1
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Shilton T, Bauman A, Beger B, Chalkley A, Champagne B, Elings-Pers M, Giles-Corti B, Goenka S, Miller M, Milton K, Oyeyemi A, Ross R, Sallis JF, Armstrong-Walenczak K, Salmon J, Whitsel LP. More People, More Active, More Often for Heart Health - Taking Action on Physical Activity. Glob Heart 2024; 19:42. [PMID: 38708404 PMCID: PMC11067976 DOI: 10.5334/gh.1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/12/2024] [Indexed: 05/07/2024] Open
Abstract
Physical inactivity is a leading contributor to increased cardiovascular morbidity and mortality. Almost 500 million new cases of preventable noncommunicable diseases (NCDs) will occur globally between 2020 and 2030 due to physical inactivity, costing just over US$300 billion, or around US$ 27 billion annually (WHO 2022). Active adults can achieve a reduction of up to 35% in risk of death from cardiovascular disease. Physical activity also helps in moderating cardiovascular disease risk factors such as high blood pressure, unhealthy weight and type 2 diabetes. For people with cardiovascular disease, hypertension, type 2 diabetes and many cancers, physical activity is an established and evidence-based part of treatment and management. For children and young people, physical activity affords important health benefits. Physical activity can also achieve important cross-sector goals. Increased walking and cycling can reduce journeys by vehicles, air pollution, and traffic congestion and contribute to increased safety and liveability in cities.
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Affiliation(s)
| | | | - Birgit Beger
- World Heart Federation, BE
- European Heart Network, BE
| | - Anna Chalkley
- Faculty of Life Sciences and Health Studies, University of Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, UK
| | | | | | - Billie Giles-Corti
- Centre for Urban Research, RMIT University, AU
- Telethon Kids Institute, AU
| | - Shifalika Goenka
- Public Health Foundation of India, IN
- Centre for Chronic Disease Control, IN
| | - Mark Miller
- World Heart Federation, UK
- Centre for Cardiovascular Science, University of Edinburgh, UK
| | - Karen Milton
- Norwich Medical School, University of East Anglia, UK
| | | | - Robert Ross
- Queen’s University School of Kinesiology and Health Studies, CA
| | - James F. Sallis
- Herbert Wertheim School of Public Health, University of California, US
- Mary MacKillop Institute for Health Research, Australian Catholic University, AU
| | | | - Jo Salmon
- Institute for Physical Activity and Nutrition, Deakin University, AU
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Neville RD, Hopkins WG, McArthur BA, Draper CE, Madigan S. Associations Between Changes in 24-Hour Movement Behaviors in Children and Adolescents During the COVID-19 Pandemic: A Systematic Review and Mediation-Based Meta-Analysis. J Phys Act Health 2024; 21:323-332. [PMID: 38194951 DOI: 10.1123/jpah.2023-0346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/25/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Although 24-hour movement behaviors are known to be interconnected, limited knowledge exists about whether change in one behavior during the COVID-19 pandemic (eg, increased screen time) was associated with change in another (eg, reduced physical activity or sleep). This review estimates mediational associations between changes in children's physical activity, screen time, and sleep during the COVID-19 pandemic. METHODS We included studies published between January 1, 2020 and June 27, 2022, in the PubMed/MEDLINE, Embase, PsycINFO, SPORTDiscus, and Web of Science databases. Summary data were extracted from included studies and analyzed with random-effects meta-regression. RESULTS This review included 26 studies representing 18,959 children across 18 mid-high-income countries (53% male; mean age, 11.5 [2.9] y). There was very good evidence of decreased total daily physical activity (factor change, 0.62; 90% CI, 0.47-0.81) and strong evidence of increased screen time (1.56; 90% CI, 1.38-1.77). There was very good evidence of decreased moderate to vigorous physical activity (0.75; 90% CI, 0.62-0.90) and weak evidence of increased sleep (1.02; 90% CI, 1.00-1.04). Mediational analysis revealed strong evidence that most of the reduction in total daily physical activity from before, to during, the pandemic was associated with increased screen time (0.53; 90% CI, 0.42-0.67). We observed no further mediational associations. CONCLUSION Increased reliance on and use of screen-based devices during the COVID-19 pandemic can be linked with reduced child and adolescent physical activity. This finding links COVID-related restrictions to potential displacement effects within child and adolescent 24-hour movement behavior.
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Affiliation(s)
- Ross D Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - William G Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, AL, Canada
- Alberta Children's Hospital Research Institute, Calgary, AL, Canada
| | - Catherine E Draper
- South African Medical Research Council Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AL, Canada
- Alberta Children's Hospital Research Institute, Calgary, AL, Canada
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3
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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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4
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Pfefferbaum B, Tucker P, Ekambaram V, Van Horn RL. Children's Sleep and Mental Health During the COVID-19 Pandemic. Curr Psychiatry Rep 2023; 25:847-856. [PMID: 37957452 DOI: 10.1007/s11920-023-01475-z] [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] [Accepted: 10/13/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic and protracted home confinement required adjustments to schedules and routines generating concern about children's sleep. This review describes general considerations regarding children's sleep, changes and disturbances in their sleep during the pandemic, and the association of sleep measures with health and psychological outcomes in general and in the context of the pandemic. RECENT FINDINGS A number of studies found an increase in the duration of children's sleep with later bedtimes and waketimes for some children. The research also documented sleep disturbances and associations between children's sleep and psychological outcomes. The extent to which increased sleep duration and changed sleep behaviors translated into improved sleep quality and/or a change in sleep disturbances remains unclear. This review suggests the importance of considering children's sleep in other mass trauma situations including, for example, natural and man-made disasters, as well as pandemics.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 3217, P.O. Box 26901, Oklahoma City, OK, 73126-0901, USA.
| | - Phebe Tucker
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, c/o 15509 Claremont Blvd, Edmond, OK, 73013, USA
| | - Vijayabharathi Ekambaram
- Department of Psychiatry, HCA Florida West Hospital, 8383 N. Davis Highway, Pensacola, FL, 32514, USA
| | - Richard L Van Horn
- University of Oklahoma, 920 Stanton L. Young Boulevard, WP 3217, P.O. Box 26901, Oklahoma City, OK, 73126-0901, USA
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Tan SYX, Padmapriya N, Bernard JY, Toh JY, Wee HL, Tan KH, Yap FKP, Lee YS, Chong YS, Godfrey K, Eriksson JG, Shek LPC, Tan CS, Chong MFF, Müller-Riemenschneider F. Cross-sectional and prospective associations between children's 24-h time use and their health-related quality of life: a compositional isotemporal substitution approach. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100918. [PMID: 37842643 PMCID: PMC10570705 DOI: 10.1016/j.lanwpc.2023.100918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/26/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023]
Abstract
Background Promoting active, balanced lifestyles among children may be an important approach to optimising their health-related quality of life (HRQoL). However, the relationships between children's movement behaviours and HRQoL remain unclear. Methods We examined the associations between movement behaviours (sleep, inactivity, light and moderate-to-vigorous intensity physical activity) assessed using accelerometers at ages 8 and 10 years and self-reported HRQoL scores (overall, and physical and emotional well-being, self-esteem, relationship with family and friends, and school functioning domains) at age 10 years among 370 children in a local birth cohort using compositional isotemporal substitution techniques. Findings Cross-sectionally, light and moderate-to-vigorous intensity physical activities were associated with better self-esteem (β = 15.94 [2.71, 29.18]) and relationship with friends (β = 10.28 [3.81, 16.74]) scores respectively. Prospectively, inactivity was associated with lower overall HRQoL (β = -10.00 [-19.13, -0.87]), relationship with friends (β = -16.41 [-31.60, -1.23]) and school functioning (β = -15.30 [-29.16, -1.44]) scores, while sleep showed a positive trend with overall HRQoL (β = 10.76 [-1.09, 22.61]) and school functioning (β = 17.12 [-0.87, 35.10]) scores. Children's movement behaviours were not associated with their physical and emotional well-being, or relationship with family scores. The isotemporal substitution analyses suggest that increasing time spent in physical activity and/or sleep at the expense of inactivity may benefit children's HRQoL. Interpretation Our findings suggest that sleep and physical activity may be associated with better HRQoL, with the inverse for inactivity. However, the relationship between children's movement behaviours and HRQoL is complex and warrants further research. Funding Singapore National Research Foundation, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research.
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Affiliation(s)
- Sarah Yi Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Natarajan Padmapriya
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jonathan Y. Bernard
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Université Paris Cité and Université Sorbonne Paris Nord, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, Inrae, F-75004, Paris, France
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Kok Hian Tan
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Fabian Kok Peng Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Keith Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Johan Gunnar Eriksson
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Digital Health Centre, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
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6
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Koa TB, Seah JX, Ong JQW, Lo JC. Short Sleep Duration in School-Age Children: Differential Factors on Weekdays and Weekends. Behav Sleep Med 2023; 21:774-786. [PMID: 36594607 DOI: 10.1080/15402002.2022.2164001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To quantify school-age children's sleep and parent-associated factors on weekdays and weekends in Singapore, and investigate school-related and parent-related factors associated with short sleep. METHODS In an online survey, 251 parents with a child aged 7-12 y in Singapore reported their child's sleep duration and school start time. Parent-related factors including sleep hygiene (e.g., parent-set bedtime), sleep priority (the amount of sleep respondents allowed their children to trade for other activities), and both parents' sleep durations, were also reported. RESULTS The prevalence of short sleep among the children was 64.5% on weekdays and 19.5% on weekends. Children's sleep duration increased from 8.42 h on weekdays to 9.45 h on weekends (p < .001). Relative to weekdays, on weekends, parents showed similar increases in sleep durations (p < .001), imposed poorer sleep hygiene on their children (reduced likelihood of setting bedtimes and increased pre-bedtime electronic device use; p < .001), and allowed their children to trade more sleep for interacting with family and friends, social media, gaming, and TV / videos (p < .001). Shorter sleep duration in children was significantly associated with earlier school start time (B = 0.80, p = .02) and poorer sleep hygiene on weekdays (B = 0.16, p < .001), but lower sleep priority (B = 0.05, p = .002) and shorter parental sleep duration on weekends (maternal: B = 0.18, p < .001, paternal: B = 0.17, p = .002). CONCLUSIONS Delaying school start times may be effective in increasing school-age children's sleep duration on weekdays, while family-based interventions designed to enhance sleep hygiene, priority of sleep over other activities, and parents' sleep durations can benefit children's sleep duration on both weekdays and weekends.
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Affiliation(s)
- Tiffany B Koa
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jia Xu Seah
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Juanita Q W Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - June C Lo
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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7
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Waters AM, Gibson L, Sluis RA, Modecki KL. Using Nightly Sleep Guidelines to Address Links Between Adolescents' Self-Reported Weekly Sleep Patterns and Anxiety and Depression Symptoms. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01610-0. [PMID: 37823958 DOI: 10.1007/s10578-023-01610-0] [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] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
Short and long nightly sleep durations are associated with anxiety and depression symptoms among adolescents. However, studies have not used recommended hours of nightly sleep or focused on sleep patterns across weekdays and weekends in examining links with anxiety and depression symptoms. The present study included 709 adolescents in Grade 11 (402 females; 307 males) who self-reported hours of sleep on weeknights and weekends and anxiety and depression symptoms. Using the recommended 8-10 h to define average nightly sleep for adolescents, sleep patterns across weekdays and weekends were categorised into seven classes: short stable, short increasing, average decreasing, average stable, average increasing, long decreasing, and long stable. Relative to average stable sleepers, short stable, short increasing, and long stable sleepers had significantly higher anxiety and depression. Adolescents require 8-10 h of sleep on weeknights, regardless of weekends, for optimal emotional wellbeing.
