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Santos IS, Echevarria P, Tovo-Rodrigues L, Matijasevich A, Domingues MR, Hallal PC. Are nocturnal awakenings at age 1 predictive of sleep duration and efficiency at age 6: Results from two birth cohorts. Sleep Med X 2024; 7:100105. [PMID: 38312370 PMCID: PMC10837084 DOI: 10.1016/j.sleepx.2024.100105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/06/2024] Open
Abstract
Objective To investigate the association of nighttime awakenings at 12 months with the duration and efficiency of nighttime sleep at 6 years of age. Methods Data from two population-based prospective studies (The Pelotas 2004 and The Pelotas 2015 Birth Cohorts) were used. Information on nighttime awakenings was provided by mothers during the 12-month follow-up interview. Infants who awakened >3 times after sleep onset at 12 months were considered frequent wakeners. Sleep duration and sleep efficiency were obtained by actigraphy at the 6-year follow-up. Children wore the device at the wrist of the non-dominant arm continuously for 3-7 days, including at least one weekend day. Unadjusted and adjusted beta coefficients were obtained by linear regression for each cohort separately. Results 2500 children from the 2004 and 2793 from the 2015 cohort had full information on nighttime awakenings at 12 months and actigraphy at 6 years and were analyzed. Prevalence of frequent wakeners was 6.3 % and 5.9 % in the 2004 and 2015 cohort, respectively. Mean bedtime and wake-up time at 6 years were, respectively, 23:23 and 08:41 h in the 2004 cohort, and 00:10 and 09:00 h int the 2015 cohort. Nighttime sleep lasted on average 7.54 and 7.24 h respectively in the 2004 and the 2015 cohort, and the sleep efficiency was 81.1 and 82.5 % respectively. In adjusted analyses, no associations were found between awakening at 12 months and sleep duration or sleep efficiency at 6 years of age. Conclusion In both cohorts sleep duration and efficiency were below the recommendation for school-age children (respectively 9-11 h and 85 %). There was no relationship between the number of nighttime awakenings at 12 months and sleep duration or efficiency at 6 years.
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Affiliation(s)
- Ina S. Santos
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Priscila Echevarria
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | | | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, SP, Brazil
| | - Marlos R. Domingues
- Post-graduate Program in Physical Education, Federal University of Pelotas, Brazil
| | - Pedro C. Hallal
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Brazil
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Clark ELM, Gutierrez-Colina A, Ruzicka EB, Sanchez N, Bristol M, Gulley LD, Broussard JL, Kelsey MM, Simon SL, Shomaker LB. Racial and ethnic sleep health disparities in adolescents and risk for type 2 diabetes: a narrative review. Ann Med 2024; 56:2399756. [PMID: 39253865 PMCID: PMC11389628 DOI: 10.1080/07853890.2024.2399756] [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: 11/27/2023] [Revised: 05/21/2024] [Accepted: 07/09/2024] [Indexed: 09/11/2024] Open
Abstract
INTRODUCTION Sleep is an essential factor for health and wellbeing in people across the age spectrum; yet many adolescents do not meet the recommended 8-10 h of nightly sleep. Unfortunately, habitually insufficient sleep, along with the metabolic changes of puberty, puts adolescents at increased risk for a host of adverse health outcomes such as obesity and type 2 diabetes (T2D). Furthermore, individuals from historically minoritized racial and ethnic groups (e.g. Hispanic/Latinx, African American/Black) are more likely to experience shorter sleep duration compared to adolescents of White/European origin, placing them at even greater risk for disparities in T2D risk. METHODS We conducted a literature review on the role of race and ethnicity in adolescent sleep health and its relation to cardiometabolic outcomes, specifically T2D. We use the minority stress model and the stress and coping theory as guiding theoretical frameworks to examine individual and societal level factors that may contribute to sleep health disparities and their downstream effects on T2D risk. RESULTS This review highlights that the unique race-related stressors adolescents from minoritized groups face may play a role in the sleep and T2D connection on a biological, psychological, and social level. However, although there has been advancement in the current research on adolescent racial and ethnic sleep health disparities in relation to T2D, mechanisms underlying these disparities in sleep health need further investigation. Addressing these gaps is crucial for identifying and mitigating sleep health disparities and T2D among racial and ethnic minority youth. CONCLUSION We conclude with a discussion of the implications and future research directions of racial and ethnic disparities in sleep health and T2D prevention research. A comprehensive understanding of adolescent sleep health disparities has potential to better inform preventative and educational programs, interventions, and policies that promote sleep health equity and improve cardiometabolic outcomes like T2D.
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Affiliation(s)
- Emma L M Clark
- Human Development & Family Studies, College of Health & Human Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ana Gutierrez-Colina
- Human Development & Family Studies, College of Health & Human Sciences, Colorado State University, Fort Collins, CO, USA
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Elizabeth B Ruzicka
- Human Development & Family Studies, College of Health & Human Sciences, Colorado State University, Fort Collins, CO, USA
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Natalia Sanchez
- Human Development & Family Studies, College of Health & Human Sciences, Colorado State University, Fort Collins, CO, USA
- Community & Behavioral Health, Epidemiology, and Global Health & Health Disparities, Colorado School of Public Health, Aurora, CO, USA
| | - Madison Bristol
- Human Development & Family Studies, College of Health & Human Sciences, Colorado State University, Fort Collins, CO, USA
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
- Community & Behavioral Health, Epidemiology, and Global Health & Health Disparities, Colorado School of Public Health, Aurora, CO, USA
| | - Lauren D Gulley
- Human Development & Family Studies, College of Health & Human Sciences, Colorado State University, Fort Collins, CO, USA
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Josiane L Broussard
- Health & Exercise Science, College of Health & Human Sciences, Colorado State University, Fort Collins, CO, USA
- Endocrinology, Diabetes and Metabolism, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Megan M Kelsey
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Stacey L Simon
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
- Pulmonology and Sleep Medicine, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Lauren B Shomaker
- Human Development & Family Studies, College of Health & Human Sciences, Colorado State University, Fort Collins, CO, USA
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
- Community & Behavioral Health, Epidemiology, and Global Health & Health Disparities, Colorado School of Public Health, Aurora, CO, USA
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Zhang R, Zheng X, Zhang L, Xu Y, Lin X, Wang X, Wu C, Jiang F, Wang J. LANMAO sleep recorder versus polysomnography in neonatal EEG recording and sleep analysis. J Neurosci Methods 2024; 410:110222. [PMID: 39038718 DOI: 10.1016/j.jneumeth.2024.110222] [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: 04/11/2024] [Revised: 06/11/2024] [Accepted: 07/17/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND The field of neonatal sleep analysis is burgeoning with devices that purport to offer alternatives to polysomnography (PSG) for monitoring sleep patterns. However, the majority of these devices are limited in their capacity, typically only distinguishing between sleep and wakefulness. This study aims to assess the efficacy of a novel wearable electroencephalographic (EEG) device, the LANMAO Sleep Recorder, in capturing EEG data and analyzing sleep stages, and to compare its performance against the established PSG standard. METHODS The study involved concurrent sleep monitoring of 34 neonates using both PSG and the LANMAO device. Initially, the study verified the consistency of raw EEG signals captured by the LANMAO device, employing relative spectral power analysis and Pearson correlation coefficients (PCC) for validation. Subsequently, the LANMAO device's integrated automated sleep staging algorithm was evaluated by comparing its output with expert-generated sleep stage classifications. RESULTS Analysis revealed that the PCC between the relative spectral powers of various frequency bands during different sleep stages ranged from 0.28 to 0.48. Specifically, the correlation for delta waves was recorded at 0.28. The automated sleep staging algorithm of the LANMAO device demonstrated an overall accuracy of 79.60 %, Cohen kappa of 0.65, and F1 Score of 76.93 %. Individual accuracy for Wake at 87.20 %, NREM at 85.70 %, and REM Sleep at 81.30 %. CONCLUSION While the LANMAO Sleep Recorder's automated sleep staging algorithm necessitates further refinement, the device shows promise in accurately recording neonatal EEG during sleep. Its potential for minimal invasiveness makes it an appealing option for monitoring sleep conditions in newborns, suggesting a novel approach in the field of neonatal sleep analysis.
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Affiliation(s)
- Ruijie Zhang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xin Zheng
- Department of Data and Algorithms, Department of Software Development, Shanghai Quanlan Technology Co., Ltd, China
| | - Lu Zhang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yan Xu
- Department of Neurology, Children's Hospital of Fudan University, National Children's Medical-Center, Shanghai, China
| | - Xinao Lin
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xuefeng Wang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chuyan Wu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Jiang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
| | - Jimei Wang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
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Gyasi RM, Aikins E, Dumedah G, Gyasi-Boadu N, Frimpong PB, Boampong MS, Buor D, Mariwah S, Naab F, Phillips DR. Risk of Sleep Problems in Middle-Aged and Older Adults Experiencing Bodily Pains: Serial Multiple Mediation Estimates of Emotional Distress and Activity Limitations. Am J Geriatr Psychiatry 2024; 32:1231-1243. [PMID: 38702252 DOI: 10.1016/j.jagp.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES Pain is increasingly becoming common among middle-aged and older adults. While research on the association between pain characteristics and sleep problems (SP) is limited in low- and middle-income countries, the underlying mechanisms of the association are poorly understood. This study examines the association of bodily pain intensity and pain interference with SP and investigates the mediating role of activity limitation and emotional distress in this association. METHODS We analyzed population-based data, including 1,201 individuals aged ≥50 (mean [SD] age 66.14 [11.85] years) from the 2016-2018 AgeHeaPsyWel-HeaSeeB study in Ghana. Multiple OLS regressions and serial multiple mediation modeling using bootstrapping analyses examined direct and indirect effects from pain to SP through activity limitation and emotional distress. RESULTS Regressions demonstrated that pain intensity and interference were significantly associated with higher levels of activity limitation, emotional distress, and SP (range: β = 0.049-0.658). Bootstrapping analysis showed that activity limitation and emotional distress serially mediated the relationship between pain intensity and SP (total effect: β = 0.264, Bootstrap 95% confidence interval [CI] = 0.165-0.362; direct effect: (β = 0.107, Bootstrap 95% CI = 0.005-0.210; total indirect effect: β = 0.156, Bootstrap 95% CI = 0.005-0.210) accounting for ∼59%. Activity limitation and emotional distress mediated pain interference and SP association (total effect: β = 0.404, Bootstrap 95% CI = 0.318-0.490; direct effect: β = 0.292, Bootstrap 95% CI = 0.201-0.384; and total indirect effect: β = 0.112, Bootstrap 95% CI = 0.069-0.156) yielding ∼28%. CONCLUSION Our data suggest that activity limitation and emotional distress may convey stress-related risks of pain on SP. Future research should evaluate if activity limitation and emotional distress could be effective targets to reduce the effect of pain on sleep in later-life.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine (NCNM), Southern Cross University, Lismore, Australia.
| | - Emelia Aikins
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gift Dumedah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nelson Gyasi-Boadu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Boakye Frimpong
- Department of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mary Sefa Boampong
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Buor
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Simon Mariwah
- Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana
| | - Francis Naab
- Perivoli Africa Research Centre (PARC), University of Bristol, Bristol, United Kingdom
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, Hong Kong
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Miadich SA, Ostner SG, Murillo AS, Bui C, Rea-Sandin G, Doane LD, Davis MC, Lemery-Chalfant K. The moderating role of early-life parental adverse and positive factors in the genetic and environmental contributions to objectively assessed sleep duration in middle childhood. J Exp Child Psychol 2024; 246:105994. [PMID: 38991312 DOI: 10.1016/j.jecp.2024.105994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 07/13/2024]
Abstract
Early-life positive and adverse parental factors, such as positive parent personality and parental stress, affect the environmental context in which children develop and may influence individual differences in children's sleep health. This study examined the moderating role of early-life parental factors in the heritability (i.e., the extent to which individual differences are due to genetic influences) of objectively assessed childhood sleep duration. A total of 351 families from the Arizona Twin Project were studied. Primary caregivers (95% mothers) reported on multiple dimensions of stress and facets of their own personality when the twins were 12 months old. Seven years later (Mage = 8.43 years, SD = 0.68), families completed a home visit, and twins (51% female; 57% White, 29% Hispanic; 30% monozygotic, 39% same-sex dizygotic, 31% other-sex dizygotic) wore actigraph watches to assess their sleep, with caregivers completing similar assessments on their personality attributes and stress. Early-life positive parent personality moderated the heritability of sleep duration (Δ-2LL [-2 log likelihood] = 2.54, Δdf = 2, p = .28), such that as positive parent personality increased, the heritability of duration decreased. Early-life parental stress also moderated the genetic contribution to sleep duration (Δ-2LL = 2.02, Δdf = 2, p = .36), such that as stress increased, the heritability of duration increased. Concurrent positive parent personality and parental stress composites showed similar patterns of findings. Results highlight the likely contribution of parent positive traits and adverse experiences to the etiology of children's sleep health, with genetic influences on children's sleep more prominent in "riskier" environments. Understanding how genetics and environments work together to influence the etiology of sleep may inform prevention programs.
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Affiliation(s)
- Samantha A Miadich
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA 01854, USA.
| | - Savannah G Ostner
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Alexys S Murillo
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Christy Bui
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Gianna Rea-Sandin
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Mary C Davis
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
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Huang J, Memon AR, Bao R, Fan H, Wang L, Liu Y, Chen S, Li C. 24-H movement behaviours research in Chinese population: A scoping review. J Exerc Sci Fit 2024; 22:397-405. [PMID: 39219863 PMCID: PMC11363828 DOI: 10.1016/j.jesf.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/30/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024] Open
Abstract
Background Numerous studies examining 24-h movement behaviours have been exponentially published globally. However, no comprehensive reviews summarized and synthesized the evidence on the Chinese population. This review aimed to map the most recent research state and fill the gaps related to 24-h movement behaviours in the Chinese population. Methods Five electronic databases (Web of Science, PubMed, Scopus, EBSCOhost, and CNKI (Chinese database)) were searched from their inceptions through October 2023. Quantitative studies published in English and/or Chinese were included if they were related to 24-h movement behaviours in the Chinese population. Results From 9431 documents screened, 53 met the inclusion criteria. All the included studies were published between 2019 and 2023, showing a notable increasing trend over the years. Most studies used cross-sectional designs (96.2 %) and self-reported measures (56.6 %). Nearly all the studies targeted general healthy population (96.2 %), especially children and adolescents (64.2 %). The main three research topics observed were health outcomes (81.1 %), prevalence (66.0 %), and correlates (15.1 %) of 24-h movement behaviours. Conclusion 24-h movement behaviours in the Chinese population has been an increasingly important research topic in the literature, with predominant focus on children and adolescents (study population), self-report measure (measurement), cross-sectional design (study design), guidelines adherence (study topic), and health outcomes examination (study topic). These findings delineate a research landscape in the Chinese population, and highlight the research gaps needed to be addressed. Future studies are suggested to target these research gaps, expanding evidence base for the Chinese populations. For instance, more studies using device-based measures, longitudinal or interventional designs, as well as qualitative and mixed-methods approaches are required.
