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Amiri N, Karami K, Valizadeh F, Mokhayeri Y. The effect of exercise on sleep habits of children with type 1 diabetic: a randomized clinical trial. BMC Pediatr 2024; 24:283. [PMID: 38678194 PMCID: PMC11055292 DOI: 10.1186/s12887-024-04760-9] [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: 11/04/2023] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Adequate sleep and exercise are important components of the human lifestyle. Paying attention to these two factors is very important to improve the condition of children with type 1 diabetes. Therefore, this study aimed to investigate the effect of exercise on sleep habits in children with type 1 diabetes. MATERIAL & METHODS 62 children with type 1 diabetes participated in this clinical trial. They will be divided into the intervention group (31) and the control group (31). Sleep habits were measured using the Children's Sleep Habits Questionnaire (CSHQ). All children's parents completed the CSHQ. The intervention for the experimental group consisted of 8 weeks of regular exercise program. The exercise program was prepared as an educational video and provided to parents. Paired sample t-test and ANCOVA test were used with SPSS 23. RESULTS 62 children with an average age of 9.32 ± 2.02 were studied. Fifty-four and eight% of the children were girls and the rest were boys. The analysis of the variance test showed a significant difference (F = 144.72, P ≤ 0.01) between the average score of the sleep habits of the control group (62.45 ± 5.12) and the experimental group (47.06 ± 4.39). CONCLUSION Sleep habits in the experimental group improved after 8 weeks of exercise training using educational videos. Exercise as a non-pharmacological treatment is an effective way to manage diabetes and improve sleep quality in diabetic children.
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Affiliation(s)
- Nastaran Amiri
- Department of Pediatrics Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Kimia Karami
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Fatemeh Valizadeh
- Razi Herbal Medicines Research Center, Department of Pediatrics Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Yaser Mokhayeri
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
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Calcaterra V, Rossi V, Tagi VM, Baldassarre P, Grazi R, Taranto S, Zuccotti G. Food Intake and Sleep Disorders in Children and Adolescents with Obesity. Nutrients 2023; 15:4736. [PMID: 38004130 PMCID: PMC10675320 DOI: 10.3390/nu15224736] [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: 10/14/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Over the last few decades, numerous scientific studies have investigated the possible association between sleep duration and adiposity during childhood, since it has been reported that sleep deprivation causes a related increase in caloric intake. Even though the underlying pathogenetic mechanisms are still under study and not completely known, the effect of dietetic habits and nutrient intake on sleep quality and patterns has been reported. The aim of this study is to explore the intricate interplay between food intake/diet patterns and pediatric sleep disturbances in children and adolescents with obesity, emphasizing the importance of not underestimating this aspect in the prevention and treatment of this complex disease. Recent evidence supports a high correlation between specific diet patterns and foods with sleep disturbances in children at all ages. Diets rich in fiber, fruit, vegetables, and anti-inflammatory nutrients and low in saturated fats seem to promote better sleep quality. Sleep disturbances are, in turn, risk factors for the development of obesity. Therefore, food strategies should be applied to counteract this harmful process. Unraveling the complex links between dietary habits, sleep patterns, and obesity is essential for developing effective strategies to combat this critical public health issue.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Virginia Rossi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Veronica Maria Tagi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Paola Baldassarre
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Roberta Grazi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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Alder ML, Johnson CR, Zauszniewski JA, Malow BA, Burant CJ, Scahill L. Feasibility of Actigraphy for Evaluating Sleep and Daytime Physical Activity in Children with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:3670-3682. [PMID: 35829946 DOI: 10.1007/s10803-022-05661-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 10/17/2022]
Abstract
This research evaluated the feasibility of actigraphy to measure sleep and physical activity in children (ages 2-8 years) with autism spectrum disorder (ASD). We also explored associations between sleep and physical activity. Validated screening measures established eligibility. Questionnaires, diaries, and 5 days and 5 nights of actigraphy monitoring were used to collect data. Of the 32 children enrolled, 27 (84.4%) completed actigraphy monitoring. Based on the median steps per day, children with high physical activity had lower total sleep time and more disruptive behaviors than children with low physical activity. Findings support the feasibility of using actigraphy to measure sleep and physical activity in children with ASD. Larger studies are needed to evaluate interactions of physical activity on sleep in this population.