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Affiliation(s)
- Allison M Waters
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia.
| | - Lily Gibson
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
| | - Rachel A Sluis
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
| | - Kathryn L Modecki
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
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8
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Gissandaner TD, Stearns MA, Sarver DE, Walker B, Ford H. Understanding the Impact of Insufficient Sleep in Children with Behavior Problems on Caregiver Stress: Results from a U.S. National Study. Clin Child Psychol Psychiatry 2023; 28:1550-1564. [PMID: 36781225 PMCID: PMC10423297 DOI: 10.1177/13591045231156342] [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] [Indexed: 02/15/2023]
Abstract
Research indicates strong connections between child ADHD, child ODD/CD, and sleep. Children experiencing these concerns also have caregivers who report feeling more stress. However, no studies have examined how child ADHD and ODD/CD interact together and with insufficient sleep to potentially exacerbate caregiver stress. Data were acquired from the 2018/2019 National Survey of Children's Health, a nationally representative survey of parents or caregivers conducted across the United States (U.S.). The current study used data for children 6-17 years old with a final analytic sample size of 41,541, representing a total of 47,357,862 U.S. youth. Overall child ADHD and ODD/CD were each uniquely associated with increased caregiver stress, while adequate child sleep duration was related to decreased caregiver stress. However, these findings were qualified by a significant two-way interaction that revealed that caregiver stress among children with comorbid ADHD and ODD/CD was not significantly greater than that of children with ODD/CD alone. Significant interactions between sleep and ODD/CD on caregiver stress were generally not observed, except potentially in females with ADHD. Our findings underscore the importance of considering strategies to reduce both youth symptoms and caregiver stress simultaneously. Additionally, ensuring adequate sleep for all children is recommended.
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Affiliation(s)
- Tre D Gissandaner
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | | | - Hannah Ford
- University of Mississippi Medical Center, Jackson, MS, USA
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9
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Grimaldi M, Bacaro V, Natale V, Tonetti L, Crocetti E. The Longitudinal Interplay between Sleep, Anthropometric Indices, Eating Behaviors, and Nutritional Aspects: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:3179. [PMID: 37513597 PMCID: PMC10385596 DOI: 10.3390/nu15143179] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Sleep is fundamental for adolescents' healthy development but undergoes dramatic changes in quantity and quality due to the conflict between biological and social rhythms. Insufficient sleep has been associated with worse physical health status and irregular eating behaviors in adolescents. This review aims to systematically synthesize the longitudinal associations between adolescents' sleep dimensions (i.e., duration, timing, quality, and insomnia symptoms) and physical health indicators (i.e., anthropometric indices, fat percentage, and risk of obesity), eating behaviors, and nutritional aspects (i.e., type of diet related to the intake of specific foods and nutrients, amount and timing of food consumption, energy expenditure). A total of 28 longitudinal studies were included. The meta-analytic results showed that longer sleep duration, better sleep quality, and lower insomnia symptoms were associated with lower BMI and fat percentage and that shorter sleep duration (<7 h) and lower sleep quality were associated with a higher risk of obesity. Conversely, anthropometric indices were not related to sleep over time. Limited literature examined the bidirectional association between adolescents' sleep and their eating behaviors and nutritional aspects. Such knowledge sheds new light on the role of sleep for adolescents' health, highlighting the need to examine further the interplay between these variables.
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Affiliation(s)
- Martina Grimaldi
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Valeria Bacaro
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Vincenzo Natale
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Lorenzo Tonetti
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Elisabetta Crocetti
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
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10
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Molleri N, Gomes Junior SC, Marano D, Zin A. Survey of the Adequacy of Brazilian Children and Adolescents to the 24-Hour Movement Guidelines before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095737. [PMID: 37174254 PMCID: PMC10178683 DOI: 10.3390/ijerph20095737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
The 24-Hour Movement Guidelines provide specific recommendations on movement behaviors for children and adolescents. The objective of this study was to verify the adequacy of children and adolescents to the guidelines for moderate to vigorous physical activity, recreational screen time, and sleep duration, and the overall adequacy to the guidelines, before and during the COVID-19 pandemic. A cross-sectional study was conducted with parents or guardians of children or adolescents from different regions of Brazil using a digital interview form including sociodemographic characteristics of families, moderate to vigorous physical activity, recreational screen time, and sleep duration before and during the pandemic. Statistically significant variation was observed in both groups in relation to moderate to vigorous physical activity and recreational screen time between the two periods evaluated. Overall adequacy to the guidelines before the pandemic was 19.28% for children from Group 1 (0-5 years old) and 39.50% for those from Group 2 (6 to 17 years old). During the pandemic, it corresponded to 3.58% in Group 1 and 4.94% in Group 2 (p-value between periods ≤0.001). This study showed the significant impact of pandemic restrictions on reducing overall compliance and physical activity, and increasing screen time among Brazilian children and adolescents.
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Affiliation(s)
- Natália Molleri
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Saint Clair Gomes Junior
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Daniele Marano
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
| | - Andrea Zin
- National Institute of Women's, Child's and Adolescent's Health Fernandes Figueira, Rio de Janeiro 22250-020, Brazil
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11
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Bacaro V, Carpentier L, Crocetti E. Sleep Well, Study Well: A Systematic Review of Longitudinal Studies on the Interplay between Sleep and School Experience in Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4829. [PMID: 36981738 PMCID: PMC10049641 DOI: 10.3390/ijerph20064829] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Adolescents spend most of their daily time in school and performing school-related activities. Different aspects of their school experiences, such as school performance, psychological factors related to school, and structural factors, consistently impact adolescents' health and are likely to be intertwined with their sleep (i.e., quantity and quality, sleep disturbances). This systematic review aimed to comprehensively summarize the reciprocal and longitudinal associations between adolescents' sleep and multiple aspects of their school experience. Using multiple search strategies and applying a two-step selection process, 25 journal articles matched the eligibility criteria and were thus included in the review. The results highlighted the contribution of poor sleep quality and sleep disturbances in predicting longitudinal school experiences-related outcomes (i.e., decreasing school engagement and performance, and increasing school-related burnout, absenteeism, and bullying). At the same time, the results showed how experiences related to the school's psychological factors (e.g., high levels of school burnout and stressful environment) and structural characteristics (e.g., early school entrance time) affect youth sleep over time (i.e., decreasing sleep quality and quantity). These main findings provided novel insights into the bidirectional relationship between school experience and sleep health, highlighting the importance of more longitudinal research investigating all aspects of healthy sleep, including the size and direction of the association.
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Affiliation(s)
- Valeria Bacaro
- Department of Psychology “Renzo Canestrari”, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
| | - Liesbeth Carpentier
- Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Elisabetta Crocetti
- Department of Psychology “Renzo Canestrari”, Alma Mater Studiorum Università di Bologna, 47521 Cesena, Italy
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Maratia F, Bacaro V, Crocetti E. Sleep Is a Family Affair: A Systematic Review and Meta-Analysis of Longitudinal Studies on the Interplay between Adolescents' Sleep and Family Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054572. [PMID: 36901581 PMCID: PMC10001512 DOI: 10.3390/ijerph20054572] [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: 12/20/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 05/06/2023]
Abstract
Family is one of the primary socialization contexts influencing adolescents' psychological health. In this regard, a crucial indicator of adolescents' health is their sleep quality. Nevertheless, it is still unclear how multiple family factors (i.e., demographic and relational) are intertwined with adolescents' sleep quality. For this reason, this systematic review with meta-analysis aims to comprehensively summarize and integrate previous longitudinal research investigating the reciprocal relation between demographics (e.g., family structure) and positive (e.g., family support) and negative (e.g., family chaos) relational family factors and adolescents' sleep quality. Several search strategies were applied, and a final set of 23 longitudinal studies that matched the eligibility criteria were included in this review. The total number of participants was 38,010, with an average age at baseline of 14.7 years (SD = 1.6, range: 11-18 years). On the one hand, the meta-analytic results showed that demographic factors (e.g., low socio-economic status) were not related to adolescents' sleep quality at a later time point. On the other hand, positive and negative family relational factors were positively and negatively related to adolescents' sleep, respectively. Furthermore, the results suggested that this association could be bidirectional. Practical implications and suggestions for future research are discussed.
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Lucchini M, Bekelman TA, Li M, Knapp EA, Dong Y, Ballard S, Deoni S, Dunlop AL, Elliott AJ, Ferrara A, Friedman C, Galarce M, Gilbert-Diamond D, Glueck D, Hedderson M, Hockett CW, Karagas MR, LeBourgeois MK, Margolis A, McDonald J, Ngai P, Pellerite M, Sauder K, Ma T, Dabelea D. Impact of the COVID-19 pandemic on children's sleep habits: an ECHO study. Pediatr Res 2023; 93:586-594. [PMID: 36195633 PMCID: PMC9531212 DOI: 10.1038/s41390-022-02309-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/04/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Sleep in childhood is affected by behavioral, environmental, and parental factors. We propose that these factors were altered during the COVID-19 pandemic. This study investigates sleep habit changes during the pandemic in 528 children 4-12 years old in the US, leveraging data from the Environmental Influences on Child Health Outcomes (ECHO) Program. METHODS Data collection occurred in July 2019-March 2020 (pre-pandemic) and two pandemic periods: December 2020-April 2021 and May-August 2021. Qualitative interviews were performed in 38 participants. RESULTS We found no changes in sleep duration, but a shift to later sleep midpoint during the pandemic periods. There was an increase in latency at the first pandemic collection period but no increase in the frequency of bedtime resistance, and a reduced frequency of naps during the pandemic. Qualitative interviews revealed that parents prioritized routines to maintain sleep duration but were more flexible regarding timing. Children from racial/ethnic minoritized communities slept less at night, had later sleep midpoint, and napped more frequently across all collection periods, warranting in-depth investigation to examine and address root causes. CONCLUSIONS The COVID-19 pandemic significantly impacted children sleep, but parental knowledge of the importance of sleep might have played a significant protective role. IMPACT During the COVID-19 pandemic, US children changed their sleep habits, going to bed and waking up later, but their sleep duration did not change. Sleep latency was longer. Parental knowledge of sleep importance might have played a protective role. Regardless of data collection periods, children from racial/ethnic minoritized communities slept less and went to bed later. This is one of the first study on this topic in the US, including prospective pre-pandemic qualitative and quantitative data on sleep habits. Our findings highlight the pandemic long-term impact on childhood sleep. Results warrants further investigations on implications for overall childhood health.
