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Tuerxun P, Xu K, Wang M, Wei M, Wang Y, Jiang Y, Li C, Zhang J. Obesogenic sleep patterns among Chinese preschool children: A latent profile and transition analysis of the association sleep patterns and obesity risk. Sleep Med 2023; 110:123-131. [PMID: 37574612 DOI: 10.1016/j.sleep.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/04/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE This paper utilized a person-centered approach to examine whether sleep patterns on school and free days are associated with obesity risk in preschool children aged 3-6 years. METHODS The cross-sectional analysis included 204 children from the Wuhan Healthy Start Project with valid sleep data in at least four consecutive days gathered via Actigraph GT3X+. Based on three domains of sleep duration, sleep onset, and sleep offset, we used latent profile analysis to identify distinct sleep patterns on school and free days separately. Additionally, we conducted latent transition analysis to explore the probabilities of sleep patterns transitions between school and free days. The multivariate logistic regression model investigated the associations of sleep patterns with overweight/obesity (OWO) (BMI ≥ age- and sex-specific 85th percentile) and abdominal obesity (AO) (WC ≥ age- and sex-specific 75th percentile). RESULTS Two sleep patterns were identified for school days: "EL-sc" (early-to-sleep/longer-duration) (n = 119; 58.3%) and "LS-sc" (late-to-sleep/shorter-duration) (n = 85; 41.7%). Similarly, "LES-fr" (late-to-sleep/early-to-wake/shorter-duration) (n = 118; 57.8%) and "ELL-fr" (early-to-sleep/late-to-wake/longer-duration) (n = 86; 42.2%) patterns were identified for free days. LTA categorized the participants into four distinct transition groups, i.e., "EL-sc→ELL-fr" (32.9%), "EL-sc→LES-fr" (24.0%), "LS-sc→LES-fr" (33.8%), and "LS-sc→ELL-fr" (9.3%). Compared with the "ELsc→ELL-fr", the "LS-sc→LES-fr" had a higher risk of OWO (AOR 4.76; 95% CI: 1.39-20.33) and AO (AOR, 2.78; 95% CI, 1.21-6.62), respectively. Neither "EL-sc→LES-fr" (AOR, 1.11; 95% CI, 0.14-6.67) nor "LS-sc→ELL-fr" (AOR, 0.74; 95% CI, 0.03-6.14) was significantly associated with OWO. Likewise, no significant association was observed for "EL-sc→LES-fr" (AOR, 0.96; 95% CI, 0.35-2.62) and "LS-sc→ELL-fr" (AOR, 0.56; 95% CI, 0.11-2.18) with AO. CONCLUSIONS "LS-sc→LES-fr" pattern is significantly associated with an increased risk of general and abdominal obesity, indicating its obesogenic nature. Furthermore, although not statistically associated with obesity outcomes, "LS-sc→ELL-fr" and "EL-sc→LES-fr" patterns exhibit a semi-obesogenic characteristic. In addition, we identified a concerning trend that preschool children are at risk of transitioning to and persisting in sleep patterns characterized by delayed and shorter sleep. These findings underscore the importance of implementing interventions and strategies to address sleep patterns as a crucial step to minimize the risk of obesity.
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Affiliation(s)
- Paiziyeti Tuerxun
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Miyuan Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mengna Wei
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yimin Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanfen Jiang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunan Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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McKay CD, Gubhaju L, Gibberd AJ, McNamara BJ, Macniven R, Joshy G, Roseby R, Williams R, Yashadhana A, Fields T, Porykali B, Azzopardi P, Banks E, Eades SJ. Health behaviours associated with healthy body composition among Aboriginal adolescents in Australia in the 'Next Generation: Youth Well-being study'. Prev Med 2023; 175:107715. [PMID: 37775084 DOI: 10.1016/j.ypmed.2023.107715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
This study described the distribution of healthy body composition among Aboriginal adolescents in Australia aged 10-24 years and examined associations with health behaviours and self-rated health. Data were cross-sectional from the 'Next Generation: Youth Well-being study' baseline (N = 1294). We used robust Poisson regression to quantify associations of self-reported health behaviours (physical activity, screen time, sleep, consumption of vegetables, fruit, soft drinks and fast food, and tobacco smoking and alcohol) and self-rated health to healthy body mass index (BMI) and waist/height ratio (WHtR). Overall, 48% of participants had healthy BMI and 64% healthy WHtR, with healthy body composition more common among younger adolescents. Higher physical activity was associated with healthy body composition (5-7 days last week vs none; adjusted prevalence ratio (aPR) healthy BMI 1.31 [95% CI 1.05-1.64], and healthy WHtR 1.30 [1.10-1.54]), as was recommended sleep duration (vs not; aPR healthy BMI 1.56 [1.19-2.05], and healthy WHtR 1.37 [1.13-1.67]). There was a trend for higher proportion of healthy body composition with more frequent fast food consumption. Healthy body composition was also associated with higher self-rated health ('very good/excellent' vs 'poor/fair'; aPR healthy BMI 1.87 [1.45-2.42], and healthy WHtR 1.71 [1.40-2.10]). Culturally appropriate community health interventions with a focus on physical activity and sleep may hold promise for improving body composition among Aboriginal adolescents.
