, -0.183 to -0.046; P = 0.001). The children with clinically significant daytime sleepiness (n = 364, 27.2%) had significantly thinner subfoveal choroid than other children (295.47 vs. 308.52 μm, P = 0.007). CONCLUSIONS Only daytime sleepiness was significantly associated with SFCT in preschool children in this study. The potential relationship between sleep disorders during childhood and children's ocular development needs further research.
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Affiliation(s)
- Shiya Shen
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiaoxiao Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Rui Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Dan Huang
- Department of Child Healthcare, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiaohan Zhang
- Department of Ophthalmology, Wuxi Children's Hospital, Wuxi, China
| | - Qingfeng Hao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Qigang Sun
- Department of Ophthalmology, Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China
| | - Haohai Tong
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xinyu Zheng
- The Fourth School of Clinical Medicine of Nanjing Medical University, Nanjing, China
| | - Yelongzi Cao
- The Fourth School of Clinical Medicine of Nanjing Medical University, Nanjing, China
| | - Shuning Liu
- The Fourth School of Clinical Medicine of Nanjing Medical University, Nanjing, China
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
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Jeon M, Dimitriou D, Halstead EJ. A Systematic Review on Cross-Cultural Comparative Studies of Sleep in Young Populations: The Roles of Cultural Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042005. [PMID: 33669583 PMCID: PMC7922907 DOI: 10.3390/ijerph18042005] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 01/21/2023]
Abstract
Recent studies have shown that sleep is influenced and shaped by cultural factors, including cultural values, beliefs and practices. However, a systematic understanding of how cultural factors in countries may influence sleep duration and sleep disturbances is still lacking. Therefore, we focused on a comparison of sleep duration and disturbances in young populations between countries. We report cross-cultural differences between the child, parent and environmental factors, and their association with sleep duration and disturbances. The review is based on literature searches of seven databases published until December 2020. Studies were included if they investigated sleep duration and disturbances of individuals up to 18 years across at least two or more countries. The results of this review have shown that sleep duration and disturbances vary between countries and regions and certain factors (e.g., bedtime routines, sleeping arrangement, physical activity and psychological functioning) have been associated with sleep duration or disturbances. This review also demonstrates that certain factors which were associated with sleep duration or disturbances in one country, were not shown in other countries, suggesting a need for recommendations for age-related sleep duration and sleep interventions to consider cultural differences that influence sleep duration or disturbances in individual countries or regions.
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Sleep profiles of Australian children aged 11–12 years and their parents: sociodemographic characteristics and lifestyle correlates. Sleep Med 2020; 73:53-62. [DOI: 10.1016/j.sleep.2020.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 11/19/2022]
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Tse AC, Yu C, Lee PH. Comparing sleep patterns between children with autism spectrum disorder and children with typical development: A matched case-control study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:2298-2303. [PMID: 32631069 DOI: 10.1177/1362361320936827] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT This study compared the sleep pattern between children with autism spectrum disorders and children with typical development using a matched case-control design (matched age, gender, and body mass index). Significant differences were found in night-time sleep duration (total amount of sleep at night), sleep efficiency (percentage of time spent asleep), sleep-onset latency (length of time that it takes to transit from awake to asleep), and wake after sleep onset (total amount of time spent awake after defined sleep onset). Findings showed that children with autism spectrum disorder had poorer sleep quality than children with typical development. Mechanisms underlying the differences should be further explored in order to develop an effective treatment intervention.
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Affiliation(s)
- Andy Cy Tse
- The Education University of Hong Kong, Hong Kong
| | - Ccw Yu
- The Hong Kong Polytechnic University, Hong Kong
| | - Paul H Lee
- The Hong Kong Polytechnic University, Hong Kong
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40
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Torrijos-Niño CE, Pardo-Guijarro MJ, Martínez-Vizcaíno V, Solera-Martínez M, Lucas-de la Cruz L, Sánchez-López M. Sleep patterns and sleep problems in a sample of Spanish schoolchildren. Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-020-00277-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Wang G, Takahashi M, Wu R, Liu Z, Adachi M, Saito M, Nakamura K, Jiang F. Association between Sleep Disturbances and Emotional/Behavioral Problems in Chinese and Japanese Preschoolers. Behav Sleep Med 2020; 18:420-431. [PMID: 31063001 DOI: 10.1080/15402002.2019.1605995] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: Sleep disturbances are often associated with emotional/behavioral problems in young children, but whether the association differs among Asian countries remains unknown. This study aimed to investigate the association between sleep disturbances and emotional/behavioral problems in Chinese and Japanese preschoolers and to explore potential differences.Methods: Participants were 1,020 Chinese preschoolers from 10 cities and 438 Japanese preschoolers from 1 city aged 4 to 5 years. Parents filled out the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ).Results: Chinese children with sleep disturbances (defined as total CSHQ score >41) demonstrated more peer problems than children without, while there was no such difference in Japanese preschoolers. Domains of sleep disturbances associated with emotional/behavioral problems in Chinese children were sleep disordered breathing and daytime sleepiness, yet in Japanese children were sleep anxiety and night wakings. Children with a higher score of sleep anxiety showed more emotional problems in Japan, but fewer conduct problems in China.Conclusions: Sleep disturbances were associated with emotional/behavioral problems in preschoolers with differences between China and Japan, indicating subcultural differences in preschoolers' sleep within Asian countries.Abbreviations: CSHQ: Children's Sleep Habits Questionnaire; SDQ: Strengths and Difficulties Questionnaire; ANCOVA: analysis of covariance; SD: standard deviation; CI: confidence interval.
