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Lupini F, Williamson AA. Health Disparities in Pediatric Sleep. Sleep Med Clin 2023; 18:225-234. [PMID: 37120165 PMCID: PMC10210975 DOI: 10.1016/j.jsmc.2023.01.005] [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] [Indexed: 02/27/2023]
Abstract
This article reviews disparities in pediatric sleep health and sleep disorders from early childhood through adolescence (birth to age 18 years). Sleep health is a multidimensional construct including sleep duration, consolidation, and other domains, whereas sleep disorders reflect both behaviorally (eg, insomnia) and medically based (eg, sleep disordered breathing) sleep diagnoses. Using a socioecological framework, we review multilevel (ie, child, family, school, health-care system, neighborhood, and sociocultural) factors linked to sleep health disparities. Mechanistic research and studies using an intersectional lens to understand overlapping marginalized identities are needed to inform multilevel interventions to promote sleep health equity in pediatrics.
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Affiliation(s)
- Francesca Lupini
- Children's National Hospital, 111 Michigan Avenue Northwest, 6 Floor CTR Suite, Room M7658, Washington, DC 20010, USA
| | - Ariel A Williamson
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street Boulevard, Room 8202, Philadelphia, PA 19146, USA; University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA.
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Zhang Z, Matenchuk BA, Skow RJ, Davenport MH, Carson V. Associations between demographic and parental factors and infant sleep characteristics. Sleep Biol Rhythms 2023; 21:221-232. [PMID: 38469278 PMCID: PMC10900024 DOI: 10.1007/s41105-022-00438-w] [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: 06/25/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022]
Abstract
Although sleep problems are highly prevalent in infants, the intrinsic and extrinsic factors that influence sleep consolidation and regulation in this age group are not well understood. This study aimed to examine the cross-sectional associations of demographic and parental factors with infant sleep characteristics. Participants were 97 Canadian mother-infant dyads primarily from Edmonton, Alberta. Demographic factors (e.g., infant age), parenting practices (e.g., sleep position, sleep initiation methods), and infants sleep characteristics (e.g., the frequency of nighttime awakenings) were assessed using the Brief Infant Sleep Questionnaire. Maternal sleep characteristics (e.g., nighttime sleep duration) were assessed using Actigraph accelerometers. Infant age (mean = 4.24 ± 2.90) was associated with most infant sleep characteristics. In multiple regression models for infant nighttime sleep duration, after removing influential observations, a negative association for side (vs. prone) sleep position was, respectively, observed. In multiple regression models for the frequency of nighttime awakenings in infants, positive associations for infants falling asleep while feeding (vs. in bed alone) and side (vs. prone) sleep position were consistently observed after removing influential observations. Lower nighttime sleep efficiency (B = - 0.08, 95%CI: - 0.13, - 0.02) and longer nighttime wake after sleep onset (B = 1.03, 95%CI: 0.41, 1.65) in mothers were associated with more frequent nighttime awakenings in infants. After removing influential observations, more frequent nighttime awakenings (B = 0.35; 95%CI: 0.09, 0.61) and longer total sleep duration (B = 0.33, 95%CI: 0.11, 0.55) in mothers were also associated with more frequent nighttime awakenings in infants. Sleep initiation methods with less parental involvement, and more continuous and efficient maternal nighttime sleep, tended to be associated with less interrupted infant sleep.
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Affiliation(s)
- Zhiguang Zhang
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB T6G 2H9 Canada
| | - Brittany A. Matenchuk
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB Canada
| | - Rachel J. Skow
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB Canada
| | - Margie H. Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB T6G 2H9 Canada
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Abstract
Play has always been an essential part of childhood, but it looks different for modern children, who increasingly engage in virtual play. More than 90% of children older than 2 years play video games, and three-quarters of American households own a video game console. Children 8 to 17 years of age spend an average of 1.5 to 2 hours daily playing video games. Recent developments framed by decades of research have provided insight into how games influence children's physical health, mental health, social behaviors, and cognitive development. Anticipatory guidance surrounding media use is often centered on screen time, but pediatricians should have some knowledge of the unique benefits and risks associated with this nearly ubiquitous activity. In light of the recent addition of gaming disorder to the International Classification of Diseases, 11th Revision, this review includes a discussion of the epidemiology, clinical features, and diagnosis of gaming disorder, including the use of existing screening tools. As games become more popular while ever-increasing in scope and complexity, this review aims to educate the modern pediatric provider about what is known, what is uncertain, and how to use this knowledge in the management of both healthy and unhealthy video gaming in children.