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Affiliation(s)
- Christopher D McKay
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Lina Gubhaju
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alison J Gibberd
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bridgette J McNamara
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rona Macniven
- School of Population Health, UNSW, Sydney, NSW, Australia
| | - Grace Joshy
- Centre for Public Health Data and Policy, National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Canberra, ACT, Australia
| | - Robert Roseby
- Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Robyn Williams
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Aryati Yashadhana
- School of Population Health, UNSW, Sydney, NSW, Australia; Centre for Primary Health Care & Equity, UNSW, Sydney, NSW, Australia
| | - Ted Fields
- School of Population Health, UNSW, Sydney, NSW, Australia; Centre for Primary Health Care & Equity, UNSW, Sydney, NSW, Australia
| | - Bobby Porykali
- Guunu-maana (Heal) Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Heath, Sydney, NSW, Australia
| | - Peter Azzopardi
- Murdoch Children's Research Institute, Melbourne, VIC, Australia; Telethon Kids Institute, Perth, WA, Australia
| | - Emily Banks
- Centre for Public Health Data and Policy, National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Canberra, ACT, Australia
| | - Sandra J Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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3
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Floyd B, Battles HT, White S, Loch C, McFarlane G, Guatelli-Steinberg D, Mahoney P. Longitudinal changes in juvenile and adolescent body mass indices before, during, and after the COVID-19 lockdown in New Zealand. Am J Hum Biol 2023; 35:e23861. [PMID: 36642922 DOI: 10.1002/ajhb.23861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE This study uses longitudinal data from school children in Dunedin, New Zealand, to evaluate impacts of COVID-19 lockdown measures on changes in body mass (BMI, kg/m2 ). Impacts are assessed using two non-mutually exclusive hypotheses. The "structured days" hypothesis holds that children tend to alter sleep patterns, reduce activity and increase snacking when not in structured environments. The bidirectional hypothesis proposes that over-weight or obese children are predisposed to further gains in unstructured settings. METHODS Juveniles and adolescents (n = 95, 60% female) were recruited from Dunedin schools. Repeated measures analyses assessed variation in intra-individual change in BMI during four periods: P1 (before summer break), P2 (during summer break), P3 (during the COVID-19 lockdown), and P4 (after the lockdown ended). The model also examined if these changes were influenced by participants' sex or body size early in the first period assessed using log-transformed BMI, log-transformed weight, height, or lower leg length. RESULTS Repeated measures analyses of per month gains in BMI (kg/m2 ) during the four periods revealed consistent period (p ≤ .001), period by sex (p ≤ .010), and period by body size (p ≤ .001) interactions across all four body size proxies. Both sexes experienced the greatest gains during the lockdown (P3), but differed in response to their summer break (P2). CONCLUSION Results are mostly consistent with the "structured days" hypothesis, but challenge the bidirectional hypothesis as defined. Further research better characterizing risks of gains in adiposity are needed.