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Affiliation(s)
- Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Micho Takahashi
- Research Center for Child Mental Development, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Ran Wu
- Counseling and Psychological Services Center, East China Normal University, Shanghai, China
| | - Zhijun Liu
- Department of Applied Psychology, School of Management, Zunyi Medical University, Zunyi, China
| | - Masaki Adachi
- Research Center for Child Mental Development, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Manabu Saito
- Department of Neuropsychiatry, Graduate school of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Kazuhiko Nakamura
- Research Center for Child Mental Development, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan.,Department of Neuropsychiatry, Graduate school of Medicine, Hirosaki University, Hirosaki, Aomori, Japan
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wang Y, Lin J, Zeng Y, Liu Y, Li Y, Xia K, Zhao J, Shen Y, Ou J. Effects of Sleep Disturbances on Behavioral Problems in Preschool Children With Autism Spectrum Disorder. Front Psychiatry 2020; 11:559694. [PMID: 33633594 PMCID: PMC7900493 DOI: 10.3389/fpsyt.2020.559694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 12/22/2020] [Indexed: 01/30/2023] Open
Abstract
Study Objectives: This study aims to identify the characteristic sleep disturbances that affect behavioral problems in children with autism spectrum disorder (ASD), providing a potential direction for sleep and behavioral intervention in ASD. Methods: The data of 513 children with ASD and 246 typically developing (TD) children aged between 2 and 5 years old were collected. The behavior performance of preschool children was assessed using the Child Behavior Checklist for 1.5-5.0 years old. The Children's Sleep Habits Questionnaire (CSHQ) was used to measure the sleep status of the children, and the Social Responsiveness Scale was used to measure the severity of disorder. Linear regression analysis was performed to examine the effects of sleep disturbances on behavioral problems, and independent-sample t-test was performed to compare the mean of the samples. Results: Compared to TD children, children with ASD had longer sleep onset delay and more night awakenings. The parasomnias score (a subscale of the CSHQ) was significantly associated with the internalizing (β = 0.113, P = 0.010), externalizing (β = 0.128, P = 0.006), and total problems (β = 0.143, P = 0.001) of children with ASD, while this association was not significant in TD children. "Bed wetting" and "restless and moves a lot" (two items in the CSHQ under parasomnia) significantly only affected the overall behavioral score in children with ASD (P < 0.05). Conclusion: Parasomnias, especially bed wetting and restlessness, are specifically associated with the behavioral problems of children with ASD rather than TD children.