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Affiliation(s)
- M L Alder
- Emory University School of Medicine, Marcus Autism Center, 1920 Briarcliff Rd. NE, Atlanta, GA, 30033, USA.
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Ave, Cleveland, OH, 44106, USA.
| | - C R Johnson
- Cleveland Clinic Children's Center for Autism, Lerner College of Medicine at Case Western Reserve University, 2801 Martin Luther King Jr. Dr, Cleveland, OH, 44104, USA
| | - J A Zauszniewski
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Ave, Cleveland, OH, 44106, USA
| | - B A Malow
- Department of Neurology, Sleep Disorders Division, Vanderbilt University Medical Center, 1161 21st Ave. South, Nashville, TN, 37232, USA
| | - C J Burant
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Ave, Cleveland, OH, 44106, USA
| | - L Scahill
- Emory University School of Medicine, Marcus Autism Center, 1920 Briarcliff Rd. NE, Atlanta, GA, 30033, USA
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Bastien L, Théoret R, Bernier A, Godbout R. Habitual sleep and intraindividual variability of sleep in gifted children: an actigraphy study. J Clin Sleep Med 2023; 19:925-934. [PMID: 36710429 PMCID: PMC10152359 DOI: 10.5664/jcsm.10484] [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: 02/18/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/31/2023]
Abstract
STUDY OBJECTIVES Giftedness is a multidimensional condition. It is increasingly put forward that gifted children (GC) could be a population at high risk for sleep problems. The current study investigated GC and typically developing children for their habitual sleep, night-to-night sleep variability, and parental reports of child sleep. METHODS The sample consisted of 62 GC (31 girls; mean age = 9.63 ± 1.71 years) and 62 typically developing children (31 girls; mean age = 9.68 ± 1.68 years). Groups were age and sex matched. Giftedness was identified using Renzulli's 3-factor definition of giftedness. Sleep duration, quality, and night-to-night variability were assessed using actigraphy. Parents were asked to complete the short-form version of the Children's Sleep Habits Questionnaire to report on their child's sleep. Groups were compared with independent sample t-tests and chi-square analyses. RESULTS GC displayed lower sleep efficiencies, more wake time after sleep onset, and more night-to-night sleep variability than typically developing children. GC were found to experience less social jetlag compared to typically developing children, and they also showed more clinically significant sleep problems as reported by parents. CONCLUSIONS Sleep maintenance and stability tend to be challenged in GC. While there is growing evidence that greater sleep variability is associated with poorer physical and emotional health, studies have yet to examine these associations in GC specifically to get a better understanding of giftedness. Overall, there is a need for research focused on both predictors and consequences of sleep patterns and sleep variability in GC. CITATION Bastien L, Théoret R, Bernier A, Godbout R. Habitual sleep and intraindividual variability of sleep in gifted children: an actigraphy study. J Clin Sleep Med. 2023;19(5):925-934.