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Affiliation(s)
- Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
| | - Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mingyi Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yanan Dong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Suyin Ballard
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sean Deoni
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Amy J Elliott
- Avera Research Institute, Sioux Falls, SD, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, USA
| | - Assiamira Ferrara
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Chloe Friedman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Maren Galarce
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Deborah Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Monique Hedderson
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Christine W Hockett
- Avera Research Institute, Sioux Falls, SD, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, USA
| | - Margaret R Karagas
- Department of Epidemiology, Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Monique K LeBourgeois
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Amy Margolis
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Julia McDonald
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Pakkay Ngai
- Division of Pediatric Pulmonology, Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | | | - Katherine Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Tengfei Ma
- Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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De Lise F, Bacaro V, Crocetti E. The Social Side of Sleep: A Systematic Review of the Longitudinal Associations between Peer Relationships and Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032017. [PMID: 36767384 PMCID: PMC9916135 DOI: 10.3390/ijerph20032017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 05/06/2023]
Abstract
In adolescence, peer relationships become crucial since youths start to rely on their peers for support. Thus, multiple facets of adolescents' well-being are affected by their peer relationships. In this vein, one of the central well-being aspects that could be affected by the peer relationships of adolescents is sleep quality. Nevertheless, it is still unclear how multiple peer relationship factors (i.e., positive, negative, emotional, and behavioral issues related to peer relationships) are intertwined with adolescents' sleep quality. For this reason, this systematic review with meta-analysis aims to summarize longitudinal studies to uncover how the interplay between peer relationship factors and adolescents' sleep quality unfolds over time. Nineteen longitudinal studies involving a total of 21,232 adolescents were included. Overall, findings from this review showed that (a) positive peer relationships and sleep quality were not associated over time; (b) negative peer relationships and sleep quality were bidirectionally associated over time; (c) few studies evaluated the bidirectional relations between emotional and behavioral issues and sleep quality, showing links with sleep schedule and duration, but not with sleep quality. Meta-analytic results were discussed, considering their implications.
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Belmon LS, Van Stralen MM, Harmsen IA, Den Hertog KE, Ruiter RAC, Chinapaw MJM, Busch V. Promoting children's sleep health: Intervention Mapping meets Health in All Policies. Front Public Health 2022; 10:882384. [PMID: 36466483 PMCID: PMC9709501 DOI: 10.3389/fpubh.2022.882384] [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] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background To design a comprehensive approach to promote children's sleep health in Amsterdam, the Netherlands, we combined Intervention Mapping (IM) with the Health in All Policies (HiAP) perspective. We aimed to create an approach that fits local infrastructures and policy domains across sectors. Methods First, a needs assessment was conducted, including a systematic review, two concept mapping studies, and one cross-sectional sleep diary study (IM step 1). Subsequently, semi-structured interviews with stakeholders from policy, practice and science provided information on potential assets from all relevant social policy sectors to take into account in the program design (HiAP and IM step 1). Next, program outcomes and objectives were specified (IM step 2), with specific objectives for policy stakeholders (HiAP). This was followed by the program design (IM step 3), where potential program actions were adapted to local policy sectors and stakeholders (HiAP). Lastly, program production (IM step 4) focused on creating a multi-sector program (HiAP). An advisory panel guided the research team by providing tailored advice during all steps throughout the project. Results A blueprint was created for program development to promote children's sleep health, including a logic model of the problem, a logic model of change, an overview of the existing organizational structure of local policy and practice assets, and an overview of policy sectors, and related objectives and opportunities for promoting children's sleep health across these policy sectors. Furthermore, the program production resulted in a policy brief for the local government. Conclusions Combining IM and HiAP proved valuable for designing a blueprint for the development of an integrated multi-sector program to promote children's sleep health. Health promotion professionals focusing on other (health) behaviors can use the blueprint to develop health promotion programs that fit the local public service infrastructures, culture, and incorporate relevant policy sectors outside the public health domain.
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Affiliation(s)
- Laura S. Belmon
- Department of Public and Occupational Health, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands,Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands,Department of Healthy Living, Public Health Service (GGD), Amsterdam, Netherlands,*Correspondence: Laura S. Belmon
| | - Maartje M. Van Stralen
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Irene A. Harmsen
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands
| | - Karen E. Den Hertog
- Department of Healthy Living, Public Health Service (GGD), Amsterdam, Netherlands
| | - Robert A. C. Ruiter
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Vincent Busch
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, Netherlands,Vincent Busch
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Magee L, Goldsmith LP, Chaudhry UAR, Donin AS, Wahlich C, Stovold E, Nightingale CM, Rudnicka AR, Owen CG. Nonpharmacological Interventions to Lengthen Sleep Duration in Healthy Children: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:1084-1097. [PMID: 36094530 PMCID: PMC9468945 DOI: 10.1001/jamapediatrics.2022.3172] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/09/2022] [Indexed: 12/15/2022]
Abstract
Importance Adequate sleep duration is necessary for many aspects of child health, development, and well-being, yet sleep durations for children are declining, and effective strategies to increase sleep in healthy children remain to be elucidated. Objective To determine whether nonpharmaceutical interventions to improve sleep duration in healthy children are effective and to identify the key components of these interventions. Data Sources CENTRAL, MEDLINE, Embase, PsycINFO, Web of Science Core collection, ClinicalTrials.gov, and WHO trials databases were searched from inception to November 15, 2021. Study Selection Randomized clinical trials of interventions to improve sleep duration in healthy children were independently screened by 2 researchers. A total of 28 478 studies were identified. Data Extraction and Synthesis Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guideline. Random-effects meta-analytic models were used to estimate pooled effect sizes. Main Outcomes and Measures Difference in sleep duration, measured in minutes. Results A total of 13 539 child participants from 45 randomized clinical trials were included. Of these, 6897 (50.9%) were in the intervention group and 6642 (49.1%) in the control group, and the mean age ranged from 18 months to 19 years. Pooled results indicate that sleep interventions were associated with 10.5 minutes (95% CI, 5.6-15.4) longer nocturnal sleep duration. There was substantial variation between trials. Sources of variation that were not associated with the study effect size included age group, whether the population was identified as having a sleep problem or being at a socioeconomic disadvantage (eg, coming from a low-income family or area), method of assessment of sleep duration (objective vs subjective), location of intervention delivery (home vs school), whether interventions were delivered in person or used parental involvement, whether behavioral theory was used, environmental change, or had greater or lower intensity. Interventions that included earlier bedtimes were associated with a 47-minute sleep extension (95% CI, 18.9-75.0; 3 trials) compared with remaining studies (7.4 minutes; 95% CI, 2.9-11.8; 42 trials) (P = .006 for group difference). Trials of shorter duration (6 months or less) had larger effects. Conclusions and Relevance Interventions focused on earlier bedtimes may offer a simple, pragmatic, effective way to meaningfully increase sleep duration that could have important benefits for child health.
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Affiliation(s)
- Lucia Magee
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Lucy P. Goldsmith
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Umar A. R. Chaudhry
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Angela S. Donin
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Charlotte Wahlich
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Elizabeth Stovold
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Claire M. Nightingale
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Alicja R. Rudnicka
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
| | - Christopher G. Owen
- Population Health Research Institute, St George’s, University of London, London, United Kingdom
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Pardhan S, Parkin J, Trott M, Driscoll R. Risks of Digital Screen Time and Recommendations for Mitigating Adverse Outcomes in Children and Adolescents. THE JOURNAL OF SCHOOL HEALTH 2022; 92:765-773. [PMID: 35253225 DOI: 10.1111/josh.13170] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The COVID-19 pandemic caused an unprecedented move to emergency remote learning around the world, leading to increased digital screen time for children and adolescents. This review highlights the potential risk of increased screen time to the eye and general health and makes recommendations to mitigate the risks posed. METHODS A narrative review of evidence of increased digital time during the COVID-19 pandemic, the risks linked to increased screen time and offer possible steps to mitigate these in students. RESULTS Digital screen time was found to have increased for children and adolescents in all the studies examined during the pandemic and data suggests that this has an impact on eye and general health. We discuss the associated risk factors and adverse outcomes associated with increased digital screen time. CONCLUSIONS This review offers evidence of increased digital time, highlights some of the well-known and not so well-known risks linked to increased screen time, and offers possible steps to mitigate these in children and adolescents during the pandemic, as well as offering schools and parents strategies to support the eye health of children and adolescents post-pandemic. We discuss a number of interventions to reduce the risk of eye strain, myopia, obesity, and related diseases that have been shown to be linked to increased digital screen time.
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Affiliation(s)
- Shahina Pardhan
- Director of Vision and Eye Research Institute, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, CB1 2LZ, UK
| | - John Parkin
- Primary Education, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Mike Trott
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Cambridge, CB1 2LZ, UK
| | - Robin Driscoll
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Cambridge, CB 2LZ, UK
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Tapia-Serrano MA, Sevil-Serrano J, Sánchez-Miguel PA, López-Gil JF, Tremblay MS, García-Hermoso A. Prevalence of meeting 24-Hour Movement Guidelines from pre-school to adolescence: A systematic review and meta-analysis including 387,437 participants and 23 countries. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:427-437. [PMID: 35066216 PMCID: PMC9338333 DOI: 10.1016/j.jshs.2022.01.005] [Citation(s) in RCA: 88] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/26/2021] [Accepted: 12/08/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Meeting the 24-Hour Movement Guidelines (physical activity, screen time, and sleep duration) has been associated with positive health indicators. However, there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world. Therefore, the main purpose of this systematic review and meta-analysis was to examine the overall (non)adherence to the 24-Hour Movement Guidelines among preschoolers, children, and adolescents worldwide. METHODS Four electronic databases (MEDLINE, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021. Studies that were conducted with apparently healthy participants and reported the overall (non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included. RESULTS Sixty-three studies comprising 387,437 individuals (51% girls) aged 3-18 years from 23 countries were included. Overall, 7.12% (95% confidence interval (95%CI): 6.45%-7.78%) of youth met all three 24-Hour Movement Guidelines, and 19.21% (95%CI: 16.73%-21.69%) met none of the 3 recommendations. Concerning sex, adherence to all recommendations was significantly lower in girls (3.75%, 95%CI: 3.23%-4.27%) than in boys (6.89%, 95%CI: 5.89%-7.89%) (p < 0.001). However, there were no sex differences regarding adherence to any of the 3 individual recommendations (girls, 15.66%, 95%CI: 8.40%-22.92%; boys, 12.95%, 95%CI: 6.57%-19.33%). In terms of age group, adherence to the 3 recommendations was 11.26% (95%CI: 8.68%-13.84%), 10.31% (95%CI: 7.49%-13.12%), and 2.68% (95%CI: 1.78%-3.58%) in preschoolers, children, and adolescents, respectively. Conversely, 8.81% (95%CI: 5.97%-11.64%) of preschoolers, 15.57% (95%CI: 11.60%-19.54%) of children, and 28.59% (95%CI: 22.42%-34.75%) of adolescents did not meet any of the recommendations. South America was the region with the lowest adherence (all: 2.93%; none: 31.72%). Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index (β = -0.37, 95%CI: -0.65 to -0.09; p = 0.010). CONCLUSION Most young people fail to meet the three 24-Hour Movement Guidelines, particularly adolescents, girls, and those who are from countries with a lower Human Development Index. Moreover, 1 in 5 young people did not meet any of these recommendations. Therefore, these results highlight the need to develop age- and sex-specific strategies to promote these movement behaviors from the early stages of life.
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Affiliation(s)
- Miguel Angel Tapia-Serrano
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Teaching Training, University of Extremadura, Avenida de la Universidad, S/N, Cáceres 10071, Spain
| | - Javier Sevil-Serrano
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Teaching Training, University of Extremadura, Avenida de la Universidad, S/N, Cáceres 10071, Spain
| | - Pedro Antonio Sánchez-Miguel
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Teaching Training, University of Extremadura, Avenida de la Universidad, S/N, Cáceres 10071, Spain
| | - José Francisco López-Gil
- Department of Physical Activity and Sport, Faculty of Sport Science, University of Murcia (UM), San Javier 30720, Spain
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Antonio García-Hermoso
- Navarrabiomed, Public University of Navarra (UPNA), Health Research Institute of Navarra (IdiSNA), Navarra Hospital Complex (CHN), Pamplona 310008, Spain.