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Affiliation(s)
- Ying Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jingjing Lin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ying Zeng
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanan Liu
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Yamin Li
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Kun Xia
- State Key Laboratory of Medical Genetics, Central South University, Changsha, China
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yidong Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jianjun Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
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Kang YQ, Song XR, Wang GF, Su YY, Li PY, Zhang X. Sleep Problems Influence Emotional/Behavioral Symptoms and Repetitive Behavior in Preschool-Aged Children With Autism Spectrum Disorder in the Unique Social Context of China. Front Psychiatry 2020; 11:273. [PMID: 32372982 PMCID: PMC7179767 DOI: 10.3389/fpsyt.2020.00273] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/20/2020] [Indexed: 12/19/2022] Open
Abstract
Sleep disturbances are common in people with autism spectrum disorder (ASD), but research on this topic is still limited in China. In the current study, we evaluated the prevalence of sleep problems in preschool-aged children with ASD and to examine the correlations between sleep disturbances and emotional/behavioral symptoms and repetitive behavior in the unique social context of China. This study recruited 475 preschool-aged children aged 3-6 years old, including 252 children with ASD (mean age 5.13 ± 1.15, 80.6% male) and 223 age-matched typically developing (TD) children (mean age 5.12 ± 0.97, 74.9% male). The parents of all children completed a sociodemographic questionnaire and the Childhood Sleep Habits Questionnaire. The parents of 114 ASD children completed the Strengths and Difficulties Questionnaire (SDQ) and the Repetitive Behavioral Questionnaire-2 (RBQ-2). The prevalence of sleep problems in preschool-aged children with ASD in this study was 81.7%, which was higher than that in TD children (61.0%). The scores for bedtime resistance, sleep anxiety, sleep duration, parasomnias, and sleep onset delay in the ASD group were significantly higher than those in the TD group (t=-7.664, P=0.000; t=-10.477, P=0.000; t=-4.133, P=0.000; Z=-3.916, P=0.000; Z=-7.093, P=0.000; respectively). Sleep onset delay explained 17.3% of the variance (adjusted R2 = 0.173) in the total SDQ score of children with ASD, and bedtime resistance explained a large proportion of total RBQ-2 score variance (adjusted R2 = 0.206). The high rate of sleep disturbances in preschool-aged children with ASD emphasizes the importance of screening for sleep problems in this population. Attention should also be directed toward formulating good sleep hygiene practices for preschool-aged children in the particular social context and cultural setting of China.
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Affiliation(s)
- Yu-Qi Kang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiao-Rong Song
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Geng-Fu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuan-Yuan Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China.,Experimental Teaching Center of Preventive Medicine, Tianjin Medical University, Tianjin, China
| | - Pei-Ying Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
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Sleep Problems in School Aged Children: A Common Process across Internalising and Externalising Behaviours? Clocks Sleep 2019; 2:7-18. [PMID: 33089186 PMCID: PMC7445839 DOI: 10.3390/clockssleep2010002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 12/19/2019] [Indexed: 11/30/2022] Open
Abstract
Sleep problems are common in childhood and impact cognitive, psychological and physical wellbeing. The current study investigated the association between sleep problems and internalising and externalising behaviour in 114 school-aged children (5–12 years) from four primary schools in Melbourne, Australia. Data were collected using the Sleep Disorder Inventory for Students to measure sleep and the Conners Behavior Rating Scale to assess behaviour, both by parent report. Hierarchical regression analysis, controlling for socioeconomic status and age, identified moderate associations between sleep problems and emotional distress, aggressive behaviour and hyperactivity/impulsivity. Findings suggest screening for sleep problems in children presenting clinically with behavioural issues is a potentially important clinical practice. Additionally, results support the elaboration of transdiagnostic theory, whereby sleep problems are a common process in both internalising and externalising behaviour in children.
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45
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Wang GF, Li WL, Han Y, Gao L, Dai W, Su YY, Zhang X. Sensory Processing Problems and Comorbidities in Chinese Preschool Children with Autism Spectrum Disorders. J Autism Dev Disord 2019; 49:4097-4108. [PMID: 31267289 DOI: 10.1007/s10803-019-04125-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Little is known about the relationship between sensory processing problems and sleep disturbances, emotional and behavioral problems and mealtime behavioral problems in Chinese children with autism spectrum disorders (ASDs). This study examined those relationships in Chinese preschool children with ASD using a case-control design. Atypical sensory processing was associated with increased risks of sleep disturbances, emotional and behavioral problems, and abnormal mealtime behaviors in the children with ASD, whereas sensory processing problems were significantly correlated with abnormal mealtime behaviors only in the typically developing children. Based on our findings, clinicians must collect information about sensory problems when a child with ASD experiences sleep disturbances and emotional and behavioral problems or presents abnormal mealtime behaviors.
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Affiliation(s)
- Geng-Fu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Wen-Lei Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yu Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Lei Gao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Wei Dai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China.,Teaching Management Center of School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuan-Yuan Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China.,Experimental Teaching Center of Preventive Medicine, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China.