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Affiliation(s)
- Daniel Alanko
- Hasbro Children's Hospital and Alpert School of Medicine at Brown University, Providence, Rhode, Island
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Schmied EA, Full KM, Lin SF, Gregorio-Pascual P, Ayala GX. Sleep health among U.S. Hispanic/Latinx children: An examination of correlates of meeting sleep duration recommendations. Sleep Health 2022; 8:615-619. [PMID: 36055935 DOI: 10.1016/j.sleh.2022.07.002] [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: 02/25/2022] [Revised: 06/06/2022] [Accepted: 07/07/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The objective of this study was to examine the association between sociodemographic, behavioral, and environmental factors and adherence to sleep duration recommendations among 1165 U.S. Hispanic/Latinx children. METHODS In this cross-sectional study, the following parent-reported variables were examined as correlates of whether children met age-appropriate nightly sleep duration recommendations: caretaker and child demographics (eg, gender, age, poverty level), presence of TV in child's bedroom, child's daily screen time and bedtime. RESULTS Most (61.4%) children (mean age: 6.39 years, SD = 2.66) met sleep duration guidelines. Multivariable regression results revealed the odds of meeting recommendations were significantly higher among children 6-12 years old living above the poverty threshold (odds ratio [OR] = 1.57; 95% confidence interval [95%CI]: 1.08, 2.31) and those with a regular bedtime ("Some of the time:" OR = 2.05; 95%CI: 1.07, 3.92; "Most of the time:" OR = 3.19; 95%CI: 1.77, 5.74; "Always:" OR = 4.46; 95%CI: 2.43, 8.13). CONCLUSIONS Sleep health disparities must be addressed through culturally and contextually appropriate interventions that combine individual-level strategies with those that address social and environmental factors.
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Affiliation(s)
- Emily A Schmied
- School of Public Health, San Diego State University, and Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California, USA.
| | - Kelsie M Full
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Shih-Fan Lin
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California, USA
| | - Petrona Gregorio-Pascual
- San Diego State University & University of California, San Diego Joint Doctoral Program in Public Health, and Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California, USA
| | - Guadalupe X Ayala
- School of Public Health, San Diego State University, and Institute for Behavioral and Community Health and SDSU HealthLINK Center, San Diego State University Research Foundation, San Diego, California, USA
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Diler F, Başkale H. The influence of sleep patterns and screen time on the sleep needs of infants and toddlers: A cross-sectional study. J Pediatr Nurs 2022; 67:e201-e207. [PMID: 35914990 DOI: 10.1016/j.pedn.2022.07.014] [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: 05/05/2022] [Revised: 06/10/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this study was to examine the effects of screen time and sleep patterns on the sleep needs of infants and toddlers. DESIGN AND METHODS A descriptive cross-sectional data were collected from 304 parents of children aged 6 to 36 months old. The screen use of children and parents was assessed with seven questions and A Brief Infant Sleep Questionnaire (BISQ) was used to assess infant sleep. RESULTS The results of this study indicate that children's adherence to the recommended sleep standards is poor. The most important criteria that caused poor sleeping were the number of awakenings at night, the duration of sleeplessness at night and the minimum total sleep time of <9 h. The most frequently used screen type in all of the age groups and parents was TV, followed by smartphones. As the age of the children increased, the rate of all screen-type use also increased. Factors predicting sleep needs included bedtime, the PED usage of children, parents' watching TV and care of the children by the babysitter. CONCLUSIONS Sleep needs are associated with the sleep patterns and screen usage of the children and parents. PRACTICE IMPLICATIONS Given that screen usage behaviors are tracked from infancy to early childhood, these findings highlight the need for prevention and intervention efforts, as well as for education and policy measures, to limit screen use and exposure from an early age.