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Affiliation(s)
- Laurianne Bastien
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
- Sleep Laboratory and Clinic, Rivière-des-Prairies Mental Health Hospital, Montréal, Quebec, Canada
| | - Rachel Théoret
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
- Sleep Laboratory and Clinic, Rivière-des-Prairies Mental Health Hospital, Montréal, Quebec, Canada
| | - Annie Bernier
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
| | - Roger Godbout
- Sleep Laboratory and Clinic, Rivière-des-Prairies Mental Health Hospital, Montréal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Quebec, Canada
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Morrison S, Haszard JJ, Galland BC, Jackson R, Meredith-Jones KA, Elder DE, Taylor RW. Where does the time go when children don't sleep? A randomized crossover study. Obesity (Silver Spring) 2023; 31:625-634. [PMID: 36575906 DOI: 10.1002/oby.23615] [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] [Received: 07/21/2022] [Revised: 08/31/2022] [Accepted: 09/14/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study aimed to describe how mild sleep deprivation in children changes time spent physically active and sedentary. METHODS In 2018 through 2020, children (n = 105) with normal sleep were randomized to go to bed 1 hour earlier (extension) or 1 hour later (restriction) than their usual bedtime for 1 week, each separated by a 1-week washout. Twenty-four-hour movement behaviors were measured with waist-worn actigraphy and expressed in minutes and proportions (percentages). Mixed-effects regression models determined mean differences in time use (95% CI) between conditions. Time gained from sleep lost that was reallocated to other movement behaviors in the 24-hour day was modeled using regression. RESULTS Children (n = 96) gained ~49 minutes of awake time when sleep was restricted compared with extended. This time was mostly reallocated to sedentary behavior (28 minutes; 95% CI: 19-37), followed by physical activity (22 minutes; 95% CI: 14-30). When time was expressed as a percentage, the overall composition of movement behavior remained similar across both sleep conditions. CONCLUSIONS Children were not less physically active when mildly sleep deprived. Time gained from sleeping less was proportionally, rather than preferentially, reallocated to sedentary time and physical activity. These findings suggest that decreased physical activity seems unlikely to explain the association between short sleep and obesity in children.
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Affiliation(s)
- Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Dawn E Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Dadgostar H, Basharkhah A, Ghalehbandi MF, Kashaninasab F. An Investigation on the Effect of Exercise on Insomnia Symptoms. Int J Prev Med 2023; 14:16. [PMID: 37033282 PMCID: PMC10080573 DOI: 10.4103/ijpvm.ijpvm_204_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/28/2021] [Indexed: 04/11/2023] Open
Abstract
Background Insomnia affects the daily activities of the sufferers and reduces attention and memory. Cognitive behavioral therapy is an expensive treatment and is not applicable to all patients, and long-term treatment with sleep medication can have side effects such as drug dependency. As an alternative form of non-pharmacological treatments, the effect of exercise therapy on improving the symptoms of insomnia is addressed in the current study. Methods A total of 32 patients diagnosed with insomnia participated in the study, from which 16 received combined resistance-aerobic exercise therapy. The rest of the patients comprised the control group. The intervention group went through a 12-week intervention in the form of aerobic exercise for 3 days a week and resistance training for another 3 days a week. Patients' sleep quality was assessed by the Pittsburgh test before and after the intervention. Results The results showed that combined aerobic-resistance exercise can improve sleep quality in patients with insomnia as well as increase subjective sleep quality and actual sleep duration, and decrease daytime dysfunction due to sleeping problems. Conclusions This study shows that, along with other insomnia treatments, exercise can improve the sleep quality of patients.