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Primary School Children's Sleep Habits: Association with Socioeconomic Factors and Physical Activity Habits. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9070965. [PMID: 35883948 PMCID: PMC9317587 DOI: 10.3390/children9070965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
Sleep disorders have significant health impacts and affect children’s performance and wellbeing. This study aims to characterise the sleep habits of Portuguese primary school children considering socioeconomic factors, daily lifestyle, presence of electronic devices in the bedrooms, and the practice of physical and sports activity (PSA) and to identify clinical factors that may be related to a child’s insufficient sleeping time. This study involved 1438 primary students. Sleep habits and problems were assessed using the short version of the Children’s Sleep Habits Questionnaire (CSHQ). The mean sleep duration was 9 h 37 min/ per night (SD = 44 min). The prevalence of global sleep disturbances was 25.8%. The main factors we identified to be positively associated with a child’s sleep deficit (i.e., <10 h) were: being older than 7 years, living further away from school, having electronic devices in the bedroom, going to bed and eating dinner later, less daily time of PSA, and having higher scores on the sleep duration subscales. Sleeping and eating habits, electronic devices in the bedroom, and a low level of engagement with PSA are associated with children’s sleep disturbance and shorter sleep duration.
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Durmuşoğlu Saltalı N, Günay Molu N, Ateş MA. Psychometric evaluation of the Turkish Adaptation of Parent-Child Sleep Interaction Scale (PSIS) for preschoolers. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2090672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
| | - Nesibe Günay Molu
- Department of Psychiatry Nursing, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Ali Ateş
- Department of Preschool Education, Girne American University, Girne, Cyprus
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Kaur R, Boobna T, Kallingal P. Effect of Covid-19 lockdown on indian children with autism. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 125:104230. [PMID: 35367807 PMCID: PMC8964314 DOI: 10.1016/j.ridd.2022.104230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/01/2022] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND To prevent the spread of Coronavirus-19 a complete lockdown was enforced in India by March, 2020. The lockdown led to drastic negative effects on the social and communicative life of people. Among these, children and adolescents have been majorly affected. The study aims to investigate the effect of lockdown on Indian children with Autism. METHODS AND PROCEDURES Thirty parents of children with Autism were given questionnaires to rate the performance of their children, pre- and post-lockdown. The questionnaires were analysed for development across activities of daily living (ADL), language and behavioral characteristics along with school and therapy performance. OUTCOME AND RESULTS The results revealed a significant regression in performance of children post-lockdown which was evident across all the domains assessed. Various additional issues like changes in sleep patterns, inadequate sitting behavior, attention span, concentration, limited eye contact, mood swings, laziness, clumsiness, hyperactivity and impulsivity were also noted post-lockdown, which were not very prominent before lockdown. CONCLUSIONS AND IMPLICATIONS The study anticipates to help be better prepared for such situations in future. This includes involvement of better intervention which includes home-based training strategies for these children. Moreover, the study highlights impact of online therapy and schooling for children with Autism.
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Affiliation(s)
- Ramandeep Kaur
- Father Muller College of Speech and Hearing, Mangalore, Karnataka 575002, India.
| | - Tamanna Boobna
- Father Muller College of Speech and Hearing, Mangalore, Karnataka 575002, India
| | - Praseena Kallingal
- Father Muller College of Speech and Hearing, Mangalore, Karnataka 575002, India
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22
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Determinants of adolescent sleep: Early family environment, obstetric factors, and emotion regulation. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1016/j.appdev.2022.101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Lifestyle changes, mental health, and health-related quality of life in children aged 6-7 years before and during the COVID-19 pandemic in South Germany. Child Adolesc Psychiatry Ment Health 2022; 16:20. [PMID: 35277185 PMCID: PMC8915143 DOI: 10.1186/s13034-022-00454-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The measures against the COVID-19 pandemic are challenging for children and parents, and detrimental effects on child health are suggested especially from lock-down measures and school closings. METHODS We conducted a cross-sectional analysis using a population based longitudinal (birth-) cohort study (SPATZ study) conducted in the South of Germany. Data included all 6 or 7 year old children for whom a questionnaire was completed during first grade of school. Consequently, we were able to analyze children being in first grade before the first lockdown in Germany (≤ 15th March 2020), as well as children being in first grade during the pandemic (> 15th March 2020). We conducted descriptive statistics and estimated the associations between the two time periods, before and during the pandemic, and various outcomes of child health using multivariable adjusted linear or logistic regression modeling. The analysis was stratified by gender. RESULTS Results among n = 362 children aged six or seven years showed substantially lower mean scores of health-related quality of life (difference in means: - 5.5, 95% confidence interval (CI) - 9.0, - 2.0), and higher mean scores in total emotional and behavioral difficulties (difference in means: 2.0, 95% CI 0.2, 3.8) in girls during vs. before the COVID-19 pandemic using multivariable linear regression modeling. In addition, weekly screen-time was increased in boys by 3.5 h (95% CI 0.6, 6.4). We did not find substantial differences in sleep quality, physical activity, and time spent with books, neither in boys nor in girls, however, the limited sample size has to be considered. CONCLUSION Child health (and behavior) of first grade school children is possibly impacted by the COVID-19 pandemic with adverse consequences possibly differing by gender.
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24
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Vyhlídal T, Dygrýn J, Chmelík F. Actigraphy-Based Characteristics of Sleep in Paediatric Cancer Patients in Remission and a Comparison with Their Healthy Peers in the Recovery Stay. Nat Sci Sleep 2022; 14:1449-1456. [PMID: 36045915 PMCID: PMC9423104 DOI: 10.2147/nss.s374234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous research has demonstrated that paediatric cancer survivors (PCS) have lower sleep quality than their healthy peers. However, the research to date has focused mainly on self-reported data. Therefore, the aim of this cross-sectional study was to characterise selected sleep parameters in PCS using objective monitoring techniques and to compare them with a control group (CG) of their healthy peers during a structured recovery stay. A specific objective was to characterise sleep with respect to gender, age, and cancer type. METHODS 26 PCS and 38 CG aged 7-15 years participated in the study. Selected sleep indicators (time in bed, total sleep time, sleep efficiency) were objectively assessed with an Actigraph wGT3X-BT accelerometer for 12 days during the recovery stay. RESULTS No significant differences were found between the PCS and CG groups in terms of the selected sleep parameters. The total time in bed was 543.1 min/day in the PCS and 537.2 min/day in the CG (p=0.91). The total sleep time was 455.3 min/day in the PCS and 457.5 min/day in the CG (p=0.57). Sleep efficiency was 85.3% in the PCS and 86.3% in the CG (p=0.36). Sleep efficiency >85% was achieved by 62% of the PCS (n=16) and 68% of the CG (n=26). There were no significant differences in sleep parameters in terms of variables such as gender, age, or cancer type. CONCLUSION The results of our study suggest that - under the same conditions - the PCS did not differ from their healthy peers in terms of the indicators of time in bed, total sleep time, and sleep efficiency. No significant differences according to age, gender, or cancer type were found.
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Affiliation(s)
- Tomáš Vyhlídal
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - František Chmelík
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
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25
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Berard M, Peries M, Loubersac J, Picot MC, Bernard JY, Munir K, Baghdadli A. Screen time and associated risks in children and adolescents with autism spectrum disorders during a discrete COVID-19 lockdown period. Front Psychiatry 2022; 13:1026191. [PMID: 36532191 PMCID: PMC9751585 DOI: 10.3389/fpsyt.2022.1026191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/04/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic may affect the screen time of children and adolescents with Autism Spectrum Disorders (ASD). This study aimed to examine the screen time of children and adolescents with ASD during a discrete lockdown period in France and identify risk factors for excessive screen time. METHODS The study sample consisted of 249 ASD subjects, 3-17 years of age, enrolled in the ELENA cohort. Information about the screen time was collected using the COVID-19 questionnaire specially created for this study. The clinical, socio-demographic and familial characteristics were collected from the last ELENA follow-up visit. RESULTS More than one third of subjects exceeded recommended levels of screen time and almost half of parents reported that their child spent more time using screen since COVID-19 pandemic beginning. Excessive screen time was significantly related to age with higher screen time in adolescents. Risk factors for excessive screen time were high withdrawn behaviors and low socioeconomic status for children, and older age and male gender for adolescents. CONCLUSION These results imply to adapt the recommendations already formulated in general population concerning the good use of screens in youth with ASD. Specific recommendations and suitable guidance are needed to help children and adolescents with ASD and their parents implement the more optimal use of screen time activities for educational, therapeutic and social goals. TRIAL REGISTRATION NUMBER NCT02625116.
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Affiliation(s)
- Mathilde Berard
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Marianne Peries
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Julie Loubersac
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Marie-Christine Picot
- Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Clinical Research and Epidemiology Unit, Department of Medical Information, University Hospital, CHU Montpellier, Montpellier, France
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre de Recherche en Épidémiologie et Statistiques, Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France
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26
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Physical Activity, Screen Time, Sedentary and Sleeping Habits of Polish Preschoolers during the COVID-19 Pandemic and WHO's Recommendations: An Observational Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111173. [PMID: 34769692 PMCID: PMC8583704 DOI: 10.3390/ijerph182111173] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/16/2021] [Accepted: 10/20/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Restrictions related to the COVID-19 pandemic may lead to a significant decrease in physical activity, an increase in sedentary behavior, and thus also such things as screen time or a change in health behavior patterns. The survey aimed to compare levels of physical activity, screen time, hours spent sitting and sleeping time among Polish children aged 3-5 years of age before and during the COVID-19 pandemic. METHODS We identified 3000 respondents under five years of age, at Polish kindergartens. The questionnaire consists of 62 questions according to the recommendations of health behavior in school-aged children. The questionnaire was completed by the parents of these children. RESULTS Only 30.77% of children complied with WHO criteria before the pandemic. During the pandemic, the percentage of children meeting the recommendations for physical activity decreased even more. Children spent much more time in a sitting position before the restrictions. The children slept as recommended 10-13 h a day, and the pandemic caused an increase in sleep duration of 10-18%. Most children had a limited time allowed for the use of electronic devices already before the pandemic, but during the pandemic the results negatively decreased by 71.54%. CONCLUSIONS The results clearly indicate decreased physical activity and increased screen time. It is also crucial to develop recommendations for prevention management strategies of sedentary lifestyles in the youngest group.
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27
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Belmon LS, Komrij NL, Busch V, Oude Geerdink E, Heemskerk DM, de Bruin EJ, Chinapaw MJM, van Stralen MM. Correlates of inadequate sleep health among primary school children. J Sleep Res 2021; 31:e13483. [PMID: 34528326 PMCID: PMC9285344 DOI: 10.1111/jsr.13483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/29/2021] [Accepted: 08/30/2021] [Indexed: 10/29/2022]
Abstract
The aim of the present study was to explore potential factors of inadequate sleep health (i.e. sleep duration, quality, and timing) of school-aged children. Data were collected among 382 primary school children (aged 4-13 years) and their parents. Personal characteristics (i.e. age, sex), individual lifestyle behaviours (i.e. screen use, sleep hygiene behaviour), social and community factors (i.e. parental sleep-related practices, parental barriers, perceived ethnicity), and living conditions (i.e. parental educational level, sleep environment) were assessed with a parental questionnaire. Sleep duration, quality, and timing were assessed with a sleep diary. Associations were analysed using linear mixed models and logistic regression analyses. In total, 332 children, with a mean (range) age of 7.5 (4-13) years, were included in the analyses. The mean sleep duration was 632 min/night, the mean sleep quality score was 40, on a scale from 10 to 50, and 25% had a bedtime that varied >40 min between weekdays. Factors negatively associated with children's sleep health included older age, perceived non-Dutch cultural background, lower parental pre-sleep emotional support, the parental barrier to get their child to bed on time when siblings have a later bedtime, high parental educational level, sleeping in a darkened bedroom, and being brought to bed after falling asleep. On average, children in the present study had adequate sleep health. The factors found to be associated with children's sleep health are useful for future healthy sleep research and intervention development.