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Affiliation(s)
- Fatma Diler
- Fatma Diler, Milas State Hospital, Milas/Muğla, Türkiye
| | - Hatice Başkale
- Hatice Başkale, Pamukkale University Faculty of Health Sciences, Denizli, Türkiye.
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Yamamoto M, Mezawa H, Sakurai K, Mori C. Association between Media Use and Bedtime Delays in Young Children: An Adjunct Study of the Japan Environment and Children’s Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159464. [PMID: 35954819 PMCID: PMC9368443 DOI: 10.3390/ijerph19159464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 12/10/2022]
Abstract
Excessive screen media use has been reported to cause shorter sleep; however, the types of media environments that affect early childhood sleep are less known. This study examined the association of multiple media use, screen time for each device, and the purpose of smartphone and tablet use with delayed bedtime among 4–8-year-olds. Participants were recruited from the Japan Environment and Children’s Study, a nationwide birth cohort study. Mothers of 1837 children reported screen media use and bedtime in a questionnaire. The association between delayed bedtimes (after 22:00 h) and media device use (smartphones, tablets, portable and console games, and TV/DVDs) was examined by logistic regression analysis. Children who used three or more devices besides TV/DVDs were more likely to have delayed bedtimes. Delayed bedtimes were associated with smartphone use, even with a 0.1–1 h/day screen time, and with prolonged screen time for tablets, portable games, and console games, but not for TV/DVDs. Gaming on smartphones and tablets was also associated with delayed bedtime. To ensure adequate sleep for young children, families must develop feasible measures to discourage children’s use of multiple devices and prolonged device use, especially for games, and a social environment that supports such measures.
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Affiliation(s)
- Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan;
- Correspondence: ; Tel.: +81-43-290-3896; Fax: +81-43-287-8011
| | - Hidetoshi Mezawa
- Medical Support Center for Japan Environment and Children’s Study, National Center for Child Health and Development, 10-1, Okura 2-chome, Setagaya-ku, Tokyo 157-8535, Japan;
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan;
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan;
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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Zhang Z, Okely AD, Pereira JR, Sousa-Sá E, Veldman SLC, Santos R. Associations of sleep characteristics with cognitive and gross motor development in toddlers. Sleep Health 2022; 8:350-355. [PMID: 35752562 DOI: 10.1016/j.sleh.2022.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine cross-sectional associations of sleep characteristics (duration, consolidation, timing, variability) with cognitive and gross motor development in toddlers. METHODS Participants were 205 toddlers (19.6 ± 4.3 months) from the GET-UP! STUDY Nap/nighttime sleep onset and offset were measured using an accelerometer and used to calculate nap/nighttime sleep duration. Total sleep duration was calculated and classified as meeting or not meeting the sleep recommendation of the Australian 24-Hour Movement Guidelines (11-14 h/d). Nighttime sleep ratio (ie, nighttime sleep duration: total sleep duration), indicative of consolidation, was expressed as a percent value. Nighttime sleep midpoint (ie, the midpoint between nighttime sleep onset and offset), indicating the lateness of sleep schedules, was converted to a decimal hour. For sleep variability, the intraindividual standard deviation of nighttime sleep duration and nighttime sleep midpoint was calculated, respectively. Cognitive development (Bayley Scales of Infant and Toddler Development-III) and specific domains of gross motor development (Peabody Developmental Motor Scales, 2nd edition) were measured. RESULTS Shorter nap duration (B = -0.87, 95%CI: -1.71, -0.02) and higher nighttime sleep ratio (B = 0.13, 95% CI: 0.02, 0.24) were associated with better cognitive development. Regarding gross motor development, positive associations were found for nighttime sleep duration (object manipulation: B = 0.26, 95% CI: 0.01, 0.51; gross motor quotient: B = 1.21, 95% CI: 0.04, 2.38) and total sleep duration (object manipulation: B = 0.28, 95% CI: 0.03, 0.52); negative associations were found for nighttime sleep midpoint (stationary: B = -0.31; 95% CI: -0.58, -0.06) and nighttime sleep duration variability (stationary: B = -0.32, 95% CI: -0.64, -0.004). CONCLUSIONS In toddlers, more consolidated sleep may be an indicator of better cognitive development. Promoting longer and more consistent nighttime sleep duration, as well as an earlier nighttime sleep schedule, may facilitate gross motor development. However, our findings for the associations of sleep characteristics with cognitive and gross motor development need to be confirmed in prospective studies.