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Affiliation(s)
- Jiafu Huang
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, 510006, China
| | - Aamir Raoof Memon
- Institute for Health and Sport, Victoria University, Melbourne, 8001, Australia
| | - Ran Bao
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Huiying Fan
- School of Physical Education, Shanghai Normal University, Shanghai, 200234, China
| | - Lijuan Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, 200438, China
| | - Yang Liu
- School of Physical Education, 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
| | - Sitong Chen
- Center for Mental Health, Shenzhen University, Shenzhen, 518061, China
| | - Chunxiao Li
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, 510006, China
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Cheng Y, Huang Y, Zhang G, Sun J. Educating adolescents on preventing substance use: The role of 24-h movement behaviors ─ data from 2021 Youth Risk Behavior Surveillance. Complement Ther Clin Pract 2024; 57:101904. [PMID: 39260079 DOI: 10.1016/j.ctcp.2024.101904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/27/2024] [Accepted: 09/06/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Little is known about how adhering to the health guidelines for physical activity (PA), screen time (ST), and sleep duration (SD) relates to substance use in adolescents. Thus, this study aims to explore the potential association between adherence to the 24-h movement behavior (24-h MB) guidelines and substance use among adolescents. METHODS Data from the 2019 Youth Risk Behavior Surveillance was analyzed. Participants reported their weekly PA, ST, SD, and substance use (alcohol and smoking) over the past 30 days. The mean age in the total participants was 15.56, and 48.03 % of the participants were females. Logistic regression was used in this study to explore the potential association between 24-h MB and substance use. Odds ratios (ORs) were reported alongside a 95 % confidence interval to enhance understanding of the observed association. RESULTS Only 2.22 % participants adhered to all three 24-h MB guidelines, while 47.99 % did not follow any guidelines. Notably, there was no significant difference in the odds of cigarette smoking between participants who followed none of the guidelines and those who followed some or all of them. Nevertheless, adherence to one or more guidelines was found to be associated with higher odds of abstaining from alcohol consumption compared to non-adherence (one guidelines: OR = 1.17 [1.08, 1.28], two guidelines: OR = 1.28 [1.13, 1.44]). CONCLUSIONS Adhering to 24-h MB guidelines may reduce adolescents' alcohol consumption, but the adherence was not significantly associated with smoking. Longitudinal studies are needed to confirm these findings. These results can inform adolescent health policies and interventions aimed at reducing substance use from the perspective of healthy time-use behaviors, which can be used for researchers and educator.
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Affiliation(s)
- Yaozhong Cheng
- Academic Affairs Office, West Anhui University, Lvan, 237012, Anhui, China.
| | - Yourui Huang
- School of Electrical and Optoelectronic Engineering, West Anhui University, Lvan, 237012, Anhui, China
| | - Gang Zhang
- School of Electrical and Optoelectronic Engineering, West Anhui University, Lvan, 237012, Anhui, China
| | - Jiangang Sun
- School of Physical Education, West Anhui University, Lvan, 237012, Anhui, China
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Padmapriya N, Bernard JY, Tan SYX, Chu AHY, Goh CMJL, Tan SL, Shek LP, Chong YS, Tan KH, Chan SY, Yap F, Godfrey KM, Lee YS, Meaney MJ, Eriksson JG, Tan CS, Law EC, Müller-Riemenschneider F. The prospective associations of 24-hour movement behaviors and domain-specific activities with executive function and academic achievement among school-aged children in Singapore. Front Public Health 2024; 12:1412634. [PMID: 39296832 PMCID: PMC11409845 DOI: 10.3389/fpubh.2024.1412634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/29/2024] [Indexed: 09/21/2024] Open
Abstract
Background Physical activity (PA), sedentary behavior (SB), and sleep are collectively referred to as 24-h movement behaviors, which may be linked to cognitive development in children. However, most of the evidence was based on cross-sectional studies and/or solely relied on parent-reported information on children's behaviors, and it remains uncertain whether all domains/contexts of PA and SB are similarly associated with executive function and academic achievement. Objective We investigated the prospective associations of accelerometer-measured 24 h-movement behaviors and domain-specific PA and SB with executive function and academic achievement among school-aged children in Singapore. Methods The Growing Up in Singapore Toward healthy Outcomes (GUSTO) cohort used a wrist-worn accelerometer (Actigraph-GT3x+) to measure 24 h-movement behaviors data at ages 5.5 and 8 years. Executive function and academic achievement were assessed using NEuroPSYchology (NEPSY) and Wechsler Individual Achievement Tests at ages 8.5 and 9-years, respectively. Compositional data analyses were conducted to explore the associations of 24 h-movement behavior with outcomes, and multiple linear regression models to examine the associations of domain-specific PA and SB with outcomes (n = 432). Results Among 432 children whose parents agreed to cognitive assessments (47% girls and 58% Chinese), the composition of 24 h-movement behaviors at ages 5.5 and 8 years was not associated with executive function and academic achievement. However, higher moderate-to-vigorous PA (MVPA) relative to remaining movement behaviors at age 5.5 years was associated with lower academic achievement [Mean difference (95% confidence interval): -0.367 (-0.726, -0.009) z-score], and reallocating MVPA time to sleep showed higher academic achievement scores [30 min from MVPA to sleep: 0.214 (0.023, 0.404) z-score]. Certain domains of PA and SB, notably organized PA/sports, outdoor play, and reading books were favorably associated with outcomes of interest, while indoor play and screen-viewing were unfavorably associated. Conclusion The associations between movement behaviors and cognitive outcomes are multifaceted, influenced by specific domains of PA and SB. This study underscores the importance of participation in organized PA/sports, outdoor active play, and reading books, while ensuring adequate sleep and limiting screen viewing, to enhance cognitive outcomes. These findings underscore the need for further research into time-use trade-offs. Such studies could have major implications for revising current guidelines or strategies aimed at promoting healthier 24 h-movement behaviors in children. Study registration https://clinicaltrials.gov/, NCT01174875.
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Affiliation(s)
- Natarajan Padmapriya
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, 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 (A*STAR), Singapore, Singapore
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sarah Yi Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Anne H Y Chu
- 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 (A*STAR), Singapore, Singapore
| | | | - Shuen Lin Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Yap Seng Chong
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Kok Hian Tan
- KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
| | - Shiao-Yng Chan
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Fabian Yap
- KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keith M 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
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Ludmer Centre for Neuroinformatics and Mental Health, Department of Psychiatry, Douglas Mental Health University Research Centre, McGill University, Montreal, QC, Canada
| | - Johan G Eriksson
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Evelyn C Law
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
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9
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Hao Y, Zhou X, Razman R, Peng S, Ahmad NS. Compliance with the 24-hour movement behaviour guidelines among children and adolescents with disabilities: a systematic review and meta-analysis. BMC Public Health 2024; 24:2357. [PMID: 39215263 PMCID: PMC11363391 DOI: 10.1186/s12889-024-19842-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Compliance with the 24-Hour Movement Guidelines (24-HMG: physical activity (PA), screen time (ST), and sleep) has been associated with numerous beneficial health outcomes among children and adolescents. However, there is a lack of consensus on the overall compliance with the 24-HMG specifically among children and adolescents with disabilities. Therefore, this systematic review and meta-analysis aimed to examine the extent to which children and adolescents with disabilities adhere to the 24-HMG globally. METHOD Quantitative studies published in English until May 2023 were sought by searching seven electronic databases: Web of Science, PubMed, SPORTDiscus, CINAHL, MEDLINE, Scopus, Psychology and Behavioural Sciences Collection. This review included studies that identified participants as individuals with disabilities and reported the overall (non) compliance with the 24-HMG among children and adolescents with disabilities. RESULTS A total of 13 studies, involving 21,101 individuals (65.95% males), aged 6 to 21 years from 9 countries, were included in the analysis. In general, 7% (95%CI: 0.05-0.09, p < 0.01) of children and adolescents with disabilities met all three 24-HMG, while 16% (95%CI: 0.13-020, p < 0.01) did not meet any of the three recommendations. Regarding adherence to individual 24-hour movement behaviour, the rates of compliance were 22% (95%CI: 0.18-0.25, p < 0.01) for PA, 49% (95%CI: 0.41-0.56, p < 0.01) for ST, and 59% (95%CI: 0.56-0.61, p < 0.01) sleep. In relation to numbers of those meeting the 24-HMG, 43% (95%CI: 0.41-0.45, p < 0.01) met one guideline, while 32% (95%CI: 0.28-0.36, p < 0.01) met two guidelines. CONCLUSION There is a notable percentage of children and adolescents with disabilities who do not meet the recommended the 24-HMG, which encompasses PA, ST, and sleep. This underscores the pressing requirement to create and execute evidence-based strategies that effectively encourage and assist these individuals with disabilities in adopting and maintaining these movement behaviours.
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Affiliation(s)
- Yaru Hao
- School of Sports Science, Changsha Normal University, Changsha, China
| | - Xiaogang Zhou
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
| | - Rizal Razman
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Sanying Peng
- Department of Physical Education, Hohai University, Nanjing, China
| | - Nor Shafrin Ahmad
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
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10
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Decker JE, Morales KH, Fair MA, Vallecorsa G, Subramanyam S, Fiks AG, Mayne S, Williamson AA, Mitchell JA. Classifying intervention components used in sleep duration interventions for children: A systematic review and meta-analysis. Sleep Med Rev 2024; 78:101995. [PMID: 39216182 DOI: 10.1016/j.smrv.2024.101995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 08/13/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
The Multiphase Optimization Strategy (MOST) is a three-phase iterative framework that could accelerate the development of behavioral interventions. This systematic review and meta-analysis was conducted within the MOST preparation phase and aimed to classify components included in pediatric sleep duration interventions, using the Behavior Change Technique (BCT) Taxonomy. Across 37 interventions, 46 out of 93 BCTs have been used, with an average of 8 techniques used per study. The most common BCTs used were instruction on how to perform the behavior (N = 29; code 4.1), practical social support (N = 22; code: 3.2), and behavioral practice/rehearsal (N = 22; code: 8.1). A latent class analysis identified two classes of interventions, distinguished by the presence of BCTs falling within the following behavior change groups: shaping knowledge, natural consequences, comparison of behavior, and repetition and substitution. Our meta-analysis revealed that interventions belonging to the latent class with these behavior change groups (N = 15) had a pooled positive intervention effect of 14 min (95 % CI: 8-21) versus 8 min (95 % CI: 1-15) for interventions without these behavior change groups (N = 19). This systematic review and meta-analysis will enhance the development of sleep promotion interventions and guide the selection of candidate intervention components for future optimization and randomized control trials.
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Affiliation(s)
- Jessica E Decker
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Knashawn H Morales
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Maddy A Fair
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Giuliana Vallecorsa
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Sanjana Subramanyam
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alexander G Fiks
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephanie Mayne
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ariel A Williamson
- The Ballmer Institute for Children's Behavioral Health, University of Oregon, Portland, OR, USA; Department of Psychology, College of Arts and Sciences, University of Oregon, Eugene, OR, USA
| | - Jonathan A Mitchell
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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11
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Choi Y, Yook JS, Cho EJ, Jeong I, Kim J, Zempo-Miyaki A, Chang E, Park DH, Kwak HB. Adolescent obesity and short sleep duration as independent risk factors for hypertension: a population-based cohort study. J Hum Hypertens 2024:10.1038/s41371-024-00946-x. [PMID: 39174671 DOI: 10.1038/s41371-024-00946-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/07/2024] [Accepted: 08/14/2024] [Indexed: 08/24/2024]
Abstract
Prevalence of hypertension in adolescents has increased worldwide and is considered a risk factor for hypertension and cardiovascular disease in adulthood. Although obesity and sleep deficiency increase this risk, the combined effects of these factors on hypertension remain unclear. This study aimed to examine the combined effects of obesity and sleep duration on hypertension in adolescents. This study was conducted using data from the 2016 to 2018 Korean National Health and Nutrition Examination Survey, which included a study population of 1272 adolescents. The participants were categorized into four groups based on sleep duration and body mass index (BMI) percentiles: normal sleep and normal body mass group (reference; normal), only short sleep group (short sleep), only overweight/obesity group (overweight/obesity), and short sleep and overweight/obesity group (short sleep and overweight/obesity). Short sleep duration was defined as <8 h of average sleep duration, and overweight/obesity was defined as a BMI ≥ 85th percentile. Hypertension in adolescents was defined as a systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. The prevalence of hypertension was 9.2% among Korean adolescents. Short sleep duration with overweight/obesity were associated with a significantly increased risk of hypertension (odds ratio = 6.57; 95% confidence interval: 3.27-13.20) in adolescents, and controlling for the potential confounding variables only partially attenuated this relationship (odds ratio = 5.28; 95% confidence interval: 2.28-12.26). This study demonstrated that the coexistence of short sleep duration and obesity was associated with an increased risk of hypertension in Korean adolescents.
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Affiliation(s)
- Youngju Choi
- Institute for Specialized Teaching and Research (INSTAR), Inha University, Incheon, Republic of Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
- Institute of Sports & Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
| | - Jang Soo Yook
- Institute of Sports & Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
| | - Eun-Jeong Cho
- Institute of Sports & Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science & Engineering, Inha University, Incheon, Republic of Korea
| | - Ilyoung Jeong
- Institute of Sports & Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science & Engineering, Inha University, Incheon, Republic of Korea
| | - Junghoon Kim
- Sports and Exercise Medicine Laboratory, Korea Maritime and Ocean University, Busan, Republic of Korea
| | - Asako Zempo-Miyaki
- Faculty of Sports and Health Sciences, Ryutsu Keizai University, Ryugasaki, Japan
| | - Eunwook Chang
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
- Institute of Sports & Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
| | - Dong-Ho Park
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
- Institute of Sports & Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science & Engineering, Inha University, Incheon, Republic of Korea
| | - Hyo-Bum Kwak
- Department of Kinesiology, Inha University, Incheon, Republic of Korea.
- Institute of Sports & Arts Convergence (ISAC), Inha University, Incheon, Republic of Korea.
- Department of Biomedical Science, Program in Biomedical Science & Engineering, Inha University, Incheon, Republic of Korea.
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12
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Jackson R, Gu C, Haszard J, Meredith-Jones K, Galland B, Camp J, Brown D, Taylor R. The Effect of Prebedtime Behaviors on Sleep Duration and Quality in Children: Protocol for a Randomized Crossover Trial. JMIR Res Protoc 2024; 13:e63692. [PMID: 39163119 PMCID: PMC11372319 DOI: 10.2196/63692] [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: 06/26/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND It is recommended that children should avoid eating dinner, being physically active, or using screens in the hour before bed to ensure good sleep health. However, the evidence base behind these guidelines is weak and limited to cross-sectional studies using questionnaires. OBJECTIVE The aim of this randomized crossover trial was to use objective measures to experimentally determine whether recommendations to improve sleep by banning electronic media, physical activity, or food intake in the hour before bed, impact sleep quantity and quality in the youth. METHODS After a baseline week to assess usual behavior, 72 children (10-14.9 years old) will be randomized to four conditions, which are (1) avoid all 3 behaviors, (2) use screens for at least 30 minutes, (3) be physically active for at least 30 minutes, and (4) eat a large meal, during the hour before bed on days 5 to 7 of weeks 2 to 5. Families can choose which days of the week they undertake the intervention, but they must be the same days for each intervention week. Guidance on how to undertake each intervention will be provided. Interventions will only be undertaken during the school term to avoid known changes in sleep during school holidays. Intervention adherence and shuteye latency (time from getting into bed until attempting sleep) will be measured by wearable and stationary PatrolEyes video cameras (StuntCams). Sleep (total sleep time, sleep onset, and wake after sleep onset) will be measured using actigraphy (baseline, days 5 to 7 of each intervention week). Mixed effects regression models with a random effect for participants will be used to estimate mean differences (95% CI) for conditions 2 to 4 compared with condition 1. RESULTS Recruitment started in March 2024, and is anticipated to finish in April 2025. Following data analysis, we expect that results will be available later in 2026. CONCLUSIONS Using objective measures, we will be able to establish if causal relationships exist between prebedtime behaviors and sleep in children. Such information is critical to ensure appropriate and achievable sleep guidelines. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12624000206527; https://tinyurl.com/3kcjmfnj. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/63692.
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Affiliation(s)
- Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Chao Gu
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | | | - Barbara Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Justine Camp
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Deirdre Brown
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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13
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Mastorci F, Lazzeri MFL, Vassalle C, Pingitore A. The Transition from Childhood to Adolescence: Between Health and Vulnerability. CHILDREN (BASEL, SWITZERLAND) 2024; 11:989. [PMID: 39201923 PMCID: PMC11352511 DOI: 10.3390/children11080989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/31/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024]
Abstract
Transitioning from childhood into adolescence is an extraordinary time of life, associated with major physical, emotional, cognitive, and social changes and characterized by dynamic development in which interaction with the environment modulates the individual resources responsible for well-being and health. This sensitive period is the time when, in addition to hormonal, metabolic, and neural changes, certain behavioral strategies begin to take shape that will shortly go on to define the emotional, social, and cultural identity of the individual. This narrative review aimed to uncover the crucial processes underlying the transition by identifying processes that are responsible for cognitive, psychosocial, and emotional development, in the absence of disease. For this aim, we highlight (1) the physical, psychological, and social determinants during the transition from childhood to adolescence; (2) the role of health-related variables in resilience or vulnerability mechanisms; and (3) recent school-based strategies to promote health and well-being. Recognizing that health and well-being are the result of the interaction of many biological, psychological, social, cultural, and physical factors will lead to comprehensive health promotion involving all actors joining the growth process, from health professionals and the educational community to parents and community. Furthermore, it is important that psychosocial dimensions are strengthened already during childhood to prevent the onset of frailty and illness in adolescence.
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Affiliation(s)
- Francesca Mastorci
- Clinical Physiology Institute, CNR, 56124 Pisa, Italy; (M.F.L.L.); (A.P.)
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14
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Hartstein LE, Mathew GM, Reichenberger DA, Rodriguez I, Allen N, Chang AM, Chaput JP, Christakis DA, Garrison M, Gooley JJ, Koos JA, Van Den Bulck J, Woods H, Zeitzer JM, Dzierzewski JM, Hale L. The impact of screen use on sleep health across the lifespan: A National Sleep Foundation consensus statement. Sleep Health 2024; 10:373-384. [PMID: 38806392 DOI: 10.1016/j.sleh.2024.05.001] [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: 02/13/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE To achieve consensus on whether screen-based digital media (1) in general, (2) via prebedtime content, and (3) via prebedtime light impairs sleep health in (a) childhood, (b) adolescence, and (c) adulthood. Furthermore, to address whether employing behavioral strategies and interventions may reduce the potential negative effects of screens on sleep health. METHODS The National Sleep Foundation convened a 16-person multidisciplinary expert panel ("Panel"). Panelists met virtually 5 times throughout 2023, during which they followed a modified Delphi RAND/UCLA Appropriateness Method to reach consensus. RESULTS The Panel conducted a literature review starting with 2209 articles, narrowed down to 522 relevant empirical articles and 52 relevant review articles. The search was refined to include 35 experimental/intervention studies that examined whether there was a causal link between screen-based digital media and sleep. In addition, panelists reviewed 5 recent relevant systematic review articles. After reviewing the summarized current literature, panelists voted on 10 candidate statements about whether screen use impairs sleep health. The Panel met virtually to discuss the results of the first round of votes, which was then followed by a second round of voting, ultimately achieving consensus on 5 out of the 10 statements. CONCLUSIONS The Panel achieved consensus that (1) in general, screen use impairs sleep health among children and adolescents, (2) the content of screen use before sleep impairs sleep health of children and adolescents, and (3) behavioral strategies and interventions may attenuate the negative effects of screen use on sleep health.
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Affiliation(s)
- Lauren E Hartstein
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Gina Marie Mathew
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - David A Reichenberger
- Department of Biobehavioral Health, Pennsylvania State University, State College, Pennsylvania, USA
| | - Isaac Rodriguez
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Nicholas Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University, State College, Pennsylvania, USA
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Dimitri A Christakis
- Department of Pediatrics, University of Washington, Special Olympics International, Seattle, Washington, USA
| | - Michelle Garrison
- Neuroscience & Behavioural Disorders Programme, Department of Public Health, Purdue University, Lafayette, Indiana, USA
| | - Joshua J Gooley
- Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore, Singapore
| | - Jessica A Koos
- Health Sciences Library, Stony Brook University, Stony Brook, New York, USA
| | - Jan Van Den Bulck
- Department of Communication and Media, University of Michigan, Ann Arbor, Michigan, USA
| | - Heather Woods
- School of Psychology and Neuroscience, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | | | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.
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15
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Sun Y, Luo D, Guan K, Luo X. Meeting 24-h movement behavior guidelines is associated with academic engagement, social-emotional functioning in obese/overweight youth. Complement Ther Clin Pract 2024; 56:101863. [PMID: 38820658 DOI: 10.1016/j.ctcp.2024.101863] [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: 03/19/2024] [Revised: 05/21/2024] [Accepted: 05/26/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND The 24-h movement behavior (24-HMB) guidelines suggest that the integration of adequate sleep (SL), increased physical activity (PA), and limited screen time (ST) has general health benefits. However, associations of meeting integrated guidelines with academic engagement and social-emotional functioning among obese/overweight youth have yet to be fully examined. Thus, we aimed to investigate the associations between meeting 24-HMB guidelines and the above-presented outcome measures among this unique group. METHODS In this cross-sectional study, 2800 children and adolescents (youth aged 6-17 years old) that were retrieved from the National Survey of Children's Health (NSCH) were included for data analysis. Exposure of interests included adherence to 24-HMB guideline(s), while indicators of academic engagement and social-emotional functioning were operationalized. Furthermore, multiple logistic regression was conducted while adjusting for social-demographic variables including age, sex, ethnicity, household income, parental education level and mental health status. RESULTS The percentages of meeting 24-HMB guidelines varied greatly across different combinations: 1399 participants (49.96 %) met 1 of the 3 guidelines, 580 participants (20.91 %) met 2 guidelines, while only 91 participants (2.94 %) met all 3 guidelines. Meeting integrated guidelines was selectively associated with higher odds of indicators (showing interest/curiosity in learning, caring about school performance, and completing all required homework) of academic engagement. Additionally, Meeting SL + ST guideline (OR = 0.52, 95%CI: 0.29-0.93, p < 00.05) was associated with lower odds of serious difficulty in concentrating, remembering, and making decisions, while meeting ST + SL guideline (OR = 1.67, 95%CI: 1.03-2.69, p < 00.05) was more likely to be good at making and keeping friendships. Furthermore, meeting all 3 guidelines was associated with less argumentative behaviors (OR = 0.58, 95%CI: 0.33-0.99, p < 00.05) and a higher level of resilience (OR = 3.51, 95%CI: 1.88-6.54, p < 00.01), while meeting any two integrated guidelines was associated with a higher level of resilience (OR = 1.72, 95%CI: 1.09-2.71, p < 00.05). CONCLUSION Findings have indicated the role of meeting 24-HMB guidelines, especially integrated guidelines in the healthy development of obese/overweight youth. Policymakers should implement a long-term plan for this unique group to engage in physical activity, achieve enough sleep, and limit screen time.
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Affiliation(s)
- Yongsheng Sun
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, 100191, Beijing, China.
| | - Danfangjun Luo
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, 100191, Beijing, China.
| | - Kaiqi Guan
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, 518060, Guangdong, China.
| | - Xun Luo
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, 518060, Guangdong, China.
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16
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Burkart S, Beets MW, Pfledderer CD, von Klinggraeff L, Zhu X, St Laurent CW, van Hees VT, Armstrong B, Weaver RG, Adams EL. Are parent-reported sleep logs essential? A comparison of three approaches to guide open source accelerometry-based nocturnal sleep processing in children. J Sleep Res 2024; 33:e14112. [PMID: 38009378 PMCID: PMC11128474 DOI: 10.1111/jsr.14112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 11/28/2023]
Abstract
We examined the comparability of children's nocturnal sleep estimates using accelerometry data, processed with and without a sleep log. In a secondary analysis, we evaluated factors associated with disagreement between processing approaches. Children (n = 722, age 5-12 years) wore a wrist-based accelerometer for 14 days during Autumn 2020, Spring 2021, and/or Summer 2021. Outcomes included sleep period, duration, wake after sleep onset (WASO), and timing (onset, midpoint, waketime). Parents completed surveys including children's nightly bed/wake time. Data were processed with parent-reported bed/wake time (sleep log), the Heuristic algorithm looking at Distribution of Change in Z-Angle (HDCZA) algorithm (no log), and an 8 p.m.-8 a.m. window (generic log) using the R-package 'GGIR' (version 2.6-4). Mean/absolute bias and limits of agreement were calculated and visualised with Bland-Altman plots. Associations between child, home, and survey characteristics and disagreement were examined with tobit regression. Just over half of nights demonstrated no difference in sleep period between sleep log and no log approaches. Among all nights, the sleep log approach produced longer sleep periods (9.3 min; absolute mean bias [AMB] = 28.0 min), shorter duration (1.4 min; AMB = 14.0 min), greater WASO (11.0 min; AMB = 15.4 min), and earlier onset (13.4 min; AMB = 17.4 min), midpoint (8.8 min; AMB = 15.3 min), and waketime (3.9 min; AMB = 14.8 min) than no log. Factors associated with discrepancies included smartphone ownership, bedroom screens, nontraditional parent work schedule, and completion on weekend/summer nights (range = 0.4-10.2 min). The generic log resulted in greater AMB among sleep outcomes. Small mean differences were observed between nights with and without a sleep log. Discrepancies existed on weekends, in summer, and for children with smartphones and screens in the bedroom.
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Affiliation(s)
- Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christopher D Pfledderer
- University of Texas Health Science Center (UTHealth) at Houston, School of Public Health in Austin, Austin, Texas, USA
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, Texas, USA
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xuanxuan Zhu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christine W St Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Elizabeth L Adams
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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17
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Figa Z, Zemeskel AG, Alemu A, Abebe M. Evidence-based intrapartum care practice and associated factors among obstetrics workers in Ethiopia, systematic review and meta-analysis. SAGE Open Med 2024; 12:20503121241261210. [PMID: 39086555 PMCID: PMC11289799 DOI: 10.1177/20503121241261210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/24/2024] [Indexed: 08/02/2024] Open
Abstract
Background Evidence-based practice is defined as using the best available research and clinical evidence by incorporating patients' values and preferences for their health needs. The use of evidence-based intrapartum care practices is an essential tool to improve the quality of obstetrics care. Objective The primary objective of this study was to determine the prevalence of evidence-based intrapartum care and associated factors among obstetrics care providers in Ethiopia. Method Important articles were retrieved from universally accepted and used databases, including Cochran, PubMed, HINARI, Google Scholar, Web of Science, African OnLine, and repositories of Ethiopian Universities. We extracted articles by using a standard JOANNA Briggs Institute data extraction sheet. To determine the existence of heterogeneity in studies, I 2 statistics and Cochran Q tests were used. The publication bias of the included studies was checked using Egger's test and a Funnel plot. Result A total of 2035 obstetrics care providers were involved in this systematic review and meta-analysis. The estimated overall rate of evidence-based intrapartum care practice in Ethiopia was 54.45% (95% CI: 43.06, 65.83); I 2 = 96.6%, p < 0.001). The studies with a sample size greater than 300 count for 47.25% (95% CI: 36.14, 65.83). Whereas obstetrics care providers have a decent knowledge of intrapartum care evidence 3.31 times, a positive attitude toward evidence 3.34 times, training 2.21 times, and work experience ⩾5 years 3.31 times associated with the practice of evidence-based intrapartum care. Conclusion The overall practice of evidence-based intrapartum care among obstetrics workers in Ethiopia is estimated to be low. Therefore, there should be a focused effort on training and disseminating protocols and guidelines to enhance knowledge and foster a positive attitude among obstetrics care providers. Additionally, the Ethiopian government should prioritize the implementation of the 2021 to 2025 National Health Equity Strategic Plan to achieve its objective of improving the quality of health services.
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Affiliation(s)
- Zerihun Figa
- Department of Midwifery, Dilla University College of Health and Medical Science, Dilla, Ethiopia
| | - Addisu Getinet Zemeskel
- Department of Midwifery, Dilla University College of Health and Medical Science, Dilla, Ethiopia
| | - Asrat Alemu
- Department of Midwifery, Dilla University College of Health and Medical Science, Dilla, Ethiopia
| | - Mesfin Abebe
- Department of Midwifery, Dilla University College of Health and Medical Science, Dilla, Ethiopia
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18
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Muayyad M, Abusnana S, Mussa BM, Helal R, Abdelrahim DN, Abdelreheim NH, Al Amiri E, Daboul M, Al-Abadla Z, Lessan N, Faris ME. Adherence to the Mediterranean diet and sleep quality are inter-correlated with flash glucose monitoring (FGM)-measured glycemia among children with type 1 diabetes. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:284. [PMID: 39310020 PMCID: PMC11414882 DOI: 10.4103/jehp.jehp_1609_23] [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: 10/08/2023] [Accepted: 12/13/2023] [Indexed: 09/25/2024]
Abstract
BACKGROUND We examined the inter-correlation between diet quality, objectively measured sleep duration, and subjectively measured sleep quality with flash glucose monitoring (FGM)-measured glycemia among young patients with type 1 diabetes (T1D). MATERIALS AND METHODS Following cross-sectional design, Fitbit® accelerometers were used to objectively assess sleep duration, while the validated questionnaires Pittsburgh sleep quality index and Mediterranean diet (MD) adherence were used to subjectively assess sleep quality and diet quality, respectively. Glycated hemoglobin (HbA1c) and FGM-reported glycemia components among children with T1D were assessed as well. RESULTS Of the 47 participants surveyed (25 boys, 22 girls, 9.31 ± 2.88 years), the majority reported high HbA1c, good sleep quality, and high adherence to the MD. However, only one-third of the participants reported a healthy sleep duration. Only the sleep latency was significantly (P < 0.05) associated with the time above range level 2 and time below range level 2 (P = 0.048) components of the FGM. A positive correlation (r = 0.309, P = 0.035) was reported between adherence to MD and time in range of the FGM. CONCLUSIONS Diet quality and sleep quality are variably inter-correlated with FGM-measured glycemia among young patients with T1D and are suggested to be considered influential factors in FGM-monitored diabetes research on this age group.
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Affiliation(s)
- Mariam Muayyad
- Nutrition Department, Al Qassimi Women's and Children's Hospital, Sharjah, UAE
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Salah Abusnana
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Bashair M. Mussa
- Basic Medical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE
| | | | - Dana N. Abdelrahim
- Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
| | | | - Elham Al Amiri
- Diabetes and Endocrinology Department, Al Qassimi Women's and Children's Hospital, Sharjah, UAE
| | - Mays Daboul
- Nutrition Department, Novomed Medical Centre, Dubai, UAE
| | - Zainab Al-Abadla
- Diabetes and Endocrinology Department, Al Jalila Children's Specialty Hospital, Dubai, UAE
| | - Nader Lessan
- Imperial College of London Diabetes Centre, Abu Dhabi, UAE
| | - MoezAlIslam E. Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Healthy Aging, Longevity and Sustainability Research Group, Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
- Nutrition and Food Research Group, Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
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19
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Zhang R, Dong X, Zhang L, Lin X, Wang X, Xu Y, Wu C, Jiang F, Wang J. Quantitative Electroencephalography in Term Neonates During the Early Postnatal Period Across Various Sleep States. Nat Sci Sleep 2024; 16:1011-1025. [PMID: 39071545 PMCID: PMC11282454 DOI: 10.2147/nss.s472595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024] Open
Abstract
Background Neonatal sleep is pivotal for their growth and development, yet manual interpretation of raw images is time-consuming and labor-intensive. Quantitative Electroencephalography (QEEG) presents significant advantages in terms of objectivity and convenience for investigating neonatal sleep patterns. However, research on the sleep patterns of healthy neonates remains scarce. This study aims to identify QEEG markers that distinguish between different neonatal sleep cycles and analyze QEEG alterations across various sleep stages in relation to postmenstrual age. Methods From September 2023 to February 2024, full-term neonates admitted to the neonatology department at the Obstetrics and Gynecology Hospital of Fudan University were enrolled in this study. Electroencephalographic (EEG) recordings were obtained from neonates aged 37-42 weeks, within 1-7 days post-birth. The ROC curve was employed to evaluate QEEG features related to amplitude, range EEG (rEEG), spectral density, and connectivity across different sleep stages. Furthermore, regression analyses were performed to investigate the association between these QEEG characteristics and postmenstrual age. Results The alpha frequency band's spectral_diff_F3 emerged as the most potent discriminator between active sleep (AS) and quiet sleep (QS). In distinguishing AS from wakefulness (W), the theta frequency's spectral_diff_C4 was the most effective, whereas the delta frequency's spectral_diff_P4 excelled in differentiating QS from W. During AS and QS phases, there was a notable increase in entropy within the delta frequency band across all monitored brain regions and in the spectral relative power within the theta frequency band, correlating with postmenstrual age (PMA). Conclusion Spectral difference showcases the highest discriminative capability across awake and various sleep states. The observed patterns of neonatal QEEG alterations in relation to PMA are consistent with the maturation of neonatal sleep, offering insights into the prediction and evaluation of brain development outcomes.
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Affiliation(s)
- Ruijie Zhang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Xinran Dong
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Lu Zhang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Xinao Lin
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Xuefeng Wang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Yan Xu
- Department of Neurology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, People’s Republic of China
| | - Chuyan Wu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Feng Jiang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Jimei Wang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
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20
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Molleri N, Gomes Junior SC, Marano D, Zin A. Adherence of Brazilian Minors to the 24-Hour Movement Guidelines after In-Person School Return. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:930. [PMID: 39063506 PMCID: PMC11277094 DOI: 10.3390/ijerph21070930] [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: 05/22/2024] [Revised: 07/01/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024]
Abstract
The levels of adequacy of movement behaviors after returning to in-person school activities following the COVID-19 pandemic are not yet well understood. This study aimed to assess the adherence of Brazilian minors to the recommendations of the 24-Hour Movement Guidelines (moderate to vigorous physical activity, recreational screen time, and sleep duration), as well as overall adherence to these guidelines, after the relaxation of COVID-19 social isolation measures and the resumption of in-person schooling. A cross-sectional study was conducted with parents or guardians (39 ± 7.8) of minors aged up to 18 years of age (3.8 ± 2.5). A total of 172 individuals responded to the questionnaire. Data were compared with those obtained in the Survey of the Adequacy of Brazilian Children and Adolescents to the 24-Hour Movement Guidelines before and during the COVID-19 Pandemic. There was an 18.6 percentage decrease (p-value < 0.001) in overall adherence to the 24-Hour Movement Guidelines when comparing the periods before the COVID-19 pandemic (March 2020) and after the return to in-person schooling (March 2021). The largest percentage drop in adherence between these periods was observed for moderate to vigorous physical activity (27.4%; p-value < 0.001) and the lowest for sleep (10.5%; p-value < 0.001). Adherence to the 24-Hour Movement Guidelines did not return to pre-pandemic levels with the resumption of in-person school activities.
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Affiliation(s)
- Natália Molleri
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/FIOCRUZ, Rio de Janeiro 22250-020, Brazil; (S.C.G.J.); (D.M.); (A.Z.)
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21
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Pereira S, Katzmarzyk PT, Hedeker D, Barreira TV, Garganta R, Farias C, Garbeloto F, Tani G, Chaput JP, Stodden DF, Maia J. Background, rationale, and methodological overview of the REACT project-return-to-action on growth, motor development, and health after the COVID-19 pandemic in primary school children. Am J Hum Biol 2024; 36:e23968. [PMID: 37489725 DOI: 10.1002/ajhb.23968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
OBJECTIVES The REACT project was designed around two main aims: (1) to assess children's growth and motor development after the COVID-19 pandemic and (2) to follow their fundamental movement skills' developmental trajectories over 18 months using a novel technological device (Meu Educativo®) in their physical education classes. In this introductory article, the first of the Journal's special issue dedicated to REACT, our goal was to present the project rationale, its methodology, training and certification of the team, statistical approach, quality control, governance, and study management. METHODS We sampled 1000 children (6-10 years of age) from 25 of the 32 primary schools in Matosinhos, northern Portugal. The protocol included a set of variables clustered around the child (growth, physical fitness, fundamental movement skills, and health behaviors), family (demographics, socioeconomic status, parental support for sports participation and physical activity), school (policies and practices for health behaviors, infrastructure for physical education and sports practices), and neighborhood and home environments (safety, sidewalks, sports facilities, as well as children electronic devices and play equipment at home). A set of standard protocols were implemented in REACT together with a rigorous system of training and certification of all members of the research team. This was complemented with a pilot study to assess, in loco, the quality of data acquisition, data entry, and control. DISCUSSION Results from REACT will provide school administrators and teachers with novel and far-reaching information related to children's growth and motor development as well as health behaviors after the COVID-19 pandemic. It will also provide city-hall education officials with insight regarding children's physical fitness, fundamental movement skills, and sports practices that will be of great importance in devising novel intervention programs to increase health-enhancing physical activity, and combat sedentariness and obesity. Finally, it will offer parents a wealth of information regarding their children's growth, motor development, and health.
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Affiliation(s)
- Sara Pereira
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
- Research Center in Sport, Physical Education, and Exercise and Health (CIDEFES), Faculty of Physical Education and Sports, Lusófona University, Lisbon, Portugal
| | | | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Tiago V Barreira
- Department of Exercise Science, Syracuse University, Syracuse, New York, USA
| | - Rui Garganta
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Cláudio Farias
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Fernando Garbeloto
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Go Tani
- Motor Behavior Laboratory, School of Physical Education and Sports, University of São Paulo, São Paulo, Brazil
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - David F Stodden
- Department of Physical Education, University of South Carolina, Columbia, South Carolina, USA
| | - José Maia
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
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22
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Sandhu APS, Tanvir, Singh K, Singh S, Antaal H, Luthra S, Singla A, Nijjar GS, Aulakh SK, Kaur Y. Decoding Cancer Risk: Understanding Gene-Environment Interactions in Cancer Development. Cureus 2024; 16:e64936. [PMID: 39165474 PMCID: PMC11335134 DOI: 10.7759/cureus.64936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2024] [Indexed: 08/22/2024] Open
Abstract
While lifestyle choices or behavioral patterns remain the most significant factors influencing cancer risk, environmental exposure to certain chemicals, both manufactured and natural, may also contribute to an individual's likelihood of developing cancer. This interplay of factors, coupled with an aging demographic and shifting lifestyle patterns, has led to an increasing prevalence of cancer in recent years. This study examines the environmental and behavioral factors that contribute to anomalies in the immune system and increase the risk of developing cancer. Significant environmental and occupational factors include the contamination of air and water, exposure to radiation, contact with harmful microorganisms and pathogens, and workplace exposure to carcinogens such as asbestos, certain chemicals, and industrial pollutants. Behavioral factors, such as food, physical activity, stress, substance misuse, and sleep patterns, have a substantial impact on immunological function and the likelihood of developing cancer. For example, pollutants like benzene and arsenic can disrupt immune function and raise the risk of developing cancer. Similarly, lifestyle variables such as inactivity and poor nutrition have been linked to an increased risk of cancer. Long-term stress and substance abuse can also decrease immunological responses, increasing the risk of developing cancer. The review underlines the complexities of examining gene-environment interactions, as well as the importance of using several perspectives to fully comprehend these pathways. Future investigations should emphasize improved methodology and larger sample sizes. Public health campaigns should aim to reduce human exposure to cancer-causing compounds known as carcinogens while also encouraging the adoption of healthy behaviors and habits. Tailored preventive approaches that account for individual genetic vulnerabilities have the potential to improve cancer prevention and treatment.
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Affiliation(s)
- Ajay Pal Singh Sandhu
- Internal Medicine, Sri Guru Ram Das University of Health Sciences and Research, Amritsar, IND
| | - Tanvir
- Medicine, Government Medical College Amritsar, Amritsar, IND
| | | | - Sumerjit Singh
- Internal Medicine, Government Medical College Amritsar, Amritsar, IND
| | - Harman Antaal
- Internal Medicine, Government Medical College Patiala, Patiala, IND
| | - Shivansh Luthra
- Medicine, Government Medical College Amritsar, Amritsar, IND
| | | | | | - Smriti K Aulakh
- Internal Medicine, Sri Guru Ram Das University of Health Sciences and Research, Amritsar, IND
| | - Yasmeen Kaur
- Medicine, Government Medical College Amritsar, Amritsar, IND
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23
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Song J, Fan L, Shi D, Lai X, Wang H, Liu W, Yu L, Liang R, Zhang Y, Wan S, Yang Y, Wang B. Sleep and liver function biomarkers in relation to risk of incident liver cancer: a nationwide prospective cohort study. BMC Med 2024; 22:261. [PMID: 38915009 PMCID: PMC11197319 DOI: 10.1186/s12916-024-03440-w] [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: 01/03/2024] [Accepted: 05/24/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND To assess the largely undetermined separate and joint effects of sleep and liver function biomarkers on liver cancer. METHODS Data of 356,894 participants without cancer at baseline in the UK Biobank were analyzed. Sleep score was evaluated using five sleep traits (sleep duration, chronotype, insomnia, snoring, and excessive daytime sleepiness) and dichotomized into healthy or unhealthy sleep. Circulating liver function biomarkers were measured. Cox proportional hazard model was performed to investigate the independent and joint associations of sleep and liver function biomarkers with liver cancer incidence. RESULTS After a median follow-up time of 13.1 years, 394 cases of incident liver cancer were documented. The multivariable-adjusted hazard ratio (HR) for liver cancer was 1.46 (95% confidence interval: 1.15-1.85) associated with unhealthy sleep (vs. healthy sleep), and was 1.17 (1.15-1.20), 1.20 (1.18-1.22), 1.69 (1.47-1.93), 1.06 (1.06-1.07), 1.08 (1.07-1.09), 1.81 (1.37-2.39), or 0.29 (0.18-0.46) associated with each 10-unit increase in alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total protein (TP), or albumin (ALB), respectively. Individuals with unhealthy sleep and high (≥ median) ALT, AST, TBIL, GGT, ALP, or TP or low (< median) ALB level had the highest HR of 3.65 (2.43-5.48), 4.03 (2.69-6.03), 1.97 (1.40-2.77), 4.69 (2.98-7.37), 2.51 (1.75-3.59), 2.09 (1.51-2.89), or 2.22 (1.55-3.17) for liver cancer, respectively. Significant additive interaction of unhealthy sleep with high TP level on liver cancer was observed with relative excess risk due to an interaction of 0.80 (0.19-1.41). CONCLUSIONS Unhealthy sleep was associated with an increased risk of liver cancer, especially in participants with lower ALB levels or higher levels of ALT, AST, TBIL, GGT, ALP, or particularly TP.
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Affiliation(s)
- Jiahao Song
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Lieyang Fan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Da Shi
- Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, T6G 2P5, AB, Canada
| | - Xuefeng Lai
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Hao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Wei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Linling Yu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Ruyi Liang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Yongfang Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Shuhui Wan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Yueru Yang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Bin Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
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24
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Becker SP, Brown A, Langberg JM, Beebe DW. Later ("evening") circadian preference is associated with poorer executive, academic, and attentional functioning in adolescents with and without ADHD. J Child Psychol Psychiatry 2024. [PMID: 39031776 DOI: 10.1111/jcpp.14030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Adolescents vary considerably in their circadian phase preference; those with greater "eveningness" (also known as "night owls") have later bedtimes, wake times, and peak arousal compared to those with greater "morningness." Prior research suggests that (a) greater eveningness is associated with worse academic, executive, and attentional functioning; and (b) adolescents with attention-deficit/hyperactivity disorder (ADHD) tend to be high in eveningness and to have deficits in these school-related constructs. However, few studies have examined circadian preference alongside two potential confounds-sleep duration and sleep quality-as predictors of daytime functioning, or whether the strength of associations differs across adolescents with and without ADHD. METHODS Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White); approximately half (52%) had ADHD. A multi-method, multi-informant design was used. Specifically, adolescents reported on their circadian preference, school night sleep duration, and sleep quality. Adolescents provided ratings of their academic motivation (intrinsic, extrinsic, and amotivation) and were administered standardized achievement tests in reading and math. Adolescents and parents completed ratings of daily life executive functioning (behavioral, emotion, and cognitive regulation), and they and teachers also provided ratings of ADHD inattentive symptoms. RESULTS Above and beyond sleep duration, sleep quality, and covariates (sex, family income, pubertal development, medication use), greater eveningness was uniquely associated with poorer academic, executive, and attentional functioning across most measures. Sleep quality was uniquely associated with a handful of outcomes, and sleep duration was not significantly uniquely associated with any outcome in the regression analyses. ADHD status did not moderate effects. CONCLUSIONS This study provides compelling evidence that poorer academic, executive, and attentional functioning are more closely associated with greater eveningness than with sleep duration or quality in adolescents. Findings suggest that targeting circadian preference may be important to reduce these problems in adolescents, especially in clinical samples such as ADHD for whom academic, executive, and attentional difficulties are exceptionally common.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Joshua M Langberg
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, NJ, USA
| | - Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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25
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Gerritsen A, Hulst RY, van Rijssen IM, Obeid J, Pillen S, Gorter JW, Verschuren O. The temporal and bi-directional relationship between physical activity and sleep in ambulatory children with cerebral palsy. Disabil Rehabil 2024; 46:2821-2827. [PMID: 37424307 DOI: 10.1080/09638288.2023.2232720] [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: 03/24/2022] [Accepted: 06/30/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Exploring the temporal and bi-directional relationship between device-based measures of physical activity and sleep in ambulatory children with cerebral palsy (CP). MATERIALS AND METHODS 24-hour activity data were collected from children with CP (n = 51, 43% girls, mean age (range); 6.8 (3-12) years; Gross Motor Function Classification System levels I to III). Nocturnal sleep parameters and daily physical activity were measured for seven consecutive days and nights using ActiGraph GT3X accelerometers. Linear mixed models were constructed to explore the relationships between sleep and activity. RESULTS Light and moderate-to-vigorous activity were negatively associated with sleep efficiency (SE) (resp. p = 0.04, p = 0.010) and total sleep time (TST) (resp. p = 0.007, p = 0.016) the following night. Sedentary time was positively associated with SE and TST the following night (resp. p = 0.014, p = 0.004). SE and TST were positively associated with sedentary time (resp. p = 0.011, p = 0.001) and negatively with moderate-to-vigorous physical activity (resp. p < 0.001, p = 0.002) the following day. Total bedtime and TST were negatively associated with light physical activity (resp. p = 0.046, p = 0.004) the following day. CONCLUSIONS The findings from this study suggest that ambulatory children with CP may not sleep better after physical activity, and vice versa, indicating that the relationship is complex and needs further investigation.
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Affiliation(s)
- Anke Gerritsen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Faculty of Health and Physical Activity, Saxion University of Applied Sciences, Enschede, the Netherlands
| | - Raquel Y Hulst
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Ilse M van Rijssen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Joyce Obeid
- CanChild, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Sigrid Pillen
- Kinderslaapexpert BV (Pediatric Sleep Expert LTd), Mook, The Netherlands
- Department of Electrical Engineering, Technical University Eindhoven, Eindhoven, The Netherlands
| | - Jan Willem Gorter
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- CanChild, Department of Pediatrics, McMaster University, Hamilton, Canada
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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Wilson-Barnes SL, Pagkalos I, Patra E, Kokkinopoulou A, Hassapidou M, Lalama E, Csanalosi M, Kabisch S, Pfeiffer AFH, DeCorte E, Cornelissen V, Bacelar P, Balula Dias S, Stefanidis K, Tsatsou D, Gymnopoulos L, Dimitropoulos K, Rouskas K, Argiriou N, Leoni R, Botana JM, Russell D, Lanham-New SA, Hart K. The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups. NUTR BULL 2024; 49:220-234. [PMID: 38773712 DOI: 10.1111/nbu.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 05/24/2024]
Abstract
A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.
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Affiliation(s)
- S L Wilson-Barnes
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
| | - I Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - E Patra
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - A Kokkinopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - M Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - E Lalama
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M Csanalosi
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - S Kabisch
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - A F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - E DeCorte
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - V Cornelissen
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - P Bacelar
- Healthium/Nutrium Software, Porto e Região, Portugal
| | - S Balula Dias
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculdade de Motricidade Human, Universidade de Lisboa, Lisbon, Portugal
| | - K Stefanidis
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - D Tsatsou
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - L Gymnopoulos
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - K Dimitropoulos
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - K Rouskas
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - N Argiriou
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | | | | | | | - S A Lanham-New
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
| | - K Hart
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
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Lindholm A, Jarbin H, Aili K, Nygren JM, Svedberg P, Larsson I. Sex Differences in Children with Uncomplicated Attention Deficit/Hyperactivity Disorder and Sleep Problems. CHILDREN (BASEL, SWITZERLAND) 2024; 11:636. [PMID: 38929216 PMCID: PMC11201524 DOI: 10.3390/children11060636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Approximately 7.6% of children are diagnosed with attention deficit/hyperactivity disorder (ADHD), and sleep impairments affect 25-85%. There is a noticeable lack of research on girls and sex differences. The aim of this study was to examine sex differences in children with uncomplicated ADHD and sleep problems. METHODS Cross-sectional baseline data were retrieved from a randomized controlled trial with weighted blankets (55 boys and 41 girls, 6-14 years) on a cohort recently diagnosed with uncomplicated ADHD and sleep problems. Differences between boys and girls in ADHD symptoms, objectively and subjectively measured sleep, anxiety, and functioning were examined via parent- or self-reported validated instruments. RESULTS Girls reported significantly lower (worse) satisfaction with well-being, life overall, and school, but not for family. Parents reported more sleep anxiety and night-time wakings among boys, but no sex differences in other measures and also not in self-reported measures or objective sleep measures. Children who reported worry, sadness, or unhappiness had more sleep problems. CONCLUSIONS Boys with ADHD and sleep problems may need support with sleep-related anxiety and night-time wakings, while girls may require support with overall functioning. Additionally, children who express feelings of worry, sadness, or unhappiness alongside their ADHD symptoms should have attention given to their sleep.
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Affiliation(s)
- Annelie Lindholm
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Håkan Jarbin
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, SE-22184 Lund, Sweden;
- Child and Adolescent Psychiatry, Region Halland, SE-30185 Halmstad, Sweden
| | - Katarina Aili
- Department of Health and Sport, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden;
| | - Jens M. Nygren
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Petra Svedberg
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Ingrid Larsson
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
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Martins J, Tapia-Serrano MÁ, Nogueira T, Sanchéz-Miguel PA. Compliance with the 24-h Movement Guidelines for Portuguese children: differences between boys and girls. Sci Rep 2024; 14:11926. [PMID: 38789500 PMCID: PMC11126725 DOI: 10.1038/s41598-023-49227-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/05/2023] [Indexed: 05/26/2024] Open
Abstract
The 24-h Movement Guidelines for children recommend at least 60 min per day of moderate-to-vigorous intensity physical activity (PA), ≤ 2 h/day of screen time, and 9-11 h/day of sleep for children. Since little information is available on the 24-h Movement Guidelines in Portuguese children, this research attempts to know the proportion of Portuguese children meeting individual and combinations of these 24-h Movement Guidelines. Another aim of this study is to test sex differences in compliance with 24-h Movement Guidelines. A final sample of 1351 Portuguese children (51.4% girls, aged 7.65 ± 1.21) participated in this cross-sectional study. PA, screen time and sleep duration were parent-reported through a questionnaire. Only 3.7% of children met all three 24-h Movement Guidelines, whereas 11.9% met none. Although boys showed greater compliance with PA recommendations and girls with screen time recommendations, no significant sex differences were found in the compliance of all three 24-h Movement Guidelines. Given that 96.3% of Portuguese children did not meet 24-h Movement Guidelines, promoting these three movement behaviours in both boys and girls is crucial to encouraging positive consequences early.
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Affiliation(s)
- João Martins
- Centro de Estudos em Educação, Faculdade de Motricidade Humana e UIDEF, Instituto de Educação, Universidade de Lisboa, 1649-004, Lisbon, Portugal.
| | - Miguel Ángel Tapia-Serrano
- Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Grupo Análisis Comportamental de la Actividad Física y el Deporte (ACAFYDE), Facultad de Formación del Profesorado, Universidad de Extremadura, Av. de la Universidad, S/N, 10004, Cáceres, Spain
| | - Telma Nogueira
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - Pedro Antonio Sanchéz-Miguel
- Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Grupo de Investigación Análisis Didáctico y Comportamental del Deporte (ADICODE), Facultad de Formación del Profesorado, Universidad de Extremadura, Av. de la Universidad, S/N, 10004, Cáceres, Spain
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Chen Q, Gong L, Song Y, Zhang J, Han X, Zhou Y, Li L, Jiang X, Hao Y, Zhou H, Lou X, Wang X. Associations between multiple sleep dimensions and suicide and non-suicidal self-injury: a cross-sectional study of 3828 Chinese young people. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02689-z. [PMID: 38780778 DOI: 10.1007/s00127-024-02689-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Suicide and non-suicidal self-injury (NSSI) are preventable concerns in young people. Suicidal ideation (SI), suicidal plans (SP) and suicidal attempt (SA) are closely related to death. Sleep problems are known risk factors for suicide and NSSI. This study aimed to explore the relationship between sleep, suicidality and NSSI. METHODS Participants were 3,828 middle school and college students aged 11-23 years from urban and rural areas of Henan Province. Sleep, suicidal phenomena and NSSI were assessed by applying self-reported questionnaires. Chi-squared tests were utilized to demonstrate the demographic data and sleep variables. The correlation between sleep, suicidality and NSSI were explored by using binary logistic regression, while adjusting socio-demographic characteristics with multivariate models. RESULTS Sleep variables except mid-sleep time were related to suicidal phenomena (P < 0.05). Greater social jet lag (SJL) [≥ 2 h (h)] was associated with increased risk of SI [Odds ratios (OR) = 1.72, 95% confidence intervals (CI):1.40-2.11], SP (OR = 2.10, 95%CI:1.59-2.79) and SA (OR = 1.50, 95%CI:1.00-2.26). Non-only child participants with SJL (≥ 2 h) had significantly increased odds of SI (OR = 1.75, 95%CI: 1.41-2.18) and SP (OR = 2.25, 95%CI: 1.66-3.05). Eveningness chronotype had the strongest correlation with SI (OR = 3.87, 95%CI:2.78-5.38), SP (OR = 4.72, 95%CI:2.97-7.50), SA (OR = 6.69, 95%CI:3.08-14.52) and NSSI (OR = 1.39, 95%CI:1.02-1.90). CONCLUSION Overlong or short sleep duration, SJL, eveningness chronotype and other sleep abnormalities (e.g., daytime dysfunction, low sleep efficiency) were associated with a higher prevalence of SI, SP and SA. Additionally, eveningness was significantly correlated with NSSI among young people. These findings suggested the importance of assessing and intervening in sleep habits to prevent suicide and NSSI in young people.
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Affiliation(s)
- Qiuyuan Chen
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Lu Gong
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yalin Song
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Jiangtao Zhang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xinke Han
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yuhang Zhou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Lijie Li
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xili Jiang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yudan Hao
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Huijun Zhou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xiaomin Lou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xian Wang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China.
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Voráčová J, Sigmund E, Vorlíček M, Dygrýn J, Sigmundová D. Accelerometer-measured sleep behaviour and parent-child sleep guideline adherence and sleep quality in Czech families with children aged 3-8 years: the FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study. J Sleep Res 2024:e14242. [PMID: 38757216 DOI: 10.1111/jsr.14242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/17/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024]
Abstract
Assessing parent-child relationship in sleep behaviours is important for facilitating changes in the sleep guideline compliance in preschool age children. The aim of this study was to examine accelerometer-measured sleep quantity and quality in families with children aged 3-8 years and investigate the parents' influence on the child's sleep. The data were obtained from the Czech cross-sectional FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study, with a final sample of 374 families. Families were recruited through the enrolment of their children in kindergartens/primary schools between March 2022 and May 2023. The sleep time window and total sleep time were assessed using a wrist-worn ActiGraph accelerometer. Participants wore this device continuously for 24 h/day over a period of 7 consecutive days. Demographic data and potential correlates were obtained via questionnaires completed by parents. Statistical analyses were completed using logistic regression and independent-samples Mann-Whitney U test. In all, 65.5% of children (60% boys, 70.9% girls) and 58.3% of parents (52.4% fathers, 64.3% mothers) achieved the recommended sleep duration. Greater sleep quantity and duration in good-quality sleep were significantly higher in girls/mothers, compared to boys/fathers. Preschoolers were more likely to comply with sleep guidelines if their mother (but not father) met the sleep recommendation and their mothers did not have a higher education level. Adhering to sleep guidelines in children was also associated with children's female gender, absence of screen device in the bedroom, and being more active. Given the high concurrence in mother-child sleep quantity, it is important to promote healthy sleep behaviours in the whole family.
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Affiliation(s)
- Jaroslava Voráčová
- Faculty of Physical Culture, Department of Social Sciences in Kinanthropology, Palacký University Olomouc, Olomouc, Czech Republic
| | - Erik Sigmund
- Faculty of Physical Culture, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Michal Vorlíček
- Faculty of Physical Culture, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jan Dygrýn
- Faculty of Physical Culture, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Dagmar Sigmundová
- Faculty of Physical Culture, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
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Li B, Valerino-Perea S, Zhou W, Xie Y, Syrett K, Peters R, He Z, Zou Y, de Vocht F, Foster C. The impact of the world's first regulatory, multi-setting intervention on sedentary behaviour among children and adolescents (ENERGISE): a natural experiment evaluation. Int J Behav Nutr Phys Act 2024; 21:53. [PMID: 38735934 PMCID: PMC11089804 DOI: 10.1186/s12966-024-01591-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/04/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Regulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world's first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils. METHODS With a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status. RESULTS Longitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings. CONCLUSIONS This regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere.
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Affiliation(s)
- Bai Li
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.
| | | | - Weiwen Zhou
- Department of Nutrition and School Health, Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Yihong Xie
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Keith Syrett
- Centre for Health, Law, and Society, School of Law, University of Bristol, Bristol, UK
| | - Remco Peters
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Zouyan He
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yunfeng Zou
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), Bristol, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
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Grasaas E, Ostojic S, Jahre H. Adherence to sleep recommendations is associated with higher satisfaction with life among Norwegian adolescents. BMC Public Health 2024; 24:1288. [PMID: 38730403 PMCID: PMC11088050 DOI: 10.1186/s12889-024-18725-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/28/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Sleep plays a crucial role in the health and well-being of adolescents; however, inadequate sleep is frequently reported in numerous countries. This current paper aimed to describe sleep duration, factors impacting sleep, consequences of insufficient sleep and satisfaction with life in Norwegian adolescents, stratified by sex and by adherence to the 8-hour sleep recommendation, and to examine potential associations between adherence to the 8-hours sleep recommendation and satisfaction with life. METHODS This is a cross-sectional study using data from the Norwegian Ungdata Survey, collected in 2021. Adolescents from five Norwegian counties were included, comprising a total of 32,161 upper secondary school students. Study variables were collected through an electronic questionnaire administered during school hours and all data are anonymous. Descriptive data of sleep patterns are presented, and linear regressions were conducted adjusting for SES, perceived stress, physical activity level, over-the-counter analgesics use, grade level and screen time. RESULTS 73% of adolescents did not adhere to the 8-hours of sleep recommendation per night, with similar results for girls and boys. 64% reported tiredness at school (minimum 1-2 days weekly) and 62% reported that screen time negatively affected their ability to sleep. 23% reported that gaming affected their sleep, with a higher prevalence in boys than girls. Satisfaction with life score was 7.0 ± 1.9 points (out of 10) for the total sample, with higher scores for boys (7.3 ± 1.8 points) than girls (6.9 ± 1.9 points). Regressions revealed a positive association with satisfaction with life (B = 0.31, 95% [0.15 to 0.48]) in adolescents adhering to sleep recommendation of 8h compared to the ones not adhering to the sleep recommendation. CONCLUSIONS Most Norwegian adolescents fail to adhere to the 8-hours of sleep recommendation and the majority feel tired at school or during activities. More than half of adolescents reported that screen time negatively affected their ability to sleep. Adhering to the sleep recommendation was associated with higher life satisfaction. Our findings highlight the importance of sufficient sleep in adolescents, while future research is needed to examine other sleep related measures on adolescents´ satisfaction with life.
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Affiliation(s)
- Erik Grasaas
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University in Agder, Kristiansand, Postbox 422, 4604, Norway.
| | - Sergej Ostojic
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University in Agder, Kristiansand, Postbox 422, 4604, Norway
| | - Henriette Jahre
- Department of Rehabilitation Science and Health Technology, Center for Intelligent Musculoskeletal health, Oslo Metropolitan University, Oslo, Norway
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Bao R, Qin H, Memon AR, Chen S, López-Gil JF, Liu S, Zou L, Cai Y. Is adherence to the 24-h movement guidelines associated with greater academic-related outcomes in children and adolescents? A systematic review and meta-analysis. Eur J Pediatr 2024; 183:2003-2014. [PMID: 38416259 DOI: 10.1007/s00431-024-05461-2] [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: 09/29/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/29/2024]
Abstract
The purpose of this systematic review was to synthesise the evidence for the association of adherence to the 24-h movement guidelines with academic-related outcomes in children and adolescents. This systematic review was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. PubMed, PsycINFO, Scopus, WOS, SPORTDiscus, and EMBASE were searched from their inception to 12 December 2023. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess the risk of bias of included studies. In total, 4326 records were identified through database searches; 10 articles met the inclusion criteria and were included in this systematic review. There were eight cross-sectional studies and two longitudinal studies; the main academic-related outcomes were academic achievement and cognitive function. A small association between adherence to all three recommendations and academic achievement (k = 5, r = 0.17, 95% CI = 0.10-0.24, I2 = 49%) was found compared to those who did not adhere to any recommendations. Conclusion: Findings from this systematic review and meta-analysis reveal a small association between adherence to all three recommendations and greater academic achievement in children and adolescents. Nevertheless, it is imperative to underscore the need for more studies to establish robust evidence underpinning this relationship. Trial registration: PROSPERO (CRD42021295403). What is Known: • Regular physical activity, reduced screen time, and optimal sleep duration are independently associated with improved academic-related outcomes in children and adolescents. • The associations between adherence to the 24-h movement guidelines and academic-related outcomes in children and adolescents have not been quantitatively synthesised. What is New: • There is a small but positive association between adherence to all three recommendations of the 24-h movement guidelines and greater academic achievement in children and adolescents. • Further well-designed research is needed to focus on academic achievement, cognitive function and classroom behaviours in young individuals.
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Affiliation(s)
- Ran Bao
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Huimin Qin
- ShanghaiTech Colleges, ShanghaiTech University, Shanghai, 201210, China
| | - Aamir Raoof Memon
- Institute for Health and Sport, Victoria University, Melbourne, 8001, Australia
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, 8001, Australia
| | | | - Shijie Liu
- School of Physical Education, Wuhan University of Technology, Wuhan, 430070, China
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Yujun Cai
- School of Physical Education, Shanghai University of Sport, Shanghai, 200438, China.
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Shearer HM, Côté P, Hogg-Johnson S, Fehlings DL. A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy. J Clin Sleep Med 2024; 20:719-726. [PMID: 38169433 PMCID: PMC11063692 DOI: 10.5664/jcsm.10980] [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: 06/05/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
STUDY OBJECTIVES Sleep quality is important during childhood and adolescence. Given the high prevalence of pain in children/youth with cerebral palsy, we aimed to measure the association between short-term pain trajectories and sleep disturbance in these individuals. METHODS We accrued the cohort between November 2019 and October 2020 and recruited children/youth who (1) were 8-18 years old; (2) had cerebral palsy with any Gross Motor Function Classification System level; and (3) could self-report pain and sleep disturbance. We collected self-reported baseline and weekly follow-up data using electronic questionnaires completed every week for 5 weeks. Sleep disturbance at 5 weeks was the primary outcome (pediatric Patient-Reported Outcomes Measurement Information System short form, v1.0-4a). We used general linear regression to assess the association between pain intensity trajectory group and sleep disturbance controlling for confounders. RESULTS A total of 190 individuals were eligible; 102 were enrolled and 89 were included in our final analysis. Pain trajectory groups had estimated crude mean sleep disturbance scores at 5 weeks ranging from 56.0 (95% confidence interval, 51.8, 60.8) to 61.8 (55.7, 67.9). Compared to those with stable, no/very mild pain, those in the stable, high-pain group had the greatest sleep disturbance (adjusted β = 5.7; 95% confidence interval, 1.2, 10.2). CONCLUSIONS Irrespective of pain trajectory, children and youth with cerebral palsy reported sleep disturbances. Those with a stable, high pain intensity in the previous 5 weeks reported the greatest sleep disturbance. The results highlight the importance of considering pain trajectories and their impact on sleep in children with cerebral palsy. CITATION Shearer HM, Côté P, Hogg-Johnson S, Fehlings DL. A good night's sleep: pain trajectories and sleep disturbance in children with cerebral palsy. J Clin Sleep Med. 2024;20(5):719-726.
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Affiliation(s)
- Heather M. Shearer
- Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sheilah Hogg-Johnson
- Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Darcy L. Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Poirier K, Gauvin L, Haddad S, Bélanger RE, Leatherdale ST, Turcotte-Tremblay AM. Evolution of Sleep Duration and Screen Time Between 2018 and 2022 Among Canadian Adolescents: Evidence of Drifts Accompanying the COVID-19 Pandemic. J Adolesc Health 2024; 74:980-988. [PMID: 38340126 DOI: 10.1016/j.jadohealth.2023.12.023] [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: 04/26/2023] [Revised: 11/19/2023] [Accepted: 12/15/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE We quantified the joint evolution of sleep duration and screen time between 2018 and 2022 in a large sample of adolescents from Quebec, Canada, to ascertain changes that occurred during the COVID-19 pandemic. METHODS A natural experiment design was used to compare variations from year to year and in association with the pandemic outbreak. Using structural equation modeling on data collected between 2018 and 2022 among adolescents attending 63 high schools, we analyzed the joint evolution of sleep duration and screen time while adjusting for previous year values, concurrent flourishing score, sex, age, and family level of material deprivation. RESULTS A total of 28,307 adolescents, aged on average 14.9 years, were included in the analyses. Between 2019 and 2022, sleep duration increased by 9.6 (5.7, 13.5) minutes and screen time by 129.2 (120.5, 138.0) minutes on average. In 2022, the adolescents spent almost equal amounts of time sleeping and using screens. Lower flourishing scores were associated with shorter sleep duration and lengthier screen time. Girls' screen time became similar to boys' over time. DISCUSSION Adolescents now spend almost equal amounts of time sleeping and using screens, a situation that calls for urgent public health actions. These findings highlight the importance of tracking changes in adolescents' behaviours over time, to design and implement interventions adapted to the changing health needs of different groups.
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Affiliation(s)
- Krystel Poirier
- Centre de Recherche VITAM, CIUSSS de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Lise Gauvin
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Slim Haddad
- Centre de Recherche VITAM, CIUSSS de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Richard E Bélanger
- Centre de Recherche VITAM, CIUSSS de la Capitale-Nationale, Quebec City, Quebec, Canada; Department of Pediatrics, Faculty of Medicine - Université Laval, Ferdinand Vandry Pavillon, Quebec City, Quebec, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne-Marie Turcotte-Tremblay
- Centre de Recherche VITAM, CIUSSS de la Capitale-Nationale, Quebec City, Quebec, Canada; Faculty of Nursing, Université Laval, Quebec City, Quebec, Canada.
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Hartman AG, Caspero K, Bodison SC, Soehner A, Akcakaya M, DeAlmeida D, Bendixen R. Pediatric Occupational Therapists' Perspectives on Sleep: A Qualitative Descriptive Study. Am J Occup Ther 2024; 78:7803205010. [PMID: 38512128 DOI: 10.5014/ajot.2024.050352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
IMPORTANCE Insufficient sleep is common among children seeking occupational therapy services but is rarely a focus of therapy despite sleep's critical impact on health. OBJECTIVE To examine pediatric occupational therapists' experiences, views, and confidence in addressing sleep concerns in their practice as well as barriers to and supports for doing so. DESIGN A qualitative descriptive study with thematic analysis of data from 1-hr virtual interviews. Rapport building, multiple-coder analysis, and member checking were used to ensure reliability and validity. SETTING Interviews were conducted remotely at each participant's preferred time and location. PARTICIPANTS Pediatric occupational therapists (N = 20) practicing across multiple settings in the United States were recruited through emails directed to their place of work and social media posts. A goal of 20 participants was set a priori with the goal of thematic saturation. OUTCOMES AND MEASURES A semistructured interview guide. RESULTS Participants were predominately cisgender (95%), female (85%), and White, non-Hispanic (90%). Overall, they voiced the importance of sleep but reported almost never writing sleep-related goals. Reported barriers that affected the participants' ability to fully address sleep in practice included therapists' lack of confidence and knowledge and low caregiver buy-in. CONCLUSIONS AND RELEVANCE The findings identify themes on the basis of which actionable steps toward promoting occupational therapists as sleep champions can be developed. Future implications include increasing sleep education opportunities, enhancing awareness of sleep health's impact on goal areas, and facilitating discussions about occupational therapy's role within the medical system and family system in supporting sleep. Plain-Language Summary: This qualitative study identifies what helps and hinders occupational therapists in addressing the sleep health concerns of their clients. We give occupational therapy clinicians and educators key supports to seek out or barriers to address.
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Affiliation(s)
- Amy G Hartman
- Amy G. Hartman, PhD, OTR/L, is Postdoctoral Fellow, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA;
| | - Kaitlyn Caspero
- Kaitlyn Caspero, MS, OTR/L, is Occupational Therapist and Founder, OT Graphically, Frederick, MD
| | - Stefanie C Bodison
- Stefanie C. Bodison, OTD, OTR/L, FAOTA, is Assistant Professor, Department of Occupational Therapy, University of Florida, Gainesville
| | - Adriane Soehner
- Adriane Soehner, PhD, is Assistant Professor, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Murat Akcakaya
- Murat Akcakaya, PhD, is Associate Professor, Department of Engineering, University of Pittsburgh, Pittsburgh, PA
| | - Dilhari DeAlmeida
- Dilhari DeAlmeida, PhD, is Associate Professor and Program Director, Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA
| | - Roxanna Bendixen
- Roxanna Bendixen, PhD, OTR/L, FAOTA, is Associate Professor and Division Director, Department of Occupational Therapy, Medical University of South Carolina, Charleston
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Wang K, Li Y, Liu S, Liu H, Zhang T, Luo J. Can an intervention integrating sports and medicine improve children's health more effectively? Monitoring based on sleep, body mass index, and heart rate variability. J Glob Health 2024; 14:04040. [PMID: 38635801 PMCID: PMC11026036 DOI: 10.7189/jogh.14.04040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
Background Theoretical studies have suggested that the integration of sports and medicine with one another could positively affect children's health. By monitoring the variation characteristics of children's sleep, body mass index (BMI), and heart rate variability (HRV), we explored and compared the influences of and differences between two interventions - physical exercise and an intervention integrating sports and medicine - on improving children's health. Methods We conducted a randomised controlled study, where we randomly divided 136 children into the physical exercise group (PEG), the integration of sports and medicine group (ISMG), and the control group. We measured sleep, BMI, and HRV at baseline and week eight. Results After the eight-week intervention, the sleep scores in the PEG and the ISMG were significantly lower than in the control group, while the scores in the ISMG were significantly lower than in the PEG. After the eight-week intervention, the BMI of both the PEG and the ISMG was significantly lower than that of the control group, without a significand difference between the two intervention groups. After the eight-week intervention, the standard deviation of normal-to-normal intervals (SDNN), root mean square differences of the standard deviation (RMSSD), low-frequency of normal (LFn), and high-frequency of normal (HFn) in the PEG and the ISMG were significantly higher than those in the control group, again without a significant difference between the two intervention groups. After intervention, sleep, BMI, and HRV of the three groups were correlated with one another to different degrees, but the correlation coefficient of the two exercise groups was higher. Conclusions Based on the interventions, we observed a significant correlation between sleep, BMI, and HRV in children. Regular physical exercise or an intervention integrating sports and medicine could synergistically improve sleep, BMI, and HRV in this population, with the latter having a better effect on improving sleep quality.
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Affiliation(s)
- Kun Wang
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
| | - Yan Li
- College of Liberal Studies, Chongqing Industry Polytechnic College (Sports Work Department), Yubei, Chongqing, China
| | - Shiqi Liu
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
| | - Hengxu Liu
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
| | - Tingran Zhang
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
| | - Jiong Luo
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
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Li J, Han Y, Bai W. Clean energy consumption, sleep duration, and the association of cancer: findings from the China health and retirement longitudinal study. Front Oncol 2024; 14:1327257. [PMID: 38699641 PMCID: PMC11063385 DOI: 10.3389/fonc.2024.1327257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/28/2024] [Indexed: 05/05/2024] Open
Abstract
Objective Studies of the association between clean energy consumption, sleep duration, and cancer are still extremely limited. We aim to investigate the individual or joint role of clean energy consumption, and sleep duration in cancer onset. Methods We used data from the China Health and Retirement Longitudinal Study. Multivariable locally weighted regression (LOESS) models were first used to assess the individual association of daily sleep time with the risk to develop cancer. Multivariate logistic regression models were conducted on the individual and interaction effects of daily sleep time and cooking fuel. Results We found that short sleep duration (≤6 hours) and non-clean energy consumption were respectively associated with an increased risk of cancer among older Chinese(p<0.05). We assessed daily sleep time in four quartiles, the adjusted odds ratios (AOR), and 95% confidence intervals (95% CI) for participants in the second (5.0 to <6.5 hours), third (6.5 to <8.0 hours), and fourth quartiles (≥8.0 hours) were 0.88 (95% CI: 0.65-1.20), 0.61 (95% CI: 0.40-0.91), and 0.53 (95% CI: 0.37-0.77), respectively. When we set the cutoff point(6.5 hours), participants who slept more than 6 hours had a 39% lower risk of cancer (AOR: 0.61, 95% CI: 0.46-0.79) compared with others. On the other hand, we conducted that exposure to clean fuel from cooking was negatively associated with cancer incidence (AOR: 0.73, 95% CI: 0.54, 0.97). Furthermore, the combination of longer sleep and cleaner fuels showed the lowest OR for cancer (AOR: 0.39, 95% CI: 0.24, 0.65). Conclusion Our study showed that sleep duration and clean energy consumption were significantly associated with cancer in elderly Chinese people. In addition, the prevalence of cancer was higher among people who slept less than six hours and used non-clean energy sources. Paying greater attention to the effects of sleep duration and clean energy on the risk of cancer may yield practical implications for cancer prevention.
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Affiliation(s)
- Jushuang Li
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yutong Han
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Wendi Bai
- Department of Public Health, Guangzhou Nansha Center for Disease Control and Prevention, Guangzhou, China
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Ghasemi P, Eslami AA, Amidi Mazaheri M. Development and psychometric properties of an instrument to measure sleep behavior self-regulation in adolescent students. Heliyon 2024; 10:e28692. [PMID: 38576587 PMCID: PMC10990850 DOI: 10.1016/j.heliyon.2024.e28692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 03/08/2024] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
Background The prevalence of inadequate sleep among adolescents is a significant worry due to its potential to adversely affect their health and academic performance. Addressing this matter necessitates a comprehensive grasp of the underlying factors influencing sleep regulation and the formulation of evidence-based interventions to counteract its detrimental consequences. Hence, the central objective of this study is to create and assess a dependable questionnaire designed to evaluate adolescents' self-regulation of sleep behavior. Methods In this cross-sectional study, data from 401 high school students randomly selected from west Iran were incorporated and subjected to psychometric assessments. The average age of the participants was 16.5 ± 0.92. Initially, 136 preliminary items were formulated, drawing from a contextual framework and comprehensive literature review. The subsequent steps involved specialized analyses, including content validity analysis, item analysis, exploratory and confirmatory factor analysis, as well as convergent validity analysis. Results Both exploratory and confirmatory factor analyses support a strong structural model, including factors like self-control, outcome expectation, goal setting, and self-efficacy, which are linked to regulating sleep behavior. The model fit was satisfactory. The instrument had 22 items which demonstrated good internal consistency, adequate test-retest reliability, and evidence of convergent validity. Conclusion In future studies exploring sleep behavior, the present questionnaire, which has demonstrated initial validity and reliability, holds the potential to provide valuable assistance in evaluating and enhancing self-regulation in sleep behavior, particularly within school environments.
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Affiliation(s)
- Parvin. Ghasemi
- Department of Health Education and Promotion Student Research Committee, School of Health, Isfahan university of Medical Sciences, Isfahan, Iran
| | - Ahmad Ali. Eslami
- Departments of Health Education and Promotion, School of Health, Isfahan university of Medical Sciences, Isfahan, Iran
| | - Maryam. Amidi Mazaheri
- Departments of Health Education and Promotion, School of Health, Isfahan university of Medical Sciences, Isfahan, Iran
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Cadenas-Sanchez C, Migueles JH, Torres-Lopez LV, Verdejo-Román J, Jiménez-Pavón D, Hillman CH, Catena A, Ortega FB. Sleep Behaviors and the Shape of Subcortical Brain Structures in Children with Overweight/Obesity: A Cross-Sectional Study. Indian J Pediatr 2024:10.1007/s12098-024-05094-1. [PMID: 38573449 DOI: 10.1007/s12098-024-05094-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/01/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES To examine the relationship between sleep and subcortical brain structures using a shape analysis approach. METHODS A total of 98 children with overweight/obesity (10.0 ± 1.1 y, 59 boys) were included in the cross-sectional analyses. Sleep behaviors (i.e., wake time, sleep onset time, total time in bed, total sleep time, sleep efficiency, and wakening after sleep onset) were estimated with wrist-worn accelerometers. The shape of the subcortical brain structures was acquired by magnetic resonance imaging. A partial correlation permutation approach was used to examine the relationship between sleep behaviors and brain shapes. RESULTS Among all the sleep variables studied, only total time in bed was significantly related to pallidum and putamen structure, such that those children who spent more time in bed had greater expansions in the right and left pallidum (211-751 voxels, all p's <0.04) and right putamen (1783 voxels, p = 0.03). CONCLUSIONS These findings suggest that more time in bed was related to expansions on two subcortical brain regions in children with overweight/obesity.
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Affiliation(s)
- Cristina Cadenas-Sanchez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain.
| | - Jairo H Migueles
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Lucia V Torres-Lopez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Juan Verdejo-Román
- Department of Personality, Assessment & Psychological Treatment, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz, Cádiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES) Madrid, Madrid, Spain
| | - Charles H Hillman
- Department of Psychology, Northeastern University, Boston, USA
- Department of Physical Therapy, Movement, & Rehabilitation Sciences, Northeastern University, Boston, USA
| | - Andrés Catena
- School of Psychology, University of Granada, Granada, Spain
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain.
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Kwon A, Kim S, Choi Y, Kim HY, Lee M, Lee M, Lee HI, Song K, Suh J, Chae HW, Kim HS. Effects of Early Wake-Up Time on Obesity in Adolescents. Child Obes 2024; 20:188-197. [PMID: 37166826 PMCID: PMC10979690 DOI: 10.1089/chi.2023.0016] [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] [Indexed: 05/12/2023]
Abstract
Background: Although numerous studies have reported that obesity in adolescents is related to shorter sleep duration, few studies have reported the effect of sleep timing, particularly early wake-up time, on obesity. Objectives: To investigate the association between wake-up time and adolescent obesity. Methods: Using the Korean National Health and Nutrition Examination Survey VII data, 1301 middle school and high school students were selected and grouped according to BMI. Sleep timing and lifestyle factors were evaluated using self-reported questionnaires. Results: The mean bedtime and wake-up time were 00:09 am and 07:06 am, respectively. Despite similar bedtimes, the group with overweight/obesity woke up earlier than the group with underweight/normal weight. The BMI z-score and the overweight/obesity relative risk decreased as the wake-up time was delayed, even after adjustment for covariates. Participants who woke up before 06:50 am had a 1.82-fold higher risk of having overweight/obesity than those who woke up after 07:30 am. Participants who woke up late tended to sleep longer than those who woke up early. Conclusions: Waking up early is significantly associated with an increased BMI z-score in adolescents and may be a risk factor for overweight/obesity.
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Affiliation(s)
- Ahreum Kwon
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sujin Kim
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, South Korea
| | - Youngha Choi
- Department of Pediatrics, Kangwon National University Hospital, Kangwon National University College of Medicine, Kangwon, South Korea
| | - Ha Yan Kim
- Department of Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Myeongjee Lee
- Department of Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Myeongseob Lee
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hae In Lee
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, South Korea
| | - Kyungchul Song
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, South Korea
| | - Junghwan Suh
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, South Korea
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Heemskerk DM, Busch V, Piotrowski JT, Waterlander WE, Renders CM, van Stralen MM. A system dynamics approach to understand Dutch adolescents' sleep health using a causal loop diagram. Int J Behav Nutr Phys Act 2024; 21:34. [PMID: 38519989 PMCID: PMC10958857 DOI: 10.1186/s12966-024-01571-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/13/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Healthy sleep is crucial for the physical and mental wellbeing of adolescents. However, many adolescents suffer from poor sleep health. Little is known about how to effectively improve adolescent sleep health as it is shaped by a complex adaptive system of many interacting factors. This study aims to provide insights into the system dynamics underlying adolescent sleep health and to identify impactful leverage points for sleep health promotion interventions. METHODS Three rounds of single-actor workshops, applying Group Model Building techniques, were held with adolescents (n = 23, 12-15 years), parents (n = 14) and relevant professionals (n = 26). The workshops resulted in a multi-actor Causal Loop Diagram (CLD) visualizing the system dynamics underlying adolescent sleep health. This CLD was supplemented with evidence from the literature. Subsystems, feedback loops and underlying causal mechanisms were identified to understand overarching system dynamics. Potential leverage points for action were identified applying the Action Scales Model (ASM). RESULTS The resulting CLD comprised six subsystems around the following themes: (1) School environment; (2) Mental wellbeing; (3) Digital environment; (4) Family & Home environment; (5) Health behaviors & Leisure activities; (6) Personal system. Within and between these subsystems, 16 reinforcing and 7 balancing feedback loops were identified. Approximately 60 potential leverage points on different levels of the system were identified as well. CONCLUSIONS The multi-actor CLD and identified system dynamics illustrate the complexity of adolescent sleep health and supports the need for developing a coherent package of activities targeting different leverage points at all system levels to induce system change.
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Affiliation(s)
- Danique M Heemskerk
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Department of Healthy Living, Public Health Service (GGD), Sarphati Amsterdam, City of Amsterdam, The Netherlands.
| | - Vincent Busch
- Department of Healthy Living, Public Health Service (GGD), Sarphati Amsterdam, City of Amsterdam, The Netherlands
| | - Jessica T Piotrowski
- Amsterdam School of Communication Research ASCoR, University of Amsterdam, Amsterdam, The Netherlands
| | - Wilma E Waterlander
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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43
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Kosticova M, Kopcakova J, Vaskova M, Slancova TK, Kolarcik P, Bakalár P. Sleep characteristics and adolescent physical activity-related injuries in sports clubs, leisure time and schools. Inj Prev 2024; 30:153-160. [PMID: 37963726 PMCID: PMC10958255 DOI: 10.1136/ip-2023-044936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/08/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE Sleep has been identified as an important factor in relation to physical activity-related injury (PARI) in adolescents. The study aimed to explore associations between sleep duration, sleep problems and PARI among Slovak adolescents in three different settings: sports clubs, leisure time and schools. METHODS We analysed data from the cross-sectional Health Behaviour in School-aged Children study conducted in 2022 on a representative sample of 10 163 Slovak adolescents aged from 10.5 to 18.3 (mean age 13.4 (SD=1.5); 50.9% boys). Data were collected through self-administered online questionnaires completed by respondents in schools during the classes. Multiple logistic regression models were used to assess associations between sleep duration during schooldays and weekends, sleep problems and PARI in sports clubs, leisure time and schools. RESULTS Adolescents with normal sleep duration during schooldays and those who reported no problems with falling asleep, waking up at night and day sleepiness had a higher chance of not being injured during PA in sports clubs, leisure time and schools compared with adolescents with short sleep duration and sleep problems. Sufficient sleep duration during the weekend increased the probability of not having PARI in leisure time and schools, with the strongest association between long sleep duration and PARI in leisure time. CONCLUSION Good sleep quality and sufficient sleep duration were found to play a protective role in relation to PARI in adolescents. The findings suggest implementing sleep interventions in PARI prevention programmes, which must be considered a key component of adolescent PA promotion.
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Affiliation(s)
- Michaela Kosticova
- Institute of Social Medicine and Medical Ethics, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Jaroslava Kopcakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Stafarik University in Kosice, Kosice, Slovakia
| | - Monika Vaskova
- Department of Sports Educology and Humanistics, Faculty of Sports, University of Presov, Presov, Slovakia
| | - Terezia Kovalik Slancova
- Department of Sports Educology and Humanistics, Faculty of Sports, University of Presov, Presov, Slovakia
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Stafarik University in Kosice, Kosice, Slovakia
| | - Peter Bakalár
- Department of Sports Educology and Humanistics, Faculty of Sports, University of Presov, Presov, Slovakia
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Singh K, Armstrong SC, Wagner BE, Counts J, Skinner A, Kay M, Li JS, Shah S, Zucker N, Neshteruk C, Story M, Suarez L, Kraus WE, Zizzi AR, Dunn J. Physical activity and sleep changes among children during the COVID-19 pandemic. NPJ Digit Med 2024; 7:70. [PMID: 38493216 PMCID: PMC10944532 DOI: 10.1038/s41746-024-01041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/14/2024] [Indexed: 03/18/2024] Open
Abstract
Daily routines, including in-person school and extracurricular activities, are important for maintaining healthy physical activity and sleep habits in children. The COVID-19 pandemic significantly disrupted daily routines as in-person school and activities closed to prevent spread of SARS-CoV-2. We aimed to examine and assess differences in objectively measured physical activity levels and sleep patterns from wearable sensors in children with obesity before, during, and after a period of school and extracurricular activity closures associated with the COVID-19 pandemic. We compared average step count and sleep patterns (using the Mann-Whitney U Test) before and during the pandemic-associated school closures by using data from activity tracker wristbands (Garmin VivoFit 3). Data were collected from 94 children (aged 5-17) with obesity, who were enrolled in a randomized controlled trial testing a community-based lifestyle intervention for a duration of 12-months. During the period that in-person school and extracurricular activities were closed due to the COVID-19 pandemic, children with obesity experienced objectively-measured decreases in physical activity, and sleep duration. From March 15, 2020 to March 31, 2021, corresponding with local school closures, average daily step count decreased by 1655 steps. Sleep onset and wake time were delayed by about an hour and 45 min, respectively, while sleep duration decreased by over 12 min as compared with the pre-closure period. Step counts increased with the resumption of in-person activities. These findings provide objective evidence for parents, clinicians, and public health professionals on the importance of in-person daily activities and routines on health behaviors, particularly for children with pre-existing obesity. Trial Registration: Clinical trial registration: NCT03339440.