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Wang G, Zhang J, Lam SP, Li SX, Jiang Y, Sun W, Chan NY, Kong APS, Zhang Y, Li S, Li AM, Jiang F, Shen X, Wing YK. Ten-Year Secular Trends in Sleep/Wake Patterns in Shanghai and Hong Kong School-Aged Children: A Tale of Two Cities. J Clin Sleep Med 2019; 15:1495-1502. [PMID: 31596215 PMCID: PMC6778342 DOI: 10.5664/jcsm.7984] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 05/30/2019] [Accepted: 05/30/2019] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVES To compare the secular trends of sleep/wake patterns in school-aged children in Hong Kong and Shanghai, two major metropolitan cities in China with two different policies that school start time was delayed in Shanghai, but advanced in Hong Kong in 10 years' time. METHODS Participants were from two waves of cross-sectional school-based surveys of children aged 6 to 11 years. In Shanghai, 4,339 and 13,795 children participated in the 2005 and 2014 surveys, respectively. In Hong Kong, 6,231 and 4,585 children participated in the 2003 and 2012 surveys, respectively. Parents reported their children's bedtime and wakeup time, and thus sleep duration, short sleep (≤ 9 hours) and weekend oversleep (difference in sleep duration between weekday and weekend > 2 hours) were determined. RESULTS Hong Kong children had later bedtime and wakeup time and slept consistently less than their Shanghai counterparts at both survey time points. The shorter sleep duration was particularly marked during weekdays. Over the interval period, weekday sleep duration significantly decreased from 9.2 to 8.9 hours as wakeup time became earlier for Hong Kong children, but increased from 9.4 to 9.6 hours as wakeup time became later for children in Shanghai. Children from both cities slept longer on the weekends. Prevalence of weekend oversleep significantly increased in Hong Kong children, but no interval change was found in Shanghai children. CONCLUSIONS The findings indicate subcultural differences in sleep/wake patterns in Shanghai and Hong Kong school-aged children. In particular, sleep duration had increased for Shanghai children, but decreased for Hong Kong children over 10 years. The benefits and barriers of delaying school start time for optimizing sleep health in school-aged children should be further explored.
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Affiliation(s)
- Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Jihui Zhang
- Department of Psychiatry, Sleep Assessment Unit, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Siu Ping Lam
- Department of Psychiatry, Sleep Assessment Unit, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Wanqi Sun
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ngan Yin Chan
- Department of Psychiatry, Sleep Assessment Unit, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Yunting Zhang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Shenghui Li
- Shanghai Jiao Tong University School of Public Health, Shanghai, China
| | - Albert Martin Li
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, N.T., Hong Kong SAR, China; *Co-first author, contributed equally
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Xiaoming Shen
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Yun Kwok Wing
- Department of Psychiatry, Sleep Assessment Unit, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
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Liu J, Feng R, Ji X, Cui N, Raine A, Mednick SC. Midday napping in children: associations between nap frequency and duration across cognitive, positive psychological well-being, behavioral, and metabolic health outcomes. Sleep 2019; 42:5499200. [PMID: 31135911 PMCID: PMC6735910 DOI: 10.1093/sleep/zsz126] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 05/02/2019] [Indexed: 12/14/2022] Open
Abstract
STUDY OBJECTIVES Poor sleep and daytime sleepiness in children and adolescents have short- and long-term consequences on various aspects of health. Midday napping may be a useful strategy to reduce such negative impacts. The effect of habitual napping on a wide spectrum of cognitive, behavioral, psychological, and metabolic outcomes has not been systematically investigated. METHODS This study characterized midday napping habits in 3819 elementary school children from the China Jintan Cohort Study. In 2011, weekly nap frequency and average duration were collected once from students at grades 4-6. Prior to their completion of elementary school at grade 6 (in 2011-2013 respective to each grade), the following outcomes were collected once: behavioral and academic achievement evaluated by teachers, and self-reported positive psychology measures including grit, self-control, and happiness. IQ tests were conducted on a subgroup. Metabolic indices, including body mass index and fasting glucose concentration, were measured through physical exams. For the whole sample, we assessed associations between napping and each outcome, adjusted for sex, grade, school location, parental education, and time in bed at night. We also conducted stratified analyses on grade 6 (cross-sectional), grade 4 (2-year gap), and grade 5 (1-year gap) data. RESULTS Overall, napping was significantly associated with higher happiness, grit, and self-control, reduced internalizing behavior problem, higher verbal IQs, and better academic achievement, although specific patterns varied across frequency and duration for different outcomes. More limited significant associations were found for decreased externalizing behavior problems, compared to non-nappers, while no significant associations were found for performance IQ and metabolic outcomes. CONCLUSIONS Results indicate benefits of regular napping across a wide range of adolescent outcomes, including better cognition, better psychological wellness, and reduced emotional/behavioral problems. The current study underscores the need for further large-scale intervention studies to establish causal effects.