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Affiliation(s)
- Zhiguang Zhang
- Faculty of Education, Beijing Normal University, Beijing, China.
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Australia
| | - João R Pereira
- CIDAF (uid/dtp/04213/2016), University of Coimbra, Coimbra, Portugal; CIDEFES - Centro de Investigação em Desporto, Educação Física e Exercício e Saúde; Universidade Lusófona, Lisbon, Portugal
| | - Eduarda Sousa-Sá
- CIDEFES - Centro de Investigação em Desporto, Educação Física e Exercício e Saúde; Universidade Lusófona, Lisbon, Portugal; Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| | - Sanne L C Veldman
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Directorate-General of Health, National Physical Activity Promotion Program, Portugal
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Zhang Z, Adamo KB, Ogden N, Goldfield GS, Okely AD, Kuzik N, Crozier M, Hunter S, Predy M, Carson V. Associations between screen time and cognitive development in preschoolers. Paediatr Child Health 2022; 27:105-110. [PMID: 35599677 PMCID: PMC9113848 DOI: 10.1093/pch/pxab067] [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: 12/18/2020] [Accepted: 07/30/2021] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVES To examine the cross-sectional associations between screen time and cognitive development in preschoolers. METHODS Participants were 97 preschoolers (36 to 60 months) in Alberta and Ontario, Canada in the supporting Healthy physical AcTive Childcare setting (HATCH) study. The time that children spent watching television, videos or DVDs (television time) or playing video or computer games (video game time) on a television, computer, or portable device was assessed using a parental questionnaire. Television time and video game time were summed to calculate total screen time. Adherence to the screen time recommendation (≤1 hour/day) of the Canadian 24-Hour Movement Guidelines was calculated. Expressive vocabulary and working memory were assessed using the Early Years Toolbox. Due to the distribution of working memory, it was categorized as a binary variable based on the median score. The associations between screen time and cognitive development were examined using mixed models (expressive vocabulary) or generalized mixed models (working memory). RESULTS Screen time was not associated with expressive vocabulary. Preschoolers who had higher total screen time were less likely to have better working memory (OR=0.52; 95%CI:0.31, 0.88), despite the null associations for television time (P=0.155) and video game time (P=0.079). Preschoolers who met the screen time recommendation were more likely to have higher working memory capacity (OR=3.48; 95%CI:1.06, 11.47), compared to those who did not meet the recommendation. CONCLUSION Limiting total screen time to no more than one hour per day may facilitate working memory development in preschoolers. Screen time may be unrelated to expressive language development in this age group.
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Affiliation(s)
- Zhiguang Zhang
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Kristi B Adamo
- Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
| | - Nancy Ogden
- Faculty of Arts, Mount Royal University, Calgary, Alberta, Canada
| | - Gary S Goldfield
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Anthony D Okely
- Early Start and Illawarra Health and Medical Research Institute, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Nicholas Kuzik
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Mitchell Crozier
- Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
| | - Stephen Hunter
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Madison Predy
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
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Demographic Correlates of Movement Behaviors in Infants: A Longitudinal Study. J Phys Act Health 2022; 19:177-185. [PMID: 35135898 DOI: 10.1123/jpah.2021-0570] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/14/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Demographic correlates of movement behaviors in infants are unclear. This study examined the longitudinal associations between demographic correlates and movement behaviors in infants. METHODS Participants were 411 parents of infants from the Early Movers project in Edmonton, Canada. Movement behaviors, infant and parental age, and nonparental care time were assessed using a parental questionnaire at 2, 4, and 6 months of age. Other infant and parental demographic variables were assessed at 2 months of age. Linear and generalized linear mixed models were conducted. RESULTS Infant age was associated with all movement behaviors except for restrained time. White infants and those with older parents had less tummy time but increased odds of having reading time. Infants of the most educated parents also had lower tummy time. Higher parental education and more siblings were associated with no screen time and longer infant sleep time. Infants with immigrant parent(s) were less likely to have reading time. No associations were found for infant sex, time spent in nonparental care, and parental marital status. CONCLUSION Since no single demographic group demonstrated healthy patterns for all movement behaviors, promotion of a healthy balance of movement behaviors may be needed universally for all infants.