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Affiliation(s)
- Laura S Belmon
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.,Sarphati Amsterdam, Public Health Service (GGD) Amsterdam, Amsterdam, the Netherlands
| | - Nina L Komrij
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.,Sarphati Amsterdam, Public Health Service (GGD) Amsterdam, Amsterdam, the Netherlands
| | - Vincent Busch
- Sarphati Amsterdam, Public Health Service (GGD) Amsterdam, Amsterdam, the Netherlands
| | - Esmée Oude Geerdink
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Danique M Heemskerk
- Sarphati Amsterdam, Public Health Service (GGD) Amsterdam, Amsterdam, the Netherlands.,Department of Health Science, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ed J de Bruin
- Department of Psychology, Health & Technology, University of Twente, Enschede, the Netherlands
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Maartje M van Stralen
- Department of Health Science, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
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28
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Merianos AL, Mahabee-Gittens EM, Choi K. Tobacco smoke exposure and inadequate sleep among U.S. school-aged children. Sleep Med 2021; 86:99-105. [PMID: 34479053 DOI: 10.1016/j.sleep.2021.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE/BACKGROUND Inadequate sleep and tobacco smoke exposure (TSE) have been separately linked to adverse childhood health consequences. Our objective was to assess the association between home TSE status and inadequate sleep among U.S. school-aged children. METHODS We analyzed 2018-2019 National Survey of Children's Health data, and included 17,851 children ages 6-11 years. Children were classified into three parent-report TSE groups: (1) did not live with a smoker (no TSE at home); (2) lived with a smoker who did not smoke inside the home (thirdhand smoke (THS) exposure only); and (3) lived with a smoker who smoked inside the home (secondhand smoke (SHS) and THS exposure). Parent-report of inadequate sleep on most weeknights was defined as <9 h, following age-specific national guidelines. We fitted a weighted multivariable logistic model to assess the association between TSE groups and inadequate sleep, adjusting for child covariates (sociodemographics, overweight status, health status, physical activity, and screen time). RESULTS About 13% and 1% of school-aged children were exposed to home THS only and home SHS and THS, respectively; approximately 36% overall had inadequate sleep. Compared to children with no TSE at home, children who were exposed to home THS only had higher odds of inadequate sleep (AOR = 1.44, 95%CI = 1.20-1.73); those exposed to home SHS and THS had higher odds of inadequate sleep (AOR = 1.83, 95%CI = 1.20-2.78). CONCLUSIONS TSE is associated with school-aged children having inadequate sleep, even when smokers did not smoke inside the home. Promoting parental smoking cessation is essential to fully protect children from related risks.
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Affiliation(s)
- Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA.
| | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA.
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29
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Albakri U, Drotos E, Meertens R. Sleep Health Promotion Interventions and Their Effectiveness: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115533. [PMID: 34064108 PMCID: PMC8196727 DOI: 10.3390/ijerph18115533] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 01/04/2023]
Abstract
Sleep is receiving increasing attention in public health. The aim of this umbrella review is to determine what non-pharmacological sleep health interventions have been evaluated among healthy populations, by examining target groups, settings, and effectiveness in improving sleep quality and duration. Comprehensive searches were conducted in five electronic databases (January 1975–February 2019), yielding 6505 records. Thirty-five articles were selected meeting the following eligibility criteria: (1) systematic reviews or meta-analyses of (2) sleep health interventions in (3) primarily healthy populations. Two reviewers independently screened for inclusion, extracted the data, and assessed the review quality. This umbrella review was registered with PROSPERO (CRD42019126291). Eleven intervention types were defined, and their effectiveness discussed. Substantial evidence demonstrated the effectiveness of later school start times, behavior change methods, and mind–body exercise. Other intervention types, including sleep education or relaxation techniques, demonstrated some promising impacts on sleep, but with less consistent evidence. Results were limited by high heterogeneity between studies, mixed results, and variable review quality. Nevertheless, this umbrella review is a first step towards understanding the current state of sleep health promotion and gives an overview of interventions across the lifespan.
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Affiliation(s)
- Uthman Albakri
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.D.); (R.M.)
- Department of Public Health, Faculty of Applied Medical Sciences, Albaha University, Albaha 65779, Saudi Arabia
- Correspondence:
| | - Elizabeth Drotos
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.D.); (R.M.)
| | - Ree Meertens
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.D.); (R.M.)
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30
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Chen ST, Liu Y, Tremblay MS, Hong JT, Tang Y, Cao ZB, Zhuang J, Zhu Z, Wu X, Wang L, Cai Y, Chen P. Meeting 24-h movement guidelines: Prevalence, correlates, and the relationships with overweight and obesity among Chinese children and adolescents. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:349-359. [PMID: 32679341 PMCID: PMC8167320 DOI: 10.1016/j.jshs.2020.07.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/20/2020] [Accepted: 06/18/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health, although it has been under-studied in China. Hence, this study aimed to investigate the prevalence of meeting the 24-h movement guidelines, its correlates, and its relationships with body mass index in children and adolescents in China. METHODS Cross-sectional data from the 2017 Youth Study in China of 114,072 children and adolescents (mean age = 13.75 years, 49.18% boys) were used. Meeting 24-h movement guidelines (≥60 min of daily moderate-to-vigorous physical activity, ≤2 h of daily leisure screen time, 9-11 h and 8-10 h nightly sleep duration for 6-13-year-olds and 14-17-year-olds, respectively) and height and weight of all participants were assessed. The prevalence of meeting the 24-h movement guidelines and World Health Organization weight status categories were determined. Generalized linear models were used to determine the correlates of meeting the 24-h movement guidelines and the relationships of meeting the 24-h movement guidelines with overweight (OW) and obesity (OB). RESULTS Only 5.12% of Chinese children and adolescents met the 24-h movement guidelines, and 22.44% were classified as OW/OB. Older children and adolescents were less likely to meet the 24-h movement guidelines. Parental education level and family income were positively related to meeting the 24-h movement guidelines. Children and adolescents meeting the 24-h movement guidelines showed lower odds ratios for OW/OB. Compared with participants meeting the 24-h movement guidelines, boys in 4th-6th grades met none of the recommendations (OR = 1.22, 95%CI: 1.06-1.40), met the screen time recommendation only (OR = 1.13, 95%CI: 1.01-1.28), met the nightly sleep duration recommendation only (OR = 1.14, 95%CI: 1.03-1.28), and had significantly higher odds ratios for OW/OB. Similar trends were observed for girls in 4th-6th grades: meeting none of the guidelines (OR = 1.35, 95%CI: 1.14-1.59), meeting sleep duration guidelines only (OR = 1.23, 95%CI: 1.08-1.39), and meeting moderate-to-vigorous physical activity + nightly sleep duration guidelines (OR = 1.24, 95%CI: 1.01-1.54). For girls in 7th-9th grades, the following trend was observed: meeting none of the guidelines (OR = 1.30, 95%CI: 1.01-1.67). CONCLUSION Very few Chinese children and adolescents met the 24-h movement guidelines. Age (negatively correlated), parental education level, and family income (both positively correlated) were correlates of meeting the 24-h movement guidelines. Children and adolescents meeting the 24-h movement guidelines were more likely to have lower risks for OW/OB, especially in the youngest age group (Grades 4-6); and girls in the middle age group (Grades 7-9) were also more likely to have lower risks for OW/OB. Further research studies should explore additional correlates and determinants for meeting the 24-h movement guidelines. Also, future studies should use longitudinal or interventional designs to determine the relationships between meeting the 24-h movement guidelines and OW/OB and other health indicators, while taking sex and age differences into account.
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Affiliation(s)
- Si-Tong Chen
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
| | - Yang Liu
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China.
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Jin-Tao Hong
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
| | - Yan Tang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China
| | - Zhen-Bo Cao
- Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China; School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Jie Zhuang
- Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China; School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Zheng Zhu
- Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China; School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Xueping Wu
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China
| | - Lijuan Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China
| | - Yujun Cai
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China
| | - Peijie Chen
- Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China; School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
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31
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van Hulst AM, Peersmann SHM, van den Akker ELT, Schoonmade LJ, van den Heuvel-Eibrink MM, Grootenhuis MA, van Litsenburg RRL. Risk factors for steroid-induced adverse psychological reactions and sleep problems in pediatric acute lymphoblastic leukemia: A systematic review. Psychooncology 2021; 30:1009-1028. [PMID: 33825231 PMCID: PMC8359839 DOI: 10.1002/pon.5654] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/05/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Steroids play an essential role in treating pediatric acute lymphoblastic leukemia (ALL). The downside is that these drugs can cause severe side effects, such as adverse psychological reactions (APRs) and sleep problems, which can compromise health-related quality of life. This study aimed to systematically review literature to identify risk factors for steroid-induced APRs and sleep problems in children with ALL. METHODS A systematic search was performed in six databases. Titles/abstracts were independently screened by two researchers. Data from each included study was extracted based on predefined items. Risk of bias and level of evidence were assessed, using the Quality in Prognosis Studies tool and the Grading of Recommendations Assessment, Development and Evaluation tool, respectively. RESULTS Twenty-four articles were included. APR measurement ranged from validated questionnaires to retrospective record retrieval, sleep measurement included questionnaires or actigraphy. Overall, quality of evidence was very low. Current evidence suggests that type/dose of steroid is not related to APRs, but might be to sleep problems. Younger patients seem at risk for behavior problems and older patients for sleep problems. No studies describing parental stress or medical history were identified. Genetic susceptibility associations remain to be replicated. CONCLUSIONS Based on the current evidence, conclusions about risk factors for steroid-induced adverse psychological reactions or sleep problems in children with ALL should be drawn cautiously, since quality of evidence is low and methods of measurement are largely heterogeneous. A standardized registration of steroid-induced APRs/sleep problems and risk factors is warranted for further studies in children with ALL.
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32
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Cartanyà-Hueso À, Martín-Sánchez JC, Lidón-Moyano C, González-Marrón A, Martínez-Sánchez JM. Differences in sleep duration in a territory with the same time zone according to the geographic longitude: the Spanish case. Sleep Med 2021; 82:151-154. [PMID: 33915431 DOI: 10.1016/j.sleep.2021.03.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE/BACKGROUND In some territories, such as Spain, daytime starts with around 1 h of difference between the easternmost and westernmost areas, but the time zone is the same in these areas. This difference might have an effect on children's sleep. The aim of this study is to assess if there are differences in the prevalence of short sleep duration between children under 15 years from easternmost (Catalonia) and westernmost (Galicia) continental territory areas in Spain. METHODS Cross-sectional study using data from the 2017 Spanish National Health Survey (n = 6106). The final sample includes 1004 children under 15 years living in Catalonia and Galicia. We categorized sleep duration according to the National Sleep Foundation recommendations with respect to age in (1) not short sleep duration and (2) short sleep duration. We calculated overall percentages of short sleep duration, and unadjusted and adjusted Prevalence Ratios (PR) with 95% Confidence Intervals (95% CI), according to area and stratified by confounders and covariates. Unadjusted and adjusted PR were obtained through generalized linear models with Poisson family and robust variance. We adjusted the associations for confounders. RESULTS Children from Galicia were less likely to have short sleep duration than children from Catalonia, aPRGalicia = 0.61 (95% CI: 0.45,0.83). CONCLUSIONS Children living in the same country, potentially with a similar timetable, could be having shorter sleep durations according to their longitude position. Further studies are needed in order to consider promoting policies to apply timetables based on the sun position instead of on the national time zone.