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Affiliation(s)
- Bruce Floyd
- School of Social Sciences, University of Auckland, New Zealand
| | | | - Sophie White
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Carolina Loch
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Gina McFarlane
- School of Anthropology and Conservation, University of Kent, Canterbury, UK
| | | | - Patrick Mahoney
- School of Anthropology and Conservation, University of Kent, Canterbury, UK
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Blunden S, McKellin W, Herdin T, Ipsiroglu OS. Social-ecological considerations informing a universal screening strategy for sleep health in the community. Front Psychiatry 2023; 14:857717. [PMID: 37020729 PMCID: PMC10067715 DOI: 10.3389/fpsyt.2023.857717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/16/2023] [Indexed: 04/07/2023] Open
Abstract
"Poor sleep health" (PSH), defined as reduced amount of sleep and non-restorative sleep, affects cognitive, social and emotional development. Evidence suggests an association of sleep deprivation and mental health problems; however, there are no universal concepts allowing a first-tier screening of PSH at a community level. The focus of this narrative review is to highlight the cultural context of the current medicalized approach to PSH and to suggest social ecological strategies informing new and holistic community-based screening concepts. We present two conceptual screening frameworks; a "medical" and a merged "social emotional wellbeing framework" and combine them utilizing the concept of "ecologies." The first framework proposes the incorporation of "sleep" in the interpretation of "vigilance" and "inappropriate" labeled behaviors. In the first framework, we provide a logic model for screening the myriad of presentations and possible root causes of sleep disturbances as a tool to assess daytime behaviors in context with PSH. In the second framework, we provide evidence that informs screening for "social emotional wellbeing" in the context of predictive factors, perpetuating factors and predispositions through different cultural perspectives. The distinct goals of both frameworks are to overcome training-biased unidirectional thinking and a priori medicalization of challenging, disruptive and/or disobedient behaviors. The latter has been explicitly informed by the critical discourse on colonization and its consequences, spearheaded by First Nations. Our "transcultural, transdisciplinary and transdiagnostic screening framework" may serve as a starting point from which adaptations of medical models could be developed to suit the purposes of holistic screening, diagnosis, and treatment of complex childhood presentations in different cultural contexts.
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Affiliation(s)
- Sarah Blunden
- Appleton Institute of Behavioral Science, Sleep and Circadian Group, Central Queensland University, Wayville, SA, Australia
- *Correspondence: Sarah Blunden,
| | - William McKellin
- Department of Anthropology, University of British Columbia, Vancouver, BC, Canada
| | - Thomas Herdin
- Division of Transcultural Communication, Department of Communication Studies, Paris-Lodron-University Salzburg, Salzburg, Austria
| | - Osman S. Ipsiroglu
- H-Behaviors Research Lab (Previously Sleep/Wake-Behaviors Lab), BC Children’s Hospital Research Institute, Vancouver, BC, Canada
- Division of Developmental Pediatrics, Respirology, and Child and Adolescent Psychiatry, Department of Pediatrics and Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Osman S. Ipsiroglu,
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5
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Howarth TP, Gentin N, Reyes-Chicuellar N, Jonas C, Williamson B, Blecher G, Widger J, Heraganahally SS. Sleep quality and obstructive sleep apnoea in Indigenous and non-Indigenous Australian children. Sleep Med 2022; 98:68-78. [DOI: 10.1016/j.sleep.2022.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 12/11/2022]
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Potential Determinants of Cardio-Metabolic Risk among Aboriginal and Torres Strait Islander Children and Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159180. [PMID: 35954531 PMCID: PMC9368168 DOI: 10.3390/ijerph19159180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Abstract
Prevention initiatives during childhood and adolescence have great potential to address the health inequities experienced by Aboriginal and Torres Strait Islander (Indigenous) populations in Australia by targeting modifiable risk factors for cardio-metabolic diseases. We aimed to synthesize existing evidence about potential determinants of cardio-metabolic risk markers—obesity, elevated blood pressure, elevated blood glucose, abnormal lipids, or a clustering of these factors known as the metabolic syndrome (MetS)—for Indigenous children and adolescents. We systematically searched six databases for journal articles and three websites for relevant grey literature. Included articles (n = 47) reported associations between exposures (or interventions) and one or more of the risk markers among Indigenous participants aged 0–24 years. Data from 18 distinct studies about 41 exposure–outcome associations were synthesized (by outcome: obesity [n = 18]; blood pressure [n = 9]; glucose, insulin or diabetes [n = 4]; lipids [n = 5]; and MetS [n = 5]). Obesity was associated with each of the other cardio-metabolic risk markers. Larger birth size and higher area-level socioeconomic status were associated with obesity; the latter is opposite to what is observed in the non-Indigenous population. There were major gaps in the evidence for other risk markers, as well as by age group, geography, and exposure type. Screening for risk markers among those with obesity and culturally appropriate obesity prevention initiatives could reduce the burden of cardio-metabolic disease.