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Affiliation(s)
- Jianghong Liu
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Rui Feng
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Xiaopeng Ji
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA.,College of Health Sciences, University of Delaware School of Nursing, Newark, DE
| | - Naixue Cui
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA.,Shandong University School of Nursing, Shandong, China
| | - Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, Philadelphia, PA
| | - Sara C Mednick
- Department of Cognitive Sciences, University of California Irvine, Irvine, CA
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Melinda TF, Sekartini R. Association between obesity and sleep disorders in primary school children: a cross-sectional study. MEDICAL JOURNAL OF INDONESIA 2019. [DOI: 10.13181/mji.v28i2.2645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The prevalence of obesity in primary school children in Jakarta has reached 14% in 2013. Among many disorders, obesity can cause sleep disorders. However, sleep disorders in children are often overlooked by parents, even though they can cause physical, social, and psychological impacts. Therefore, it is necessary to find the association between obesity and sleep disorders in primary school children. METHODS This cross-sectional study was performed between July–September 2015 on 107 children attending Menteng 01 Primary School, Jakarta. Children's weight and height were measured and then their parents filled out the brief infant sleep questionnaire (BISQ). The collected data were analyzed using chi-square. RESULTS In this study, 20.6% of the children were obese, which was higher than the prevalence of obesity in Jakarta. Meanwhile, sleep disorders occurred in 62.6% of children. Data about children’s sleep habits and parents’ opinion about their children’s sleep were obtained. It showed that snoring and parents’ opinion about sleep disorders were factors associated with children’s sleep disorder. Statistical analysis also showed a significant association between obesity and sleep disorders in children (p = 0.037). CONCLUSIONS The incidence of obesity in primary school children is high and is associated with sleep disorders.
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50
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Ren Y, Yao X, Liu Y, Liu S, Li X, Huang Q, Liu F, Li N, Lu Y, Yuan Z, Li S, Xiang H. Outdoor air pollution pregnancy exposures are associated with behavioral problems in China's preschoolers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:2397-2408. [PMID: 30467751 DOI: 10.1007/s11356-018-3715-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/07/2018] [Indexed: 05/22/2023]
Abstract
There are mounting evidences indicated that maternal exposure to outdoor air pollutants in pregnancy affects children's neural development, but the researches on children's behavioral difficulties are seldom. We explored the association between maternal exposure to outdoor air pollution during different trimesters of pregnancy and the prevalence of behavioral difficulties among 657 preschool children aged 3-4 from three kindergartens in Wuhan, China. This is a cross-sectional study. Children's behavioral difficulties were assessed by the Strengths and Difficulties Questionnaire (SDQ) (reported by parents). Maternal exposure to outdoor air pollutants during pregnancy were estimated based on the daily average measured concentration levels from ground monitoring stations. Potential confounding factors including children-related, maternal, and socio-economic status (SES) were adjusted in the study. We calculated the prevalence of each type of behavioral difficulties and used binary logistic regression method to estimate the crude odds ratio (cOR), adjusted odds ratio (aOR), and corresponding 95% confidence intervals (95% CIs) for 1 μg/m3 increase in each air pollutant during every exposure window in single- and two-pollutant models. The prevalence of participants' total behavioral difficulties was 9.6%. In single-pollutant models, during full gestation, positive associations were observed between exposure to NO2 (aOR = 1.204, 95% CI 1.042, 1.392), particle matter (PM)10 (aOR = 1.070, 95% CI 1.018, 1.125), PM2.5 (aOR = 1.095, 95% CI 1.021, 1.176) and total difficulties, exposure to PM10 (aOR = 1.040, 95% CI 1.001, 1.081), PM2.5 (aOR = 1.053, 95% CI 1.000, 1.109) and prosocial behavior, respectively. In the first trimester, exposure to SO2 (aOR = 1.047, 95% CI 1.009, 1.086), NO2 (aOR = 1.039, 95% CI 1.013, 1.066), PM10 (aOR = 1.013, 95% CI 1.004, 1.023), and PM2.5 (aOR = 1.016, 95% CI 1.004, 1.028) were all positively associated with total difficulties. The associations between second and third trimesters' exposure to all pollutants and outcomes were not statistically significant. However, in the two-pollutant models, second trimester exposure to PM2.5 (aOR = 1.078, 95%CI 1.023, 1.137) was positively associated with total behavioral difficulties after adjusting for PM10. Exposure to outdoor air pollutants SO2, NO2, PM10, and PM2.5 during pregnancy may be associated with behavioral difficulties, especially in the first trimester.
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Affiliation(s)
- Yunzhao Ren
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Xing Yao
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Yisi Liu
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Suyang Liu
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Xiao Li
- Gilead Sciences Inc, 333 Lakeside Drive, Foster City, CA, 94404, USA
| | - Qing Huang
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Feifei Liu
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Na Li
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University of Hawaii at Manoa, 1960 East-West Rd, Biomed Bldg, D105, Honolulu, HI, 96822, USA
| | - Zhanpeng Yuan
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Shiyue Li
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China.
| | - Hao Xiang
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China.
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
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