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Liang X, He X, Liu Q, Ren Y, Xu S, Chen L, Wang F, Bi Y, Peng Z. The impact of dietary and sleep rhythms on blood pressure in children and adolescents: a cross-sectional study. Hypertens Res 2024; 47:649-662. [PMID: 37919430 DOI: 10.1038/s41440-023-01493-7] [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: 06/27/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023]
Abstract
Evidence about the relationship between meal and sleep time and CVD in children is scarce. The aims of this study were to describe the association between life rhythm patterns and blood pressure in children. This research was conducted among 5,608 children aged 6 to 15 years old in Chongqing and Sichuan provinces in 2021 and 2022. Dietary and sleep rhythms information was collected. The time of the first meal and last meal, and sleep time, were obtained. The mean age was 10.48 ± 2.24 years old, with 2958 (52.75%) male participants. The mean feeding window on weekdays was 11.69 h, 12.42 h, and 13.23 h for participants aged 6-7 years old, 8-12 years old and 13-15 years old, respectively. Weekday feeding window and last mealtime were positively correlated with blood pressure levels. And the changes in the feeding window between weekdays and weekends were significantly correlated with BP. Sleep duration and change in wake time were significantly correlated with SBP. Based on these results, this study identified the optimal combination of dietary and sleep rhythm interventions for children younger than 12 years of age and aged 12 and older, respectively. Disorder dietary and sleep rhythms disorders may correlate with elevated blood pressure levels, suggesting developing optimal dietary and sleep rhythm patterns could prevent the incidence of CVDs in children. The optimal dietary rhythm was defined by the indexes of breakfast time, dinner time and daily feeding window. As good meal patterns are defined as satisfied the following three items: for children younger than 12 years should have breakfast after 7:30 am; aged 12 years and over should have breakfast after 7 am; having dinner before 6 pm; daily feeding window less than 12.5 h. And less optimal dietary rhythm should satisfy any condition or eat dinner between 6 pm and 8 pm; and poor dietary rhythm should not satisfy any of the three criteria and eat dinner after 8 pm. Children with optimal dietary rhythm (in group A) had lower SBP (P < 0.001), DBP (P = 0.002) and MAP (P < 0.001) than those in group C.
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Affiliation(s)
- Xiaohua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400016, China.
| | - Xiangqian He
- College of Medical Informatics, Medical Data Science Academy, Chongqing Medical University, Chongqing, 400014, China
| | - Qin Liu
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400016, China
| | - Yanling Ren
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400016, China
| | - Sipei Xu
- The First Department of Clinical Medicine, Chongqing Medical University, Chongqing, 400016, P. R. China
| | - Lan Chen
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400016, China
| | - Fengming Wang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400016, China
| | - Yang Bi
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400016, China
| | - Zhilian Peng
- Traditional Chinese Medicine Hospital of Jiulongpo District, Chongqing, China
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Zhao Q, He M, Zhang M, Chu Y, Ban B. Non-linear relationship between sleep duration and blood pressure in children with short stature. Front Pediatr 2023; 11:1302750. [PMID: 38027291 PMCID: PMC10657848 DOI: 10.3389/fped.2023.1302750] [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: 10/02/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Evidence regarding the relationship between sleep duration and blood pressure is controversial. Therefore, the aim of this study was to investigate the relationship between sleep duration and blood pressure in children with short stature. Methods A total of 1,085 participants with short stature were enrolled from the Affiliated Hospital of Jining Medical University in China. The variables involved in this study included sleep duration, anthropometric indicators and biochemical parameters. Sleep duration was evaluated in a face-to-face interview. Results The average age of the 1,085 selected participants was 10.2 ± 3.5 years old, and approximately 763 (70.32%) of them were male. The results of adjusted linear regression showed that sleep duration was negatively associated with systolic blood pressure z scores (SBP-Z) and diastolic blood pressure z scores (DBP-Z) after adjusting for confounders (β -0.07, 95% CI -0.13, -0.01 P = 0.038; β -0.05, 95% CI -0.10, -0.01 P = 0.035, respectively). A nonlinear relationship was detected between sleep duration and blood pressure, including SBP-Z, DBP-Z and mean arterial pressure z scores (MAP-Z). The inflection point of the nonlinear relationship between sleep duration and SBP-Z is 10 h, and the inflection point of DBP-Z and MAP-Z is 8 h. Conclusion This study revealed a nonlinear relationship between sleep duration and blood pressure in children with short stature. The findings suggest that the optimal sleep duration in children with short stature was 8-10 h, and sleep durations either too short or too long were associated with increased blood pressure levels.
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Affiliation(s)
- Qianqian Zhao
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Department of National Telemedicine Center of China, Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
| | - Mingming He
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Department of National Telemedicine Center of China, Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Department of National Telemedicine Center of China, Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
| | - Yuntian Chu
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
- Department of National Telemedicine Center of China, Chinese Research Center for Behavior Medicine in Growth and Development, Jining, China
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Okely AD, Ghersi D, Loughran SP, Cliff DP, Shilton T, Jones RA, Stanley RM, Sherring J, Toms N, Eckermann S, Olds TS, Zhang Z, Parrish AM, Kervin L, Downie S, Salmon J, Bannerman C, Needham T, Marshall E, Kaufman J, Brown L, Wille J, Wood G, Lubans DR, Biddle SJH, Pill S, Hargreaves A, Jonas N, Schranz N, Campbell P, Ingram K, Dean H, Verrender A, Ellis Y, Chong KH, Dumuid D, Katzmarzyk PT, Draper CE, Lewthwaite H, Tremblay MS. A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep. Int J Behav Nutr Phys Act 2022; 19:2. [PMID: 34991606 PMCID: PMC8734238 DOI: 10.1186/s12966-021-01236-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/08/2021] [Indexed: 12/20/2022] Open
Abstract
Abstract Background In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updated Australian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleep were developed and the outcomes from this process. Methods The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. The Canadian 24-Hour Movement Guidelines for Children and Youth best met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines. Results Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and young people (13-17 years). Conclusions To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used to develop movement behaviour guidelines. The judgments of the Australian Guideline Development Group did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian Guidelines were adopted with only very minor alterations. This allowed the Australian Guidelines to be developed in a shorter time frame and at a lower cost. We recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines that was developed using the GRADE approach is available with all supporting materials. Other countries may consider this approach when developing and/or revising national movement guidelines. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01236-2.
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Affiliation(s)
- Anthony D Okely
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia. .,Illawarra Health and Medical Research Institute, Wollongong, Australia.
| | - Davina Ghersi
- Research Policy and Translation, National Health and Medical Research Council, Canberra, Australia.,National Health & Medical Research Council Clinical Trials Centre, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Sarah P Loughran
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Dylan P Cliff
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Trevor Shilton
- National Heart Foundation (WA), 334 Rokeby Road, Subiaco, Australia
| | - Rachel A Jones
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Rebecca M Stanley
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Julie Sherring
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Natalie Toms
- Preventive Programs, Commonwealth Department of Health, Canberra, Australia
| | - Simon Eckermann
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Timothy S Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Zhiguang Zhang
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Anne-Maree Parrish
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Lisa Kervin
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Sandra Downie
- Preventive Programs, Commonwealth Department of Health, Canberra, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia
| | | | | | | | - Jordy Kaufman
- Swinburne University of Technology, Melbourne, Australia
| | - Layne Brown
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Janecke Wille
- Federation of Ethnic Communities Council of Australia (FECCA), Canberra, Australia
| | - Greg Wood
- Australian Sports Commission, Leederville, Western Australia
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, Australia
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, Toowoomba, Australia
| | - Shane Pill
- The Australian Council for Health, Physical Education and Recreation (ACHPER), Wayville, Australia and Flinders University, Adelaide, South Australia
| | | | - Natalie Jonas
- Australian Curriculum, Assessment and Reporting Authority (ACARA), SA, Sydney, Australia
| | - Natasha Schranz
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Active Healthy Kids Australia, Adelaide, Australia and National Heart Foundation, Adelaide, South Australia
| | - Perry Campbell
- Australian Children's Education & Care Quality Authority (ACECQA), Sydney, Australia
| | - Karen Ingram
- NSW Education Standards Authority (NESA), Sydney, Australia
| | - Hayley Dean
- NSW Education Standards Authority (NESA), Sydney, Australia
| | - Adam Verrender
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Yvonne Ellis
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Kar Hau Chong
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | | | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Hayley Lewthwaite
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
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dos Santos EDSG, de Souza OF. EVIDENCE OF THE ASSOCIATION BETWEEN SLEEP DURATION AND BLOOD PRESSURE IN ADOLESCENTS: A SYSTEMATIC REVIEW. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2020; 39:e2019225. [PMID: 32785432 PMCID: PMC7409100 DOI: 10.1590/1984-0462/2021/39/2019225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/27/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To review the epidemiological evidence of the association between sleep duration and blood pressure in adolescents. DATA SOURCES We performed a systematic review of observational studies in Medline, Scopus, Lilacs, Web of Science, Science Direct databases and Virtual Libraries in English, Spanish and Portuguese published until September 2018. Studies were selected first by title and abstract, then by complete reading, according to the eligibility criteria. The reference list of selected articles was evaluated in order to retrieve relevant studies. DATA SYNTHESIS Initially, 1,455 articles were retrieved. After exclusion due to duplicity or not meeting the eligibility criteria, 13 articles were included in the review. Studies varied greatly in sample size (143 to 6,940 patients), methods of measuring blood pressure and sleep duration, cutoff points, categorization and adjustment of variables. The main evidence from the studies is that short sleep duration is associated with high blood pressure in adolescence, although the presence of association between high blood pressure and long sleep duration is possible, but not clear in the literature. CONCLUSIONS Sleep duration, especially short duration, is associated with high blood pressure in adolescents. Such evidence draws attention to implications on cardiovascular health in this age group.
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Gender-Specific Longitudinal Association of Sleep Duration with Blood Pressure among Children: Evidence from CHNS 2004-2015. Int J Hypertens 2020; 2020:5475297. [PMID: 32765906 PMCID: PMC7374217 DOI: 10.1155/2020/5475297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose We conducted this study to add the evidence regarding the gender-specific association between sleep duration and blood pressure (BP) in children. Methods A secondary analysis was performed among 1000 children aged 7–13 years, who had at least two rounds of survey records in China Health and Nutrition Survey through 2004–2015. Generalized estimating equation was used to explore the gender-specific association of sleep duration with BP. The subgroup analysis was applied in those participants with normal weight. Results The time trend of decreasing sleep duration, along with increasing BP level, was observed in each age group during the survey period. Short sleepers (<9 hours per day) have higher level of both systolic BP (SBP) and diastolic BP (DBP) than long sleepers in girls (all p < 0.05). By contrast, only SBP was higher in short sleepers among boys (p < 0.05). There was gender difference in the association between sleep duration and DBP (p for interaction <0.05). The stratification analysis showed that short sleep duration could consistently predict a higher level of diastolic BP (DBP) in both crude (β = 2.968, 95% CI: 1.629, 4.306) and adjusted models (β = 1.844, 95% CI: 0.273, 3.416) only in girls. Sleep duration was also analyzed as continuous variable, and the very similar associations were observed. Moreover, the established associations can be verified among children with normal weight. Conclusions There was a time trend of decreasing sleep duration alongside increasing BP among children from 2004 to 2015. Short sleep duration was independently associated with increased DBP; however, only girls were susceptible to the association.
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Jansen EC, Dunietz GL, Matos-Moreno A, Solano M, Lazcano-Ponce E, Sánchez-Zamorano LM. Bedtimes and Blood Pressure: A Prospective Cohort Study of Mexican Adolescents. Am J Hypertens 2020; 33:269-277. [PMID: 31840156 DOI: 10.1093/ajh/hpz191] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/07/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Hypertension affects up to 5% of children worldwide and predicts later cardiovascular morbidity. Associations of short sleep and hypertension have been frequently reported in adults but less consistently in children. This study aims to examine the role of late bedtimes, a marker of short sleep duration, and potentially misaligned circadian rhythms, on incident elevated blood pressure (BP) in a large cohort of Mexican children. METHODS Participants included 2,033 adolescents recruited from public schools in Morelos, Mexico, free from elevated BP (<90th sex, age, and height-standardized percentile). Fourteen months later, all adolescents had a second BP assessment. We abstracted baseline habitual bedtimes from questionnaires to evaluate the association between bedtime and elevated BP incidence (≥90th percentile). Risk ratios and 95% confidence intervals were estimated with discrete-time mixed survival models, adjusting for potential confounders and accounting for clustering by school. RESULTS Participants were 12.5 (SD = 0.6) years old at baseline. At the follow-up visit 10% of adolescents had developed elevated BP. Compared to participants with a habitual weekday bedtime between 9 and 10 pm, those with a weekday bedtime 11 pm or later had a 1.87 times higher risk of developing elevated BP over the follow-up period (95% CI = 1.09, 2.21), after accounting for confounders. Participants with earlier weekday bedtimes also had a higher risk of elevated BP (RR = 1.96; 95% CI = 1.27, 3.01). The associations persisted after accounting for wake time. CONCLUSION These data showed a U-shaped association between weekday bedtime and elevated/high BP risk among Mexican adolescents.
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Affiliation(s)
- Erica C Jansen
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Amilcar Matos-Moreno
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Maritsa Solano
- Department of Chronic Disease, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Eduardo Lazcano-Ponce
- Department of Chronic Disease, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Xiao Q, Chaput JP, Olds T, Fogelholm M, Hu G, Lambert EV, Maher C, Maia J, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C, Katzmarzyk PT. Sleep characteristics and health-related quality of life in 9- to 11-year-old children from 12 countries. Sleep Health 2019; 6:4-14. [PMID: 31699637 DOI: 10.1016/j.sleh.2019.09.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 08/26/2019] [Accepted: 09/17/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Previous studies have linked short sleep duration, poor sleep quality, and late sleep timing with lower health-related quality of life (HRQoL) in children. However, almost all studies relied solely on self-reported sleep information, and most studies were conducted in high-income countries. To address these gaps, we studied both device-measured and self-reported sleep characteristics in relation to HRQoL in a sample of children from 12 countries that vary widely in terms of economic and human development. METHODS The study sample included 6,626 children aged 9-11 years from Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. Waist-worn actigraphy was used to measure total sleep time, bedtime, wake-up time, and sleep efficiency on both weekdays and weekends. Children also reported ratings of sleep quantity and quality. HRQoL was measured by the KIDSCREEN-10 survey. Multilevel regression models were used to determine the relationships between sleep characteristics and HRQoL. RESULTS Results showed considerable variation in sleep characteristics, particularly duration and timing, across study sites. Overall, we found no association between device-measured total sleep time, sleep timing or sleep efficiency, and HRQoL. In contrast, self-reported ratings of poor sleep quantity and quality were associated with HRQoL. CONCLUSIONS Self-reported, rather than device-based, measures of sleep are related to HRQoL in children. The discrepancy related to sleep assessment methods highlights the importance of considering both device-measured and self-reported measures of sleep in understanding its health effects.
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Affiliation(s)
| | | | - Timothy Olds
- University of South Australia, Adelaide, Australia
| | | | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Carol Maher
- University of South Australia, Adelaide, Australia
| | - Jose Maia
- University of Porto, Porto, Portugal
| | | | | | | | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
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Jiang W, Hu C, Li F, Hua X, Zhang X. Association between sleep duration and high blood pressure in adolescents: a systematic review and meta-analysis. Ann Hum Biol 2019; 45:457-462. [PMID: 30387692 DOI: 10.1080/03014460.2018.1535661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CONTEXT Sleep has been assessed as a risk factor for health consequences. Among adults, excessively longer and shorter sleep durations are associated with high blood pressure (BP), but knowledge of the association between sleep duration and high BP among adolescents is limited. OBJECTIVES To estimate the associations between sleep duration and high BP in adolescents. METHODS PubMed, Web of Science, and Cochrane databases were searched for eligible publications up until 20 November 2017. This study reviewed the reference lists from retrieved articles to search for relevant studies. Pooled odds ratios (ORs) were calculated using a random-effects meta-analysis. Sub-group and sensitivity analyses were conducted to identify heterogeneity. Publication bias was evaluated using Egger's test. RESULTS Seven studies involving 21,150 participants were included, with ages ranging from 10-18 years. For primary analysis, compared with the reference sleep duration, the pooled OR for high BP was 1.51 (95% confidence interval [CI] = 1.04-2.19) for the short sleep duration overall. For long sleep duration, the pooled OR was 1.04 (95% CI = 0.78-1.38). Further sub-group analysis showed that short sleep duration had a higher risk of incident high BP in males (OR = 1.55, 95% CI = 1.24-1.93) than in females (OR = 1.23, 95% CI = 0.47-3.22). CONCLUSIONS Among adolescents, and particularly male adolescents, short sleep duration may be a risk factor for high BP. More attention should be given to this lifestyle factor.
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Affiliation(s)
- Wen Jiang
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
| | - Chengyang Hu
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
| | - Fengli Li
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
| | - Xiaoguo Hua
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
| | - Xiujun Zhang
- a Department of Epidemiology and Biostatistics, School of Public Health , Anhui Medical University , Hefei , China
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Fobian AD, Elliott L, Louie T. A Systematic Review of Sleep, Hypertension, and Cardiovascular Risk in Children and Adolescents. Curr Hypertens Rep 2018; 20:42. [PMID: 29717377 DOI: 10.1007/s11906-018-0841-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Many of the risk factors for heart disease have recently been shown to develop during childhood such as left ventricular hypertrophy and fibrous plaque lesions. As risk for cardiovascular disease in children and adolescents has risen, sleep duration has decreased, and inadequate sleep in children and adolescents has been found to be associated with cardiovascular disease risk. The aims of this manuscript are to provide an updated systematic review of the literature assessing sleep, hypertension, and cardiovascular risk and evaluate the strength of the evidence based on the available research. RECENT FINDINGS A systematic review was conducted using six databases from January 1, 2015 through March 9, 2018. We sought studies which looked at the relationship between sleep duration, sleep timing, or sleep quality and outcome variables of hypertension, inflammation, obesity, glucose or insulin, and lipids in children and adolescents. We found 24 studies which met our criteria. Nine studies included hypertension as an outcome variable; fifteen included obesity; thirteen included glucose or insulin; eight included lipids; and three included measures of inflammation. The existing literature on sleep and cardiovascular disease in children and adolescents is limited and relatively weak. Only one RCT was identified, and the overwhelming majority of studies had a high risk of bias. The strongest evidence of an association with sleep is with obesity, hypertension, and insulin sensitivity. Further research using more standardized methods and objective measures is needed to determine if a causal relationship truly exists between sleep and cardiovascular risk.
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Affiliation(s)
- Aaron D Fobian
- Department of Psychiatry, University of Alabama at Birmingham, 1720 2nd Ave. S., SC 1025, Birmingham, AL, 35294, USA.
| | - Lindsey Elliott
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tinnie Louie
- Department of Clinical and Diagnostic Science, University of Alabama at Birmingham, Birmingham, AL, USA
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Bal C, Öztürk A, Çiçek B, Özdemir A, Zararsız G, Ünalan D, Ertürk Zararsız G, Korkmaz S, Göksülük D, Eldem V, İsmailoğulları S, Erdem E, Mazıcıoğlu MM, Kurtoğlu S. The Relationship Between Blood Pressure and Sleep Duration in Turkish Children: A Cross-Sectional Study. J Clin Res Pediatr Endocrinol 2018; 10:51-58. [PMID: 28619699 PMCID: PMC5838373 DOI: 10.4274/jcrpe.4557] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE As in adults, hypertension is also an important risk factor for cardiovascular disease in children. We aimed to evaluate the effect of sleep duration on blood pressure in normal weight Turkish children aged between 11-17 years. METHODS This cross-sectional study was conducted in the primary and secondary schools of the two central and ten outlying districts of Kayseri, Turkey. Subjects were 2860 children and adolescents (1385 boys, 1475 girls). Systolic and diastolic blood pressures were measured according to the recommendations of the Fourth Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Sleep duration was classified as follows: ≤8 hours, 8.1-8.9 hours, 9.0-9.9 hours or ≥10 hours. RESULTS For short sleeper boys and girls (participants with a sleep duration ≤8 h) the prevalence of prehypertension and hypertension was 35.0% and 30.8%, respectively. In univariate binary logistic regression analyses (age-adjusted), each unit increment in sleep duration (hours) in boys and girls, decreased the prehypertension and hypertension risk by 0.89 [odds ratio (OR)] [confidance interval (CI); 0.82-0.98] and 0.88 (OR) (CI; 0.81-0.97), respectively (p<0.05). In multiple binary logistic regression analyses [age- and body mass index (BMI)-adjusted] the location of the school and sleep duration categories were shown to be the most important factors for prehypertension and hypertension in both genders, while household income was the most important factor, only in boys. CONCLUSIONS A sleep duration ≤8 h is an independent risk factor for prehypertension and hypertension in Turkish children aged 11-17 years.
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Affiliation(s)
- Cengiz Bal
- Eskişehir Osmangazi University Faculty of Medicine, Department of Biostatistics, Eskişehir, Turkey
| | - Ahmet Öztürk
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Betül Çiçek
- Erciyes University Faculty of Health Sciences, Department of Nutrition and Dietetics, Kayseri, Turkey,* Address for Correspondence: Erciyes University Faculty of Health Sciences, Department of Nutrition and Dietetics, Kayseri, Turkey Phone: +90 352 207 66 66/28654 E-mail:
| | - Ahmet Özdemir
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - Gökmen Zararsız
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Demet Ünalan
- Erciyes University Halil Bayraktar Health Services Vocational College, Kayseri, Turkey
| | - Gözde Ertürk Zararsız
- Erciyes University Faculty of Medicine, Department of Biostatistics; Erciyes Teknopark, Turcosa Analytics Solutions Ltd. Co, Kayseri, Turkey
| | - Selçuk Korkmaz
- Trakya University Faculty of Medicine, Department of Biostatistics, Edirne, Turkey
| | - Dinçer Göksülük
- Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Vahap Eldem
- İstanbul University Faculty of Science, Department of Biology, İstanbul, Turkey
| | - Sevda İsmailoğulları
- Erciyes University Faculty of Medicine, Department of Neurology, Kayseri, Turkey
| | - Emine Erdem
- Erciyes University Faculty of Health Sciences, Department of Pediatric Nursing, Kayseri, Turkey
| | - Mümtaz M Mazıcıoğlu
- Erciyes University Faculty of Medicine, Department of Family Medicine, Kayseri, Turkey
| | - Selim Kurtoğlu
- Memorial Hospital, Department of Pediatrics, Kayseri, Turkey
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