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Browne J, Becker D, Orellana L, Ryan J, Walker T, Whelan J, Alston L, Egan M, Johnson B, Rossignoli A, Crooks N, Brown AD, Bolton KA, Fraser P, Le H, Bell C, Hayward J, Sanigorski A, Backholer K, Allender S, Strugnell C. Healthy weight, health behaviours and quality of life among Aboriginal children living in regional Victoria. Aust N Z J Public Health 2022; 46:595-603. [DOI: 10.1111/1753-6405.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/01/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jennifer Browne
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Denise Becker
- Biostatistics Unit, Faculty of Health Deakin University Geelong Victoria
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health Deakin University Geelong Victoria
| | - Joleen Ryan
- School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Troy Walker
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Jill Whelan
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Laura Alston
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Rural Health, Faculty of Health Deakin University Warrnambool Victoria
| | - Mikaela Egan
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Brittney Johnson
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Amy Rossignoli
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Nicholas Crooks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Andrew D. Brown
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Kristy A. Bolton
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Faculty of Health Deakin University Geelong Victoria
| | - Penny Fraser
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Ha Le
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Health Economics, Faculty of Health Deakin University Geelong Victoria
| | - Colin Bell
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Josh Hayward
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Andrew Sanigorski
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Steven Allender
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Rural Health, Faculty of Health Deakin University Warrnambool Victoria
| | - Claudia Strugnell
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
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Blunden S, Yiallourou S, Fatima Y. Sleep health and its implications in First Nation Australians: A systematic review. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 21:100386. [PMID: 35199075 PMCID: PMC8844889 DOI: 10.1016/j.lanwpc.2022.100386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Understanding the state of sleep health in First Nations Australians offers timely insight into intervention and management opportunities to improve overall health and well-being. This review explored the determinants and burden of poor sleep in First Nations Australians. A systematic search was conducted to identify studies published until August 2020 in First Nations Australian adults. Nine studies (n = 2640) were included, three in community settings, six in clinical populations. Across studies compared with non-Indigenous people, 15–34% of First Nations Australians experience less than recommended hours (<7 h/night), 22% reported fragmented, irregular, and unrefreshing sleep with a high prevalence of OSA in clinical populations (39-46%). Findings show First Nations Australians are significantly more likely to report worse sleep health than Non-Indigenous Australians in all measured domains of sleep. Co-designed sleep programs and service delivery solutions are necessary to ensure timely prevention and management of sleep issues in First Nations communities which to date have been underserved. Funding No external funding was provided for this work.
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Affiliation(s)
- Sarah Blunden
- Appleton Institute of Behavioural Science, Central Queensland University, 44 Greenhill Rd Wayville Adelaide, South Australia, Australia
- Corresponding author.
| | - Stephanie Yiallourou
- Baker Heart and Diabetes Institute and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Yaqoot Fatima
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia
- Centre for Rural and Remote Health, James Cook University, Queensland, Australia
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9
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Moreno JP, Razjouyan J, Lester H, Dadabhoy H, Amirmazaheri M, Reesor-Oyer L, O'Connor TM, Hernandez DC, Najafi B, Alfano CA, Crowley SJ, Thompson D, Baranowski T. Later sleep timing predicts accelerated summer weight gain among elementary school children: a prospective observational study. Int J Behav Nutr Phys Act 2021; 18:94. [PMID: 34247639 PMCID: PMC8273994 DOI: 10.1186/s12966-021-01165-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/25/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES AND BACKGROUND Social demands of the school-year and summer environment may affect children's sleep patterns and circadian rhythms during these periods. The current study examined differences in children's sleep and circadian-related behaviors during the school-year and summer and explored the association between sleep and circadian parameters and change in body mass index (BMI) during these time periods. METHODS This was a prospective observational study with 119 children ages 5 to 8 years with three sequential BMI assessments: early school-year (fall), late school-year (spring), and beginning of the following school-year in Houston, Texas, USA. Sleep midpoint, sleep duration, variability of sleep midpoint, physical activity, and light exposure were estimated using wrist-worn accelerometry during the school-year (fall) and summer. To examine the effect of sleep parameters, physical activity level, and light exposure on change in BMI, growth curve modeling was conducted controlling for age, race, sex, and chronotype. RESULTS Children's sleep midpoint shifted later by an average of 1.5 h during summer compared to the school-year. After controlling for covariates, later sleep midpoints predicted larger increases in BMI during summer, (γ = .0004, p = .03), but not during the school-year. Sleep duration, sleep midpoint variability, physical activity levels, and sedentary behavior were not associated with change in BMI during the school-year or summer. Females tended to increase their BMI at a faster rate during summer compared to males, γ = .06, p = .049. Greater amounts of outdoor light exposure (γ = -.01, p = .02) predicted smaller increases in school-year BMI. CONCLUSIONS Obesity prevention interventions may need to target different behaviors depending on whether children are in or out of school. Promotion of outdoor time during the school-year and earlier sleep times during the summer may be effective obesity prevention strategies during these respective times.