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Affiliation(s)
- Karnika Singh
- Duke University Department of Biomedical Engineering, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Durham, NC, USA
| | - Sarah C Armstrong
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Brooke E Wagner
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Julie Counts
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Asheley Skinner
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Melissa Kay
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Jennifer S Li
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Svati Shah
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Nancy Zucker
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Psychiatry and Behavioral Science, Durham, NC, USA
| | - Cody Neshteruk
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Mary Story
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Lilianna Suarez
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - William E Kraus
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Alexandra R Zizzi
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Jessilyn Dunn
- Duke University Department of Biomedical Engineering, Durham, NC, USA.
- Duke Center for Childhood Obesity Research, Durham, NC, USA.
- Duke University Department of Biostatistics, Durham, NC, USA.
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45
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Li F, Yin L, Luo W, Gao Z, Ryu S, Sun M, Liu P, Yang Z. Isotemporal substitution effect of 24-hour movement behavior on the mental health of Chinese preschool children. Front Public Health 2024; 12:1288262. [PMID: 38560447 PMCID: PMC10979542 DOI: 10.3389/fpubh.2024.1288262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
The 24-h movement behavior of preschoolers comprises a spectrum of activities, including moderate-to-vigorous intensity physical activity (MVPA), light-intensity physical activity (LPA), screen-based sedentary behavior (SCSB), non-screen-based sedentary behavior (NSCSB), and sleep. While previous research has shed light on the link between movement behaviors and children's mental health, the specific impacts on the unique demographic of Chinese preschoolers remain underexplored. This study significantly contributes to the literature by exploring how 24-h movement behavior affects the mental health of preschoolers in a Chinese context. The study involved205 Chinese preschool children (117 boys and 88 girls) between the ages of 3 and 6 years wore accelerometers to measure their LPA, MVPA, and sedentary behavior (SB), while their parents reported the time spent on sleep and SCSB. The parents also completed the Strength and Difficulties Questionnaire to assess their children's mental health. The study used compositional regression and isotemporal substitution models to examine the relationship between the various components of 24-h movement behavior and mental health. The results showed that greater NCSSB compared to MVPA, LPA, sleep, and SCSB was associated with good prosocial behavior and lower scores on externalizing problems. This highlights the potential of NSCSB as a beneficial component in the daily routine of preschoolers for fostering mental well-being. Replacing 15 min of sleep and SCSB with 15 min of NSCSB was associated with a decrease of 0.24 and 0.15 units, respectively, in externalizing problems. Reallocating 15 min of sleep to NSCSB was linked to an increase of 0.11 units in prosocial behavior. There were no significant substitution effects between LPA and MVPA time with any other movement behavior on prosocial behavior and externalizing problems. Given the positive associations observed, further longitudinal studies are necessary to explore the link between 24-h movement behavior and mental health in preschool children.
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Affiliation(s)
- Fang Li
- School of Physical Education, Hunan First Normal University, Changsha, China
| | - Long Yin
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Wanhong Luo
- School of Physical Education, Hunan First Normal University, Changsha, China
| | - Zan Gao
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, TN, United States
| | - Suryeon Ryu
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, MN, United States
| | - Mingyun Sun
- School of Mathematics and Statistics, Hengyang Normal University, Hengyang, China
| | - Pan Liu
- School of Physical Education, Hunan University of Technology, Zhuzhou, China
| | - Zongyu Yang
- School of Physical Education and Health Sciences, Guangxi University for Nationalities, Nanning, China
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46
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Duraccio KM, Xu Y, Beebe DW, Lanphear B, Chen A, Braun JM, Kalkwarf H, Cecil KM, Yolton K. High levels of sleep disturbance across early childhood increases cardiometabolic disease risk index in early adolescence: longitudinal sleep analysis using the Health Outcomes and Measures of the Environment study. Sleep 2024; 47:zsad318. [PMID: 38092369 PMCID: PMC10925946 DOI: 10.1093/sleep/zsad318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/12/2023] [Indexed: 03/12/2024] Open
Abstract
STUDY OBJECTIVES This study examines the impact of sleep duration, bedtime, and sleep disturbance during early childhood on the risk of cardiometabolic disorder (CMD) in early adolescence. METHODS Within the Health Outcomes and Measures of Environment Study, we examined sleep patterns of 330 children from ages 2 to 8 years and the relationship of these sleep patterns with cardiometabolic risk measures at age 12 (N = 220). We used a group-based semi-parametric mixture model to identify distinct trajectories in sleep duration, bedtime timing, and sleep disturbance for the entire sample. We then examined the associations between sleep trajectories and CMD risk measures using general linear models using both an unadjusted model (no covariates) and an adjusted model (adjusting for child pubertal stage, child sex, duration of breastfeeding, household income, maternal education, and maternal serum cotinine). RESULTS In the unadjusted and adjusted models, we found significant differences in CMD risk scores by trajectories of sleep disturbance. Children in the "high" disturbance trajectory had higher CMD risk scores than those in the 'low' disturbance trajectory (p's = 0.002 and 0.039, respectively). No significant differences in CMD risk were observed for bedtime timing or total sleep time trajectories in the unadjusted or adjusted models. CONCLUSIONS In this cohort, caregiver-reported sleep disturbance in early childhood was associated with more adverse cardiometabolic profiles in early adolescence. Our findings suggest that trials to reduce CMD risk via sleep interventions-which have been conducted in adolescents and adults-may be implemented too late.
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Affiliation(s)
| | - Yingying Xu
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Dean W Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Heidi Kalkwarf
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Kim M Cecil
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Kimberly Yolton
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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47
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Lemes VB, Sehn AP, Reuter CP, Burns RD, Gaya AR, Gaya ACA, Brand C. Associations of sleep time, quality of life, and obesity indicators on physical literacy components: a structural equation model. BMC Pediatr 2024; 24:159. [PMID: 38454408 PMCID: PMC10921767 DOI: 10.1186/s12887-024-04609-1] [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: 09/12/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
AIM To verify the association between ideal sleep time and physical literacy components while also considering multiple mediators, such as quality of life and obesity, using a sample of adolescents. METHODS This cross-sectional study consisted of 470 adolescents aged 11-17 years from southern Brazil. Sleep time, health-related quality of life, and physical literacy components (i.e., physical education enjoyment, sports participation, sedentary behavior, moderate to vigorous physical activity, sex, and age) were evaluated through self-reported questionnaires. In addition, body mass index (BMI), and waist circumference were determined. The theoretical/statistical support of the structural equation model was evaluated according to fit parameters and strength of association. RESULTS A direct association was observed between more sleep time and lower levels of obesity. The obesity indicators also had a negative association with HqOL, and HqOL had a positive association with physical literacy. The indirect associations indicated that the ideal sleep time was positively associated with HqOL and physical literacy components, considering the negative mediation effect of obesity. The model explains physical literacy in 31% of the variance (R = 0.31). CONCLUSION There was an indirect association between ideal sleep duration and quality of life and between both variables with physical literacy. These relationships occur even considering the negative influence of obesity. Therefore, a child who sleeps adequately has a higher likelihood of being physically active, regardless of obesity, potentially enhancing overall quality of life across various domains.
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Affiliation(s)
| | - Ana Paula Sehn
- University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | | | | | | | | | - Caroline Brand
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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48
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Merianos AL, Stone TM, Mahabee-Gittens EM, Jandarov RA, Choi K. Tobacco Smoke Exposure and Sleep Duration among U.S. Adolescents. Behav Sleep Med 2024; 22:234-246. [PMID: 37417788 PMCID: PMC10772738 DOI: 10.1080/15402002.2023.2232498] [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: 07/08/2023]
Abstract
OBJECTIVES Tobacco smoke exposure (TSE) and poor sleep are public health problems with their own set of consequences. This study assessed whether TSE was associated with sleep duration among U.S. adolescents. METHOD We conducted a secondary analysis of 2013-2018 National Health and Nutrition Examination Survey data including 914 nontobacco-using adolescents ages 16-19 years. TSE measures included cotinine and self-reported home TSE groups including no home TSE, thirdhand smoke (THS) exposure, and secondhand smoke (SHS)+THS exposure. Sleep duration was assessed in hours and categorically as insufficient sleep (recommended hours). Weighted multiple linear regression and multinomial regression models were conducted. RESULTS Adolescents with higher log-cotinine levels had higher number of sleep hours (β = 0.31, 95%CI = 0.02,0.60) and were at increased odds of reporting excess sleep (AOR = 1.41, 95%CI = 1.40,1.42), but were at reduced odds of reporting insufficient sleep (AOR = 0.88, 95%CI = 0.87,0.89). Compared to adolescents with no home TSE, adolescents with home THS exposure and home SHS+THS exposure were at increased odds of reporting insufficient sleep (AOR = 2.27, 95%CI = 2.26,2.29; AOR = 2.75, 95%CI = 2.72,2.77, respectively) and excess sleep (AOR = 1.89, 95%CI = 1.87,1.90; AOR = 5.29, 95%CI = 5.23,5.34, respectively). CONCLUSIONS TSE may affect insufficient and excess sleep duration among adolescents. Eliminating TSE may promote adolescent respiratory and sleep health.
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Affiliation(s)
| | - Timothy M. Stone
- Division of Biostatistics and Bioinformatics, Department of
Environmental and Public Health Sciences, College of Medicine, University of
Cincinnati, 160 Panzeca Way, Cincinnati, OH, 45267, USA
| | - E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati
Children’s Hospital Medical Center, College of Medicine, University of
Cincinnati, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH, 45229, USA
| | - Roman A. Jandarov
- Division of Biostatistics and Bioinformatics, Department of
Environmental and Public Health Sciences, College of Medicine, University of
Cincinnati, 160 Panzeca Way, Cincinnati, OH, 45267, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on
Minority Health and Health Disparities, Bethesda, Maryland, USA
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49
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Malheiros LE, da Costa BG, Lopes MV, Martins da Costa R, Chaput JP, Silva KS. Association of sleep timing and sleep variability with health-related outcomes in a sample of Brazilian adolescents. Behav Sleep Med 2024; 22:129-139. [PMID: 37154038 DOI: 10.1080/15402002.2023.2207699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVES This cross-sectional study aimed to examine the relationships of sleep timing and sleep variability with depressive symptoms, health-related quality of life (HRQoL), daytime sleepiness, and body mass index (BMI) in adolescents. METHODS Adolescents from three schools (n = 571, 56% female, 16.3 ± 1.0 years) had their sleep examined by actigraphy, their anthropometrics assessed, and answered a survey. Sleep timing was examined by combining groups of median-dichotomized onset and wakeup times (early onset and early wakeup; early onset and late wakeup; later onset and early wakeup; later onset and later wakeup); sleep variability was based on within-participant standard deviations of onset and wakeup; and sleep duration as the length of time between onset and wakeup. The sleep variables were separated for weekdays and weekend. Mixed linear models were fitted to compare each sleep variable with health-related outcomes. RESULTS Higher values of daytime sleepiness were observed in adolescents from the late-early and late-late timing group during the week. Greater sleep midpoint and wakeup variability on weekdays were related with higher daytime sleepiness. Adolescents in the late-late and early-late groups showed higher daytime sleepiness. Increased of all sleep variability variables was related with greater daytime sleepiness. Higher depressive symptoms scores were found among adolescents in the late-early subgroup and with the increase of sleep variability. Participants with greater sleep onset variability and sleep midpoint variability reported less HRQoL. CONCLUSIONS Not only sleep duration, but sleep timing and variability also relate to health outcomes, and should be addressed by policies and interventions among adolescents.
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Affiliation(s)
- Luís Ea Malheiros
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Bruno Gg da Costa
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
- School of Physical and Health Education, Nipissing University, North Bay, Canada
| | - Marcus Vv Lopes
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Rafael Martins da Costa
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kelly S Silva
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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50
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Vestergaard CL, Skogen JC, Hysing M, Harvey AG, Vedaa Ø, Sivertsen B. Sleep duration and mental health in young adults. Sleep Med 2024; 115:30-38. [PMID: 38330693 DOI: 10.1016/j.sleep.2024.01.021] [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: 10/28/2023] [Revised: 01/10/2024] [Accepted: 01/21/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND The association between sleep duration and mental illness has been established in middle-aged and older populations, yet remains less explored in younger adults. Additionally, a common limitation to existing studies is the lack of statistical power to explore less common disorders. The purpose of this study was to examine sleep duration as a predictor for a range of mental disorders and well-being in a longitudinal sample of young adults. METHODS Data were derived from two waves (w1, w2) of the SHoT survey, which invited all full-time university and college students in Norway. The response rates were 34.4 % (n = 62,498) in 2021 (w1) and 35.1 % (n = 59,554) 2022 (w2). This study utilized a nested longitudinal sample from both w1 and w2, encompassing 21,289 students. Demographics, sleep duration (w1), and mental health (w2) were measured by self-report questionnaires. Sex-stratified linear regression models and log-link binomial regression analyses were employed to determine the proportion and calculate the risk ratios, respectively, for mental illness across different sleep duration categories. RESULTS The mean age of the sample was 24.8 years ± 4.5 years (w1). Students with shorter sleep durations, and to some degree longer sleep durations (illustrating a ᒐ-shaped association), exhibited a higher risk for all assessed mental disorders and well-being outcomes one year later, compared to students sleeping 8-9 h. The ᒐ-shaped trend was consistent for both female and male students. CONCLUSION Sleep duration appears to be a transdiagnostic marker for mental health in young adults.
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Affiliation(s)
- Cecilie L Vestergaard
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway.
| | - Jens C Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway; Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway; Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Mari Hysing
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Allison G Harvey
- Department of Psychology, University of California, Berkeley, USA
| | - Øystein Vedaa
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway; Department of Research and Innovation, Helse-Fonna HF, Haugesund, Norway
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