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Affiliation(s)
- Àurea Cartanyà-Hueso
- Group of Evaluation of Health Determinants and Health Policies, Departament de Ciéncies Básiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Juan Carlos Martín-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Departament de Ciéncies Básiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.
| | - Cristina Lidón-Moyano
- Group of Evaluation of Health Determinants and Health Policies, Departament de Ciéncies Básiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Adrián González-Marrón
- Group of Evaluation of Health Determinants and Health Policies, Departament de Ciéncies Básiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M Martínez-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Departament de Ciéncies Básiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
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Komrij NL, van Stralen MM, Busch V, Inhulsen MBMR, Koning M, de Jong E, Renders CM. Predictors of Changes in Sleep Duration in Dutch Primary Schoolchildren: the ChecKid Study. Int J Behav Med 2021; 28:189-199. [PMID: 32314258 PMCID: PMC8016776 DOI: 10.1007/s12529-020-09876-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Healthy sleep duration is essential to health and well-being in childhood and later life. Unfortunately, recent evidence shows a decline in sleep duration among children. Although effective interventions promoting healthy sleep duration require insight into its predictors, data on these factors are scarce. This study therefore investigated (i) which individual (lifestyle), social and cultural factors, and living conditions and (ii) which changes in these factors might be associated with the changes in sleep duration of Dutch primary schoolchildren observed over time. METHOD Data from the ChecKid study was used, a dynamic cohort study among 4-13-year-old children living in the city of Zwolle, the Netherlands. Associations between changes in sleep duration and individual (lifestyle) factors (i.e., age, sex, physical activity behavior, sugar-sweetened beverage consumption, screen behavior), social and cultural factors (i.e., parental rules, ethnicity), and living conditions (i.e., parental education, presence of screens in the bedroom, household size) were analyzed using multivariable linear regression. RESULTS A total of 1180 children participated, aged 6.6 ± 1.4 years in 2009. Mean sleep duration decreased from 11.4 ± 0.5 h/night in 2009 to 11.0 ± 0.5 h/night in 2012. Older children, boys, children who used screens after dinner, children with greater computer/game console use, and children whose parents had low levels of education had a greater decrease in sleep duration. CONCLUSIONS This article reports on one of the first large, longitudinal cohort studies on predictors of child sleep duration. The results of the study can inform future interventions aimed at promoting healthy sleep in primary schoolchildren.
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Affiliation(s)
- Nina L Komrij
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Vincent Busch
- Department of Epidemiology & Health Promotion, Youth Section, Municipal Health Service Amsterdam, Amsterdam, The Netherlands
| | - Maj-Britt M R Inhulsen
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Epidemiology & Health Promotion, Youth Section, Municipal Health Service Amsterdam, Amsterdam, The Netherlands
| | - Maaike Koning
- Research Centre Healthy Cities, Knowledge Centre for Health and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands
| | - Elske de Jong
- Research Centre Healthy Cities, Knowledge Centre for Health and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- Research Centre Healthy Cities, Knowledge Centre for Health and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands
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López-Bueno R, López-Sánchez GF, Casajús JA, Calatayud J, Tully MA, Smith L. Potential health-related behaviors for pre-school and school-aged children during COVID-19 lockdown: A narrative review. Prev Med 2021; 143:106349. [PMID: 33271236 PMCID: PMC7701882 DOI: 10.1016/j.ypmed.2020.106349] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/25/2020] [Accepted: 11/24/2020] [Indexed: 01/22/2023]
Abstract
As a consequence of the COVID-19 pandemic, different measures have been implemented by governments from each affected country. Such measures usually involve restrictions on the movement of citizens, and have had a profound effect on usual activities and timetables. As a result of school closures and strict restrictions regarding going outside home, children have been one of the most disadvantaged population groups during the lockdown period. We therefore aimed to investigate potential health risk behaviors amongst isolated pre-school and school-aged children. We retrieved relevant articles from MEDLINE, Web of Science, PsycInfo, and Scopus databases to describe identified health-related behaviors (i.e. screen exposure, environmental influence, physical activity and fitness, sedentariness, sleep patterns, eating habits, psychological response, body composition, and injuries) in relation to social isolation and social deprivation of children without previous illness or conditions. This review depicts the potential health-related behaviors according to related literature, and put the focus on future short and long-term sequels of social isolation. Socio-affective complications and insufficient physical activity are underscored as two of the main concerns, particularly among socio-economic deprived children. Both issues could be effectively addressed with either adequate parental or community guidance.
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Affiliation(s)
- Rubén López-Bueno
- Depatment of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain.
| | | | - José A Casajús
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Belfast, United Kingdom
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, United Kingdom
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Baukienė E, Jusienė R. Associations among Toddlers’ and Preschoolers’ Sleep Problems, Emotional Reactivity, Sleep Regime and Parental Applied Rules for Screen-Based Media Use. PSICHOLOGIJA 2021. [DOI: 10.15388/psichol.2020.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background. Children’s sleep problems are associated with temperament. One of the dimensions of temperament – higher emotional reactivity – is defined as a risk factor for children’s emotional, behavioral, and sleep problems. Screen-based media use is a very common phenomenon among children that relates to sleep problems. Still there is a gap of research explaining the interactions between children’s sleep problems, temperament, and parental discipline (sleep regime and rules for screen-based media use). The aim of this study is to evaluate the relations between preschool children’s sleep problems and parents’ discipline (sleep regime and rules for screen-based media use), and the role of children’s emotional reactivity. Methods. This research is a part of the longitudinal study “Electronic Media Use and Young Children’s Health” conducted in the year 2017–2018 and funded by the Research Council of Lithuanian (agreement no. GER-006/2017). Participants are 876 children aged 2 to 5 years old and their parents. Children’s sleep problems and emotional reactivity were assessed using the Child Behavior Checklist (CBCL/1½-5). Information about rules for screen-based media use and sleep regime was obtained using the parent-report questionnaire. Results. Sleep problems are related to emotional reactivity, sleep regime, and rules for screen media use. Children without regular sleep regime and without constant rules for screen-based media use have higher sleep problems and emotional reactivity. The results of the regression analysis show that emotional reactivity, together with sleep regime and rules for screen-based media use, significantly explain one-fifth to one-third of children’s sleep problems at different ages of the preschool period. However, the prognostic value of emotional reactivity and parental discipline varies according to a child’s age, as they are significant predictors of sleep problems among two, three and four-year-olds, but no longer explain sleep problems of five-year-olds. The path analysis confirmed that emotional reactivity, directly and through mediating variables, e.g., parental reported child’s sleep regime and rules for screen-based media use, is significantly associated with children’s sleep problems. Conclusions. Emotional reactivity should be considered as a significant risk factor in the relation between children’s sleep problems, sleep regime and parental applied rules for screen-based media use. These results are important while identifying children at higher risk for sleep problems. The results also support that parental discipline, such as sleep regime and rules for screen-based media use, are significant for preventing sleep problems in children with higher emotional reactivity.
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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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Cartanyà-Hueso À, Lidón-Moyano C, Martín-Sánchez JC, González-Marrón A, Matilla-Santander N, Miró Q, Martínez-Sánchez JM. Association of screen time and sleep duration among Spanish 1-14 years old children. Paediatr Perinat Epidemiol 2021; 35:120-129. [PMID: 32662112 DOI: 10.1111/ppe.12695] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Due to the change in screen time usage in the last decade, there is needed to add more evidence about the relationship of screen time and sleep duration. OBJECTIVE To assess the association between screen time and sleep duration among Spanish children between 1 and 14 years old. METHODS We used data from the 2017 Spanish National Health survey, conducted on a representative sample of the Spanish population. We categorised daily leisure screen time as 0-59, 60-119, 120-179, and ≥180 minutes. We classified sleep duration, depending on the age, as proper sleep duration and short sleep duration. We calculated unadjusted, and adjusted prevalence ratio (PR) and 95% confidence interval (CI) of short sleep duration according to daily leisure screen time after adjusting for potential confounders. PR's were derived from fitting generalised linear models with Poisson distribution and robust variance. RESULTS Of the 5517 Spanish children aged 1-14 years, 44.3% spent 120 minutes or more of daily leisure screen time and 23.6% had short sleep duration. 24.5% and 28.2% of children spending between 120 and 179 minutes and exceeding 180 minutes of daily leisure screen time suffered short sleep duration, respectively. In the adjusted model, higher patterns of daily leisure screen time were associated with short sleep duration: adjusted PR120-179 = 1.34 (95% CI 1.18, 1.54) and adjusted PR≥180 = 1.48 (95% CI 1.27, 1.73). CONCLUSIONS Around one out of four Spanish children between 1 and 14 years old, exceeding 120 minutes of daily leisure screen time, had short sleep duration. More scientific research is needed for institutions to work on providing novel healthcare programmes that consider these new determinants of child health.
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Affiliation(s)
- Àurea Cartanyà-Hueso
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Cristina Lidón-Moyano
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Juan Carlos Martín-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Adrián González-Marrón
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Nuria Matilla-Santander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Queralt Miró
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M Martínez-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
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Hiscock H, Ng O, Crossley L, Chow J, Rausa V, Hearps S. Sleep Well Be Well: Pilot of a digital intervention to improve child behavioural sleep problems. J Paediatr Child Health 2021; 57:33-40. [PMID: 32770791 DOI: 10.1111/jpc.15106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/09/2020] [Accepted: 07/17/2020] [Indexed: 01/03/2023]
Abstract
AIM To investigate whether a digital sleep intervention improves child and care giver sleep and psychosocial outcomes. METHODS A total of 120 families with children aged 2-13 years, reporting moderate to severe child behavioural sleep problems, were recruited from a hospital sleep clinic waitlist or the community. Children from non-English speaking families, with known intellectual disability (IQ < 70) or severe medical problems excluded. Tailored behavioural sleep strategies were delivered to primary care givers via a smart phone app and complementary website. Eligible families completed a baseline questionnaire and child 'sleep check' then received the digital sleep intervention for 5 weeks, and then completed a post questionnaire. OUTCOMES care giver report of child sleep as no/mild versus moderate/severe problem over past month (primary outcome); problem child sleep patterns (Brief Infant Sleep Questionnaire or Child Sleep Habits Questionnaire), child temperament, care giver mental health (Kessler 6), care giver sleep, health service use for their child's sleep and time off work/activities to access services. RESULTS At follow up, care givers reported fewer moderate/severe child sleep problems (84.6-40.7%), improved problem child sleep patterns, better temperament and improved care giver mental health. Care giver sleep quality and quantity remained unchanged. Health service use (averaged over a 6-month period pre- and post-intervention) fell from 18.9% pre- to 14.1% post-intervention. CONCLUSION A digital sleep intervention appears promising in improving sleep in children with moderate/severe behavioural sleep problems, and care giver mental health. It may be a useful alternative to face-to-face management of behavioural sleep problems.