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Carson V, Zhang Z, Predy M, Pritchard L, Hesketh KD. Longitudinal associations between infant movement behaviours and development. Int J Behav Nutr Phys Act 2022; 19:10. [PMID: 35090492 PMCID: PMC8800227 DOI: 10.1186/s12966-022-01248-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to address methodological limitations of the evidence that informed national and international movement behaviour guidelines for the early years. Specifically, the primary objective was to examine the longitudinal associations of infant physical activity (i.e., tummy time) and sedentary behaviour (i.e., back time, screen time, reading time, restrained time) with gross motor development. Secondary and tertiary objectives were to examine longitudinal associations of: (1) infant physical activity and sedentary behaviour with communication, fine motor, personal-social, and problem solving development, and (2) sleep time with primary and secondary outcomes. METHODS Participants were 411 parents and their infants from the Early Movers project in Edmonton, Canada. Physical activity, sedentary behaviour, and sleep were measured with a parental questionnaire and the Ages & Stages Questionnaire (ASQ-3) developmental screening tool was administered at 2, 4, and 6 months. Parents reported the dates six major gross motor milestones (i.e., independent sitting, crawling, assisted standing, assisted walking, independent standing, independent walking) were acquired in the first 18 months of life according to World Health Organization criteria. In a subsample (n = 125), gross motor development was assessed using the Alberta Infant Motor Scale (AIMS) at 6 months. RESULTS Higher tummy time across time points was significantly associated with higher ASQ-3 gross motor and personal-social development scores over time, higher total AIMS scores at 6 months, and earlier acquisition of all gross motor milestones. Higher reading time across time points was significantly associated with higher ASQ-3 fine motor, gross motor, personal-social, and total development scores over time. In contrast, higher back time across time points was significantly associated with lower total AIMS scores at 6 months and the later acquisition of assisted standing, assisted walking, and independent walking. Similarly, higher restrained time across time points was significantly associated with a later acquisition of supported walking. CONCLUSIONS Tummy time was consistently longitudinally associated with more advanced gross motor development and reading with more advanced total development. Whereas, some detrimental associations were observed for back and restrained time. Findings support the promotion of tummy time and certain sedentary behaviours (i.e., reading) in young infants to enhance overall development.
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Affiliation(s)
- Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada.
| | - Zhiguang Zhang
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Madison Predy
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Lesley Pritchard
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Vic, Australia
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11
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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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12
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Picca M, Manzoni P, Milani GP, Mantovani S, Cravidi C, Mariani D, Mezzopane A, Marinello R, Bove C, Ferri P, Macchi M, Agostoni C. Distance learning, technological devices, lifestyle and behavior of children and their family during the COVID-19 lockdown in Lombardy: a survey. Ital J Pediatr 2021; 47:203. [PMID: 34635133 PMCID: PMC8503704 DOI: 10.1186/s13052-021-01156-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/15/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and the subsequent national lockdowns, school closures and distance learning may have had both negative and positive effects on physical and mental health of children. METHODS A cross-sectional study was conducted on a large group of children between 1 and 10 years old in Lombardy, Italy (n = 3392). Their parents filled in a survey answering single or multiple-choice questions about their offspring's behavior changes (including sleep, dietary habits, emotional disturbances), relationship with siblings, parents and peers, the use of digital technologies, and distance learning experience during the lockdown. RESULTS Parents reported lifestyles and emotional alterations during the lockdown. The modifications of family relationships, parents' remote working, and screen time were associated with sleep, emotional and behavioral modifications. Distance learning was overall considered adequate. CONCLUSIONS This study reported the most updated data on the effects of COVID-19 pandemic lockdown on children between 1 and 10 years of age in a large sample of Italian schoolchildren. The results of this study point out that pediatricians and authorities should support relationships within families during the COVID-19 pandemic. Parents' remote working might play an important role for this purpose.