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Affiliation(s)
- Jennette P Moreno
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA.
| | - Javad Razjouyan
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA.,Department of Medicine, Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, 77030, USA.,Big Data Scientist Training Enhancement Program (BD-STEP), VA Office of Research and Development, Washington, DC, USA
| | - Houston Lester
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA.,Department of Management, University of Mississippi, Oxford, MS, USA
| | - Hafza Dadabhoy
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Mona Amirmazaheri
- VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA.,Department of Surgery, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Baylor College of Medicine, Houston, TX, USA
| | - Layton Reesor-Oyer
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Teresia M O'Connor
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Daphne C Hernandez
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bijan Najafi
- Department of Surgery, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Baylor College of Medicine, Houston, TX, USA
| | - Candice A Alfano
- Department of Psychology, Sleep and Anxiety Center of Houston (SACH), University of Houston, Houston, TX, USA
| | - Stephanie J Crowley
- Department of Psychiatry & Behavioral Sciences, Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL, USA
| | - Debbe Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Tom Baranowski
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
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10
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Blunden S, Fatima Y, Yiallourou S. Sleep health in Indigenous Australian children: a systematic review. Sleep Med 2021; 80:305-314. [PMID: 33618099 DOI: 10.1016/j.sleep.2021.01.065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE/BACKGROUND The health and wellbeing of Indigenous Australian children has long been an issue of concern. However, to date there is a lack of attention to sleep health (particularly education and appropriate health service availability) in Indigenous Australians. The present review aimed to evaluate the prevalence of sleep problems in Indigenous Australians children. METHOD Up to August 2020, a systematic search using the keywords: "sleep problems"; "sleep disturbances"; "sleep quality"," "sleep disorder"; "sleep apnoea"; "obstructive sleep apnoea"; "OSA"; and "sleep-disordered breathing" AND "Indigenous Australians"; "Aboriginal"; "Torres Strait Islander"; was conducted on PubMed; Informit Indigenous Collection Scopus and CINAHL; "LIt.search tool" from the Lowitja Institute; Indigenous HealthInfoNet, Google Scholar (advanced), government agencies and relevant grey literature. RESULTS The search found only 13 studies focusing on sleep issues in Indigenous Australian children (birth to 17 years) with a pool of up to 4664 participants with 11 community-based studies (using mostly parental or self-report) and two in clinical populations (sleep laboratory). Three studies were longitudinal, all others were cross-sectional. Insomnia symptoms varied from 15% to 34.7%. Indigenous children reported severe daytime sleepiness (20%), short sleep (10.9%) late sleepers (50%). Snoring was reported in 14.2% with children in the community while up to 51% were objectively diagnosed to have OSA in a clinical setting. CONCLUSION The availability of only 13 studies investigating paediatric Indigenous sleep highlights the paucity of data in this area. Compared with non-indigenous people, Indigenous children are significantly more likely to experience short sleep duration and a high proportion reported symptoms of sleep disordered breathing. Working and conferring with Indigenous communities is an opportunity to engage in partnerships to improve sleep health and subsequently general health.
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Affiliation(s)
- S Blunden
- Appleton Institute of Behavioural Science, Central Queensland University, 44 Greenhill Rd, Wayville, Adelaide, South Australia, 5034, Australia.
| | - Y Fatima
- Institute for Social Science Research, University of Queensland, Brisbane, Australia; Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia.
| | - S Yiallourou
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Vic, 3004, Australia.
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