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Affiliation(s)
- Harriet Hiscock
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Health Services Research Unit, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Olivia Ng
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Louise Crossley
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jennifer Chow
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Vanessa Rausa
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Stephen Hearps
- Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Ranum BM, Wichstrøm L, Pallesen S, Falch-Madsen J, Steinsbekk S. Persistent Short Sleep from Childhood to Adolescence: Child, Parent and Peer Predictors. Nat Sci Sleep 2021; 13:163-175. [PMID: 33623458 PMCID: PMC7894796 DOI: 10.2147/nss.s290586] [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: 11/05/2020] [Accepted: 01/15/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Many children have periods when they sleep too little, with widely recognized detrimental effects. Less is known about persistent short sleep during childhood. Therefore, the present study aimed to investigate the prevalence of persistent short sleep in school-aged children and identify a set of child, parent, and peer predictors thereof. PARTICIPANTS AND METHODS Objectively measured sleep duration (hip-held accelerometer) was biennially assessed in a community sample followed from 6 to 14 years (n=801). A latent profile analysis was applied to assess whether a subgroup of children slept consistently short across time and predictors of persistent short sleep were determined through regression analysis. RESULTS A subgroup of children (n=160; 20.2%) was identified as having persistent short sleep across time. Temperamental negative affectivity (β=0.08; 95% CI=0.01, 0.15; p=0.03) and low observer-assessed parental emotional availability (β=-.09; 95% CI=-.18, -.01; p=0.04) predicted membership to that group. Teacher ratings of victimization from bullying were not associated with persistent short sleep (β=0.01; 95% CI: -.10, 11; p=0.88). CONCLUSION High child temperamental negative affectivity and low parental emotional availability may be involved in the development of persistent short sleep through childhood.
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Affiliation(s)
- Bror M Ranum
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Jonas Falch-Madsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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40
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Ricci C, Schlarb AA, Rothenbacher D, Genuneit J. Digital media, book reading, and aspects of sleep and sleep-related fears in preschoolers: the Ulm SPATZ Health Study. SOMNOLOGIE 2020. [DOI: 10.1007/s11818-020-00290-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract
Background
High levels of digital media use with screen-based devices has been found to threaten several aspects of child and adolescent health. However, the rapid change in digital media use behavior in our society over the past decade has rendered much of the existing evidence outdated.
Materials and methods
The present work reports data ascertained from 2016 to 2019 on preschoolers’ digital media use and book reading among 4‑ to 6‑year-old children from the longitudinal Ulm SPATZ Health Study. These data are supplemented by exploring the association of child digital media use and book reading with aspects of children’s sleep and sleep-related fears.
Results
After data management, 581 children participated at the age of 4 years. At the ages of 5 and 6 years, data were available for 508 and 426 participants, respectively. Median age of the mothers was 33 years (range 21–54) and 70% had graduated from high school. Most time spent using digital media was represented by passive activities in front of a screen. Time spent using digital media increased with children’s age. An increased risk of the fear of sleeping alone (RR: 1.35, [95% CI: 1.07; 1.70]) and fear of the dark (1.47 [95% CI 1.16; 1.87]) was documented for exposure to “all media” higher than the median as compared to lower levels. Exposure to “books” above the median and compared to lower levels was tentatively associated with a relevant 18% reduction in the risk of both fear of sleeping alone and fear of the dark (0.82 [95% CI 0.65; 1.03] and 0.82 [95% CI 0.64; 1.05], respectively).
Conclusion
Our results suggest that reducing time spent using digital media and potentially substituting this time by reading books, which seem to be a safe alternative, is a valid solution to reduce some common aspects of poor sleep in preschoolers.
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Chaput JP, Willumsen J, Bull F, Chou R, Ekelund U, Firth J, Jago R, Ortega FB, Katzmarzyk PT. 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5-17 years: summary of the evidence. Int J Behav Nutr Phys Act 2020; 17:141. [PMID: 33239009 PMCID: PMC7691077 DOI: 10.1186/s12966-020-01037-z] [Citation(s) in RCA: 379] [Impact Index Per Article: 94.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/14/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) released in 2020 updated global guidelines on physical activity and sedentary behaviour for children, adolescents, adults, older adults and sub-populations such as pregnant and postpartum women and those living with chronic conditions or disabilities. OBJECTIVE To summarize the evidence on the associations between physical activity, sedentary behaviour, and health-related outcomes used to inform the 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5-17 years. METHODS The update of the WHO guideline recommendations for children and adolescents utilized and systematically updated the evidence syntheses on physical activity and sedentary behaviour conducted for the 2016 Canadian 24-Hour Movement Guidelines for Children and Youth, the 2019 Australian 24-Hour Movement Guidelines for Children and Young People (5-17 years), and the 2018 Physical Activity Guidelines for Americans, Second Edition. Systematic reviews published from 2017 up to July 2019 that addressed the key questions were identified, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rate the certainty of the evidence for the entire body of evidence. RESULTS The updated literature search yielded 21 relevant systematic reviews. The evidence base reviewed (i.e., existing and new systematic reviews) provided evidence that greater amounts and higher intensities of physical activity as well as different types of physical activity (i.e., aerobic and muscle and bone strengthening activities) are associated with improved health outcomes (primarily intermediate outcomes). There was sufficient evidence to support recommendations on limiting sedentary behaviours, which was not addressed in the 2010 WHO guidelines. However, there is still insufficient evidence available to fully describe the dose-response relationships between physical activity or sedentary behaviour and health outcomes, and whether the associations vary by type or domain of physical activity or sedentary behaviour. CONCLUSIONS Addressing the identified research gaps will better inform guideline recommendations in children and adolescents, and future work should aim to prioritize these areas of research. In the meantime, investment and leadership is needed to scale up known effective policies and programs aimed at increasing activity in children and adolescents.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, Canada.
- Department of Pediatrics, University of Ottawa, Ontario, Ontario, Canada.
| | - Juana Willumsen
- Physical Activity Unit, Department for Health Promotion, World Health Organization, Geneva, Switzerland
| | - Fiona Bull
- Physical Activity Unit, Department for Health Promotion, World Health Organization, Geneva, Switzerland
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Science, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Wang F, Bíró É. Determinants of sleep quality in college students: A literature review. Explore (NY) 2020; 17:170-177. [PMID: 33246805 DOI: 10.1016/j.explore.2020.11.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/12/2020] [Accepted: 11/15/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To review the various determinants of sleep quality among college students. METHODS The PubMed, Web of Science and Cochrane Library databases were searched with the search string "sleep quality" AND "college students" for articles published between January 2007 and October 2017. Articles were excluded if they (1) examined sleep quality as a risk factor for other outcomes or (2) involved inpatients or participants under medical care. RESULTS The 112 identified studies were classified into categories according to the investigated determinants and their effect on sleep quality. Physical activity and healthy social relations improved sleep quality, while caffeine intake, stress and irregular sleep-wake patterns decreased sleep quality. Less consistent results were reported regarding eating habits and sleep knowledge, while proper napping during the day might improve overall sleep quality. CONCLUSIONS College students are vulnerable to different risk factors for sleep quality. When designing interventions to improve sleep quality among college students, the main determinants need to be taken into consideration.
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Affiliation(s)
- Feifei Wang
- Institute of Health Promotion and Sport Sciences, Faculty of Education and Psychology, Eötvös Loránd University ELTE, 1075 Budapest, Kazinczy u. 23-27, Hungary.
| | - Éva Bíró
- Division of Health Promotion, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen Kassai út 26, Hungary
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Rubín L, Gába A, Dygrýn J, Jakubec L, Materová E, Vencálek O. Prevalence and correlates of adherence to the combined movement guidelines among Czech children and adolescents. BMC Public Health 2020; 20:1692. [PMID: 33176735 PMCID: PMC7661270 DOI: 10.1186/s12889-020-09802-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background There are limited studies on the prevalence of adherence to the combined guidelines for physical activity (PA), sedentary behavior, and sleep in children and adolescents. Moreover, little is known about correlates of adherence to the guidelines. Therefore, the main aim of this study is to examine the prevalence and identify the correlates of adherence to the combined movement guidelines among children and adolescents. Methods A total of 355 children aged 8–13 years (44% boys) and 324 adolescents aged 14–18 years (43% boys) from the Czech Republic participated in this study. PA and sleep duration were estimated using multi-day 24-h raw data from wrist-worn accelerometers. Recreational screen time was parent proxy-reported in children and self-reported in adolescents. Seventeen potential correlates were grouped into three homogenous categories for biological and cognitive, behavioral, and family correlates. The multi-level multivariable logistic regression was applied to identify correlates of adherence to combined movement guidelines and to specific combinations of any of two recommendations. Results Approximately 6.5% of children and 2.2% of adolescents met all recommendations of the combined movement guidelines. In children, girls (OR = 0.4; 95% CI = 0.1–0.9) and participants with overweight or obese fathers (OR = 0.3; 95% CI = 0.1–0.7) had significantly lower odds of adherence to the combined movement guidelines. Additionally, children had higher odds of meeting specific combinations of two recommendations if they reported regular fruit and vegetable intake, participated in organized PA, or if their fathers had a university degree. Meanwhile, paternal overweight and obesity, and high sleep efficiency were associated with lower odds of meeting specific combinations of recommendations. In adolescents, sex, fruit and vegetable intake, organized PA, and active play were correlates of meeting specific combinations of any two recommendations. Conclusions A low proportion of children and adolescents met the combined movement guidelines and several correlates related to family were identified. Family is a key source of influence for healthy movement behaviors during childhood and adolescence.
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Affiliation(s)
- Lukáš Rubín
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic.,Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic.
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Lukáš Jakubec
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Eliška Materová
- Faculty of Physical Culture, Palacký University Olomouc, třída Míru 117, 771 11, Olomouc, Czech Republic
| | - Ondřej Vencálek
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
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Hiltunen P, Leppänen MH, Ray C, Määttä S, Vepsäläinen H, Koivusilta L, Sajaniemi N, Erkkola M, Roos E. Relationship between screen time and sleep among Finnish preschool children: results from the DAGIS study. Sleep Med 2020; 77:75-81. [PMID: 33338700 DOI: 10.1016/j.sleep.2020.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES To examine the associations between screen time, the time spent on different screen devices, and sleep in a sample of Finnish preschool children. METHODS The current study analyzed cross-sectional data from the DAGIS study carried out in Finland in 2015-2016 on 736 children aged 3-6 years. Parents reported in a 7-day diary the durations the child used screen devices daily, with separate details about watching TV or DVDs, using tablets or smartphones, and using computers. In addition, parents reported children's bedtimes and wake-up times, which were further used in calculating sleep duration. Parents answered questions regarding their child's sleep consistency. Statistical analyses included adjusted general linear modeling. RESULTS An hourly increase in total screen time was associated with 11 min later bedtime (p < 0.001) and 10 min shorter sleep duration (p < 0.001). More TV/DVD watching was associated with later bedtimes (p = 0.016) and a shorter sleep duration (p = 0.001). More smartphone/tablet use was associated with later bedtimes (p = 0.005), later wake-up times (p = 0.038), and weaker sleep consistency (p = 0.024). More computer use was associated with later bedtimes (p = 0.046). Results did not differ between genders. CONCLUSIONS Increased screen time was associated with later bedtimes and shorter sleep duration among preschool children. Adverse associations with sleep outcomes were found for each screen device. Attention should be paid to promoting balanced use of screens and regular sleep habits in young children.
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Affiliation(s)
- Pauliina Hiltunen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland.
| | - Marja H Leppänen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Public Health, Faculty of Medicine, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Suvi Määttä
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Faculty of Social Sciences, University of Helsinki, Unioninkatu 37, P.O. Box 54, 00014 University of Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Leena Koivusilta
- Department of Social Research, University of Turku, FI-20014, Turku, Finland
| | - Nina Sajaniemi
- Faculty of Educational Sciences, University of Helsinki, Siltavuorenpenger 1-5, 10, P.O. Box 9, 00014 University of Helsinki, Finland; Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, P.O. Box 111, FI-8010, Joensuu, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland; Department of Public Health, Faculty of Medicine, P.O. Box 63, 00014 University of Helsinki, Finland.
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Perceived Determinants of Children's Inadequate Sleep Health. A Concept Mapping Study among Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197315. [PMID: 33036399 PMCID: PMC7578965 DOI: 10.3390/ijerph17197315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 01/07/2023]
Abstract
An increasing number of children experience inadequate sleep, which negatively effects their health. To promote healthy sleep among children, it is essential to understand the underlying determinants. This online concept mapping study therefore explores potential determinants of children’s inadequate sleep as perceived by professionals with expertise in the sleep health of children aged 4–12 years. Participants (n = 27) were divided in three groups: (1) doctors (n = 9); (2) nurses (n = 11); (3) sleep experts (n = 7). Participants generated potential determinants (i.e., ideas) of children’s inadequate sleep. Subsequently, they sorted all ideas by relatedness and rated their importance. These data were analysed using multidimensional scaling and hierarchical cluster analysis. The results of all three groups were combined and validated by an additional group of professionals (n = 16). A large variety of perceived determinants were identified. The most important determinants perceived by all groups belonged to the categories psychosocial determinants (i.e., worrying, a change in daily life), daytime and evening activities (i.e., screen use before bedtime, stimulating game play before bedtime, inadequate amount of daytime physical activity), and pedagogical determinants (i.e., inconsistent sleep schedule, lack of a bedtime routine). These perspectives are valuable for future longitudinal studies on the determinants of children’s sleep and the development of future healthy sleep interventions.
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46
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Difficulties in Getting to Sleep and their Association with Emotional and Behavioural Problems in Adolescents: Does the Sleeping Duration Influence this Association? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051691. [PMID: 32150909 PMCID: PMC7084249 DOI: 10.3390/ijerph17051691] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 01/22/2023]
Abstract
Sleep problems are common in adolescence with a negative impact on the mental health and functioning of adolescents. However, the roles of different sleep problems in relation to emotional and behavioural problems (EBPs), classified according to the 10th version of the International Classification of Diseases as emotional, conduct, hyperactivity and social functioning disorders, are not clear. The first aim of the study was to investigate the association between difficulties in getting to sleep and EBPs in adolescents. The second aim was to explore the role of sleep duration in this association. We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2018 in Slovakia. Presented are results for specific age groups of 13-year-old (N = 1909) and 15-year-old (N = 1293) adolescents. Subjective measures of sleep variables were used. Binary logistic regression models adjusted for age and gender were used to assess associations between difficulties in getting to sleep, sleep duration and EBPs measured using the Strengths and Difficulties Questionnaire. Modification of the association between difficulties in getting to sleep and EBPs by sleep duration was also explored. We found that difficulties in getting to sleep at least once a week as well as insufficient sleep (less than 8 h) increased the probability of EBPs. Interactions of sleep duration with difficulties in getting to sleep on EBPs were found to be non-significant. The results suggest that caregivers and clinicians should screen and intervene for both sleep quality and quantity problems in adolescents as they might indicate and promote EBPs.
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Rensen N, Steur LMH, Wijnen N, van Someren EJW, Kaspers GJL, van Litsenburg RRL. Actigraphic estimates of sleep and the sleep-wake rhythm, and 6-sulfatoxymelatonin levels in healthy Dutch children. Chronobiol Int 2020; 37:660-672. [PMID: 32126835 DOI: 10.1080/07420528.2020.1727916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Sleep and the sleep-wake rhythm are essential for children's health and well-being, yet reference values are lacking. This study therefore aimed to assess actigraphic estimates of sleep and the 24-h sleep-wake rhythm, as well as 6-sulfatoxymelatonin (aMT6s) levels in healthy children of different age groups. Additionally, relationships between the outcomes and sex, highest parental educational level (as an indication of socioeconomic status (SES)), and body-mass-index (BMI) were explored. In this cross-sectional study, healthy Dutch children (2-18 years) wore an actigraph (GT3x) for 7 consecutive days, collected first-morning void urine and completed a sleep log and sociodemographic questionnaire. Actigraphically estimated sleep variables were sleep onset latency (SOL), sleep efficiency (SE), total sleep time (TST), and wake after sleep onset (WASO). Non-parametric sleep-wake rhythm variables were intradaily variability (IV); interdaily stability (IS); the activity counts and timing of the least active 5-h period (L5counts and midpoint) and of the most active 10-h period (M10 counts and midpoint); and the relative amplitude (RA), i.e. the ratio of the difference and the sum of M10 and L5 counts. Finally, creatinine-corrected aMT6s levels were obtained by isotope dilution mass spectrometry. Effects of age group (preschool 2-5 years/school-aged 6-12 years/teenager 13-18 years), sex, highest parental educational level and BMI (Z-scores) were explored. Ninety-four children participated, equally divided across age groups (53% boys). Teenagers slept less, but more efficiently, than younger children, while their 24 h sleep-wake rhythm was the least stable and most fragmented (likely due to fragmentation of daytime activity). Additionally, aMT6s levels significantly declined over the age groups. Children from highly educated parents had lower sleep efficiency, but a more stable sleep-wake rhythm. Finally, sex or increase in BMI was not associated with any of the outcomes in this study. In conclusion, this study provides reference values of healthy children across different age groups and different sociodemographic factors. In the future, this information may help to better interpret outcomes in clinical populations.
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Affiliation(s)
- Niki Rensen
- Princess Máxima Center for Pediatric Oncology , Utrecht, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Pediatric Oncology , Amsterdam, The Netherlands
| | - Lindsay M H Steur
- Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Pediatric Oncology , Amsterdam, The Netherlands
| | - Noa Wijnen
- Princess Máxima Center for Pediatric Oncology , Utrecht, The Netherlands
| | - Eus J W van Someren
- Netherlands Institute for Neuroscience, Sleep and Cognition , Amsterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit, Amsterdam Neuroscience, Integrative Neurophysiology and Psychiatry , Amsterdam, The Netherlands
| | - Gertjan J L Kaspers
- Princess Máxima Center for Pediatric Oncology , Utrecht, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Pediatric Oncology , Amsterdam, The Netherlands
| | - Raphaële R L van Litsenburg
- Princess Máxima Center for Pediatric Oncology , Utrecht, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Pediatric Oncology , Amsterdam, The Netherlands
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Child and Parent Perceived Determinants of Children's Inadequate Sleep Health. A Concept Mapping Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051583. [PMID: 32121382 PMCID: PMC7084543 DOI: 10.3390/ijerph17051583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 12/11/2022]
Abstract
Many children do not meet the recommendations for healthy sleep, which is concerning given the potential negative effects on children’s health. To promote healthy sleep, it is crucial to understand its determinants. This concept mapping study therefore explores perspectives of children and parents on potential determinants of children’s inadequate sleep. The focus lies on 9–12 year old children (n = 45), and their parents (n = 33), from low socioeconomic neighbourhoods, as these children run a higher risk of living in a sleep-disturbing environment (e.g., worries, noise). All participants generated potential reasons (i.e., ideas) for children’s inadequate sleep. Next, participants sorted all ideas by relatedness and rated their importance. Subsequently, multidimensional scaling and hierarchical cluster analyses were performed to create clusters of ideas for children and parents separately. Children and parents both identified psychological (i.e., fear, affective state, stressful situation), social environmental (i.e., sleep schedule, family sleep habits), behavioural (i.e., screen behaviour, physical activity, diet), physical environmental (i.e., sleep environment such as temperature, noise, light), and physiological (i.e., physical well-being) determinants. These insights may be valuable for the development of future healthy sleep interventions.
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49
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Harskamp-van Ginkel MW, Kool RE, van Houtum L, Belmon LS, Huss A, Chinapaw MJM, Vrijkotte TGM. Potential determinants during 'the first 1000 days of life' of sleep problems in school-aged children. Sleep Med 2020; 69:135-144. [PMID: 32078930 DOI: 10.1016/j.sleep.2019.12.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/12/2019] [Accepted: 12/23/2019] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVES Early life determinants of sleep problems are mostly unknown. The first 1000 days of life (ie, the time between conception and a child's second birthday) is a period where the foundations for optimum health, growth and neurodevelopment are established. The aim of this explorative study is to identify potential early life determinants of sleep problems at age 7-8 years. METHODS Data from the Amsterdam Born Children and their Development cohort study (n = 2746) were analyzed. Sleep problems at age 7-8 years were reported by the caregiver in the 'Child Sleep Habits Questionnaire'. A higher total score indicates more sleep problems. After multiple imputation (n = 20), we studied multivariable associations between all potential determinants and sleep problems using regression analysis. RESULTS A higher pre-pregnancy body mass index (BMI) was associated with more sleep problems at age 7-8 years [β 0.12 (95% CI 0.05, 0.18)]. Children of mothers with symptoms of anxiety during pregnancy [β 0.06 (95% CI 0.03, 0.09)] and infancy period [β 0.04 (95% CI 0.00, 0.07)] had more sleep problems. Children of mothers drinking ≥1 glass of alcohol a day around 14 weeks of gestation had a 2 points higher sleep problem score [β 2.55 (95% CI 0.21, 4.89)] and children of mothers smoking ≥1 cigarette per day in that period had a one point higher score [β 1.07 (95% CI 0.10, 2.03)]. Infants with relative weight loss (delta BMI-SD) had a higher sleep problem score during childhood [β -0.32 (95%CI -0.60, -0.04)]. CONCLUSIONS We identified several potential determinants during pregnancy and infancy associated with childhood sleeping problems. We encourage further research into these and other potential determinants to replicate results and to identify underlying mechanisms.
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Affiliation(s)
- Margreet W Harskamp-van Ginkel
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands.
| | - Ruth E Kool
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands
| | - Lieke van Houtum
- Sarphati Amsterdam, Public Health Service (GGD), City of Amsterdam, Nieuwe Achtergracht 100, Amsterdam, the Netherlands
| | - Laura S Belmon
- Sarphati Amsterdam, Public Health Service (GGD), City of Amsterdam, Nieuwe Achtergracht 100, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Anke Huss
- University Utrecht, Institute for Risk Assessment Sciences, Yalelaan 2, Utrecht, Netherlands
| | - Mai J M Chinapaw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Tanja G M Vrijkotte
- Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands
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50
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Cartanyà-Hueso À, Lidón-Moyano C, González-Marrón A, Martín-Sánchez JC, Martínez-Sánchez JM. Screen time use and sleep in children: are there differences among social classes? Sleep Med 2020; 68:153. [PMID: 32044550 DOI: 10.1016/j.sleep.2019.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 12/12/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Àurea Cartanyà-Hueso
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Cristina Lidón-Moyano
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Adrián González-Marrón
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Juan Carlos Martín-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M Martínez-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.
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