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Affiliation(s)
- Marina Picca
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Paola Manzoni
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Gregorio Paolo Milani
- Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Pediatric Area, Via della Commenda 9, 20121 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Claudio Cravidi
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Danila Mariani
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Angela Mezzopane
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Roberto Marinello
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Chiara Bove
- Department of Human Sciences for Education, University of Milan-Bicocca, Milan, Italy
| | - Paolo Ferri
- Department of Human Sciences for Education, University of Milan-Bicocca, Milan, Italy
| | - Marina Macchi
- Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Pediatric Area, Via della Commenda 9, 20121 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Pediatric Area, Via della Commenda 9, 20121 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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13
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Feng S, Huang H, Wang N, Wei Y, Liu Y, Qin D. Sleep Disorders in Children With Autism Spectrum Disorder: Insights From Animal Models, Especially Non-human Primate Model. Front Behav Neurosci 2021; 15:673372. [PMID: 34093147 PMCID: PMC8173056 DOI: 10.3389/fnbeh.2021.673372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/16/2021] [Indexed: 02/05/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder with deficient social skills, communication deficits and repetitive behaviors. The prevalence of ASD has increased among children in recent years. Children with ASD experience more sleep problems, and sleep appears to be essential for the survival and integrity of most living organisms, especially for typical synaptic development and brain plasticity. Many methods have been used to assess sleep problems over past decades such as sleep diaries and parent-reported questionnaires, electroencephalography, actigraphy and videosomnography. A substantial number of rodent and non-human primate models of ASD have been generated. Many of these animal models exhibited sleep disorders at an early age. The aim of this review is to examine and discuss sleep disorders in children with ASD. Toward this aim, we evaluated the prevalence, clinical characteristics, phenotypic analyses, and pathophysiological brain mechanisms of ASD. We highlight the current state of animal models for ASD and explore their implications and prospects for investigating sleep disorders associated with ASD.
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Affiliation(s)
- Shufei Feng
- Department of Pediatric Rehabilitation Medicine, Kunming Children’s Hospital, Kunming, China
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
| | - Haoyu Huang
- Department of Pediatric Rehabilitation Medicine, Kunming Children’s Hospital, Kunming, China
| | - Na Wang
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Yun Liu
- Department of Pediatric Rehabilitation Medicine, Kunming Children’s Hospital, Kunming, China
| | - Dongdong Qin
- Department of Pediatric Rehabilitation Medicine, Kunming Children’s Hospital, Kunming, China
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
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14
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Ricci C, Poulain T, Rothenbacher D, Genuneit J. The Associations Between Media Use, Midpoint of Sleep, and Sleep Quality in German Preschoolers: A Mediation Analysis Based on the Ulm SPATZ Health Study. Nat Sci Sleep 2021; 13:1025-1035. [PMID: 34262374 PMCID: PMC8273753 DOI: 10.2147/nss.s307821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/16/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION The relation of electronic media use with sleep quality among preschoolers is a matter of ongoing debate. Longitudinal data are scarce and do not account for sleeping schedules. METHODS We used the German Children's Sleep Habits Questionnaire to measure parent-reported child's sleep quality; its score is computed by the sum of 34 items defined by a 1-3 level Likert scale (score ranging 34-102), with higher values representing lower sleep quality. A causal mediation analysis of these relations using data from the Ulm SPATZ Health Study in Germany was conducted. Repeated data on electronic media use, book reading, sleep quality, sleep duration, and midpoint of sleep were prospectively collected yearly from ages 4 to 6 years (n=563) during parent's working days and free days. RESULTS We observed negative correlations of sleep quality with sleep duration and midpoint of sleep at ages 4-5 (R=-0.21 to -0.10), which attenuated with age 6 years. Sleep duration and midpoint of sleep were strongly positively correlated at all ages (R=0.55-0.95). We observed significant negative associations between total electronic media use and TV/DVD watching, while book reading did neither affect the sleep quality score nor sleep duration or midpoint of sleep. We found little evidence for an indirect negative effect of media use on sleep quality via sleep duration or midpoint of sleep, indicating that media use acts independently on sleep duration, midpoint of sleep, and sleep quality. Non-statistically significant associations of sleep duration and midpoint of sleep on sleep quality indicate that these are independent aspects of sleep adequacy. Evidence for this was stronger during free days. CONCLUSION Media use acted on sleep quality through a direct effect in a prospective fashion. Thus, we conclude that electronic media use increases the risk for sleep impairments in German preschoolers, while book reading seems to be a safe and healthy alternative.
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Affiliation(s)
- Cristian Ricci
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | | | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany.,Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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15
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Chen X, Qiang Y, Liu X, Yang Q, Zhu Q, Li B, Wang R. The Prevalence of Insufficient Sleep and Bedtime Delay Among Kindergarten Children Aged 3 to 6 Years in a Rural Area of Shanghai: A Cross-Sectional Study. Front Pediatr 2021; 9:759318. [PMID: 34900866 PMCID: PMC8655690 DOI: 10.3389/fped.2021.759318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/21/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction: Sleep deprivation in children is a global public health problem that affects the physical and mental development of children. Bedtime delay induced by longer screen time and heavy study load is a common cause of sleep deprivation in children. However, the prevalence of insufficient sleep and bedtime delay and related influencing factors among kindergarten children is limited in Shanghai, China. Methods: In 2018, we selected 8,586 children aged 3 to 6 years and their parents in Songjiang District, Shanghai. Data was collected among parents by face-to-face questionnaire interview with signed informed consent. We defined insufficient sleep as those who slept for < 10 h in children aged 3-5 years or 9 h in children aged 6 years within 24 h, and we define bedtime delay as children with bedtime after 21:00. SAS 9.1.3 software was used to calculate the prevalence of bedtime delay and insufficient sleep, and logistic regression was used to explore potential influencing factors. Results: The prevalence of insufficient sleep and bedtime delay among children aged 3 to 6 years was 11.67 and 56.85%, respectively. The prevalence of insufficient sleep among boys was slightly higher than among girls [odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.04-1.35]. With the increase of the age of children, the prevalence of insufficient sleep increased gradually (P < 0.05). The prevalence of insufficient sleep was higher among the only child in the family (OR = 1.18, 95% CI: 1.02-1.36) and those with longer hours of TV watching (OR = 109, 95% CI: 1.02-1.16). Meanwhile, the prevalence of bedtime delay was also higher among the only child in the family (OR = 1.17, 95% CI: 1.06-1.79), among those with parents accompanying for sleep (OR = 1.21, 95% CI: 1.10-1.34), and those with longer TV watching time (OR = 1.13, 95% CI: 1.07-1.18). Conclusions: Insufficient sleep and bedtime delay were prevalent in Chinese children aged 3 to 6 years, especially in boys and older children. TV watching as well as parents accompanying for sleep were associated with insufficient sleep and bedtime delay. We recommend that parents should limit the screen time of children, advocate earlier bedtime and later morning wake-up among children, as well as make their children sleep in separate beds or rooms in younger age.
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Affiliation(s)
- Xi Chen
- Shanghai Skin Disease Hospital, Shanghai, China
| | - Yan Qiang
- Shanghai Skin Disease Hospital, Shanghai, China
| | - Xia Liu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qing Yang
- Songjiang Maternity and Child Health Hospital, Shanghai, China
| | - Qingqing Zhu
- Songjiang Maternity and Child Health Hospital, Shanghai, China
| | - Bin Li
- Shanghai Skin Disease Hospital, Shanghai, China
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