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Affiliation(s)
- Haleh Dadgostar
- Department of Sports Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Basharkhah
- Department of Sports Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Address for correspondence: Dr. Afsaneh Basharkhah, Department of Sports Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. E-mail:
| | - Mir Farhad Ghalehbandi
- Mental Health Research Center, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Kashaninasab
- Mental Health Research Center, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
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Shi Y, Cheng G, Jiang N, Li C, Min X, Yan Y. Association of outdoor activity time and screen time with sleep for 36 to 54 months children in Kaifu District, Changsha: A birth cohort study. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2022; 47:1408-1417. [PMID: 36411692 PMCID: PMC10930368 DOI: 10.11817/j.issn.1672-7347.2022.210687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The prevalence rate of sleep problems in children in China is increasing in recent years. There are inconsistencies in the relationship between physical activity and sleep, and the impact of screen time on young children seems more obvious.This study aims to understand the current situation of outdoor activity time, screen time and sleep (total sleep duration, bedtime, and wake-up time) and the associations between outdoor activity time and screen time with sleep for children aged 36-54 months in Kaifu District of Changsha. METHODS Using the cluster sampling method, 1 286 newborns delivered in 3 community health service centers in Kaifu District, Changsha from January to December 2015 were selected as the research subjects to establish a prospective birth cohort. According self-designed questionnaire and household follow-up to select 36, 42, 48, 54 months Children's data. The mixed linear model was used to explore the associations of outdoor activity time and screen time with sleep. RESULTS The 36-54 months children's total sleep duration was decreased from 11.60 h/d to 10.92 h/d (P<0.001); bedtime time delayed from 21:58 to 22:00 (P=0.124); wake-up time advanced from 7:52 to 7:37 (P<0.001); outdoor activity time was decreased from 2.58 h/d to 1.94 h/d (P<0.001), and screen time was decreased from 1.28 h/d to 1.09 h/d (P<0.001). With aging, the prevalence of sleep <10 h/d and outdoor activity time <2 h/d was increased significantly, and the prevalence of screen time ≥1 h/d was decreased (P<0.05). Mixed linear models showed that longer outdoor activity time was related to increased total sleep duration (β=0.22, 95% CI 0.00 to 0.44) and delayed wake-up time (β=0.16, 95% CI 0.00 to 0.32), and longer screen time was related to delayed bedtime (β=0.22, 95% CI 0.05 to 0.39) and wake-up time (β=0.24, 95% CI 0.08 to 0.41). These associations were different in gender. Longer outdoor activity time was related to delayed wake-up time (β=0.37, 95% CI 0.14 to 0.59) in boys, but not in girls (β=-0.16, 95% CI -0.33 to 0.01). Longer screen time was associated with delayed bedtime (β=0.40, 95% CI 0.09 to 0.63) and wake-up time (β=0.33, 95% CI 0.15 to 0.51) in girls, but only related to delayed wake-up time (β=0.29, 95% CI 0.06 to 0.52) in boys, and the degree of association was lower than that of girls. CONCLUSIONS Among children aged 36-54 months in Kaifu District, Changsha, there are problems including going to bed late and getting up late, insufficient physical activity, and long screen time. Outdoor activity time and screen time are related to sleep. Increasing outdoor activity time and reducing screen time can help to improve children's sleep.
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Affiliation(s)
- Yan Shi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
| | - Gang Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Ni Jiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Chao Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Xianying Min
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Yan Yan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
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Castiglione-Fontanellaz CEG, Timmers TT, Lerch S, Hamann C, Kaess M, Tarokh L. Sleep and physical activity: results from a long-term actigraphy study in adolescents. BMC Public Health 2022; 22:1328. [PMID: 35820897 PMCID: PMC9275054 DOI: 10.1186/s12889-022-13657-0] [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: 02/04/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Research to date suggests that physical activity is associated with improved sleep, but studies have predominantly relied on self-report measures and have not accounted for school day/free day variability. To address these gaps in the literature, the aim of the present study was to (a) quantify physical activity in adolescents using long-term daily actigraphy measurement and (b) to examine the association between actigraphically assessed steps and sleep behavior in a sample of healthy adolescents. To be able to capture intra- and inter-individual differences in the daily physical activity of adolescents, we examined within as well as between subjects effects and its association with sleep. METHODS Fifty adolescents between 10 and 14 years of age were included in the present study. In total 5989 days of actigraphy measurement (average of 119 ± 40 days per participant; range = 39-195 days) were analyzed. We use multilevel modeling to disentangle the within and between subject effects of physical activity on sleep. In this way, we examine within an individual, the association between steps during the day and subsequent sleep on a day-to-day basis. On the other hand, our between subjects' analysis allows us to ascertain whether individuals with more overall physical activity have better sleep. RESULTS Within a subject more steps on school and free days were associated with later bed times on school and free days as well as later rise times on school days only. On the other hand, comparing between subjects' effects, more steps were associated with lower sleep efficiency on free and school days. No other significant associations were found for the other sleep variables. CONCLUSION Our results obtained through objective and long-term measurement of both sleep and number of steps suggest weak or non-significant associations between these measures for most sleep variables. We emphasize the importance of the methodology and the separation of within subject from between subject features when examining the relationship between physical activity and sleep.
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Affiliation(s)
- Chiara E G Castiglione-Fontanellaz
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern, Switzerland.,Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tammy T Timmers
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern, Switzerland
| | - Christoph Hamann
- Department of Child and Adolescent Psychiatry and Psychosomatic Medicine, University Children's Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern, Switzerland.,Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern, Switzerland. .,Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
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Lai JS, Blackwell CK, Tucker CA, Jensen SE, Cella D. Measuring PROMIS® Physical Activity and Sleep Problems in Early Childhood. J Pediatr Psychol 2022; 47:534-546. [PMID: 35552434 PMCID: PMC9113359 DOI: 10.1093/jpepsy/jsac028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 02/27/2022] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Physical activity (PA) and sleep are leading health indicators for individuals of all ages. Monitoring young children’s PA and sleep using psychometrically sound instruments could help facilitate timely interventions to promote healthy development. This article describes the development of the PROMIS® Early Childhood (EC) Parent Report Physical Activity (PA) and Sleep Problems (SP) measures for children aged 1–5 years.
Methods
Item pools were generated by interviewing parents, input from content experts, and literature review. Data from a U.S. general population sample were used to determine factor structures of item pools via factor analytic approaches, estimate item parameters via item response theory (IRT) models, and establish norms. Pearson correlations were used to evaluate across-domain associations. Analysis of variance was used and known-groups’ validity of PA and SP by comparing their scores to PROMIS EC Parent Report Global Health: child’s physical, emotional, and mental conditions.
Results
Initial item pools consisted of 19 and 26 items for PA and SP, respectively. Factor analyses’ results supported unidimensionality of 5 and 16 items measuring PA and SP, respectively, which were then calibrated using IRT. Norms were established by centering to a probability-based U.S. general population. Computerized adaptive testing algorithms were established. Some analyses supported initial measure validity.
Conclusions
The PROMIS EC PA calibrated scale and SP item banks are user-friendly and brief, yet produce precise scores. Both measures enable psychometrically sound assessment of PA behavior and sleep problems. Future studies to comprehensively evaluate the validity of these two measures are warranted.
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Affiliation(s)
- Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - Courtney K Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - Carole A Tucker
- Department of Nutrition, Metabolic and Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, USA
| | - Sally E Jensen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
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Dutil C, Podinic I, Sadler CM, da Costa BG, Janssen I, Ross-White A, Saunders TJ, Tomasone JR, Chaput JP. Sleep timing and health indicators in children and adolescents: a systematic review. Health Promot Chronic Dis Prev Can 2022; 42:150-169. [PMID: 35481337 PMCID: PMC9116724 DOI: 10.24095/hpcdp.42.4.04] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
INTRODUCTION To continue to inform sleep health guidelines and the development of evidence-based healthy sleep interventions for children and adolescents, it is important to better understand the associations between sleep timing (bedtime, wake-up time, midpoint of sleep) and various health indicators. The objective of this systematic review was to examine the associations between sleep timing and 9 health indicators in apparently healthy children and adolescents 5 to 18 years old. METHODS Studies published in the 10 years preceding January 2021 were identified from searches in four electronic databases. This systematic review followed the guidelines prescribed in PRISMA 2020, the methodological quality and risk of bias were scored, and the summary of results used a best-evidence approach for accurate and reliable reporting. RESULTS Forty-six observational studies from 21 countries with 208 992 unique participants were included. Sleep timing was assessed objectively using actigraphy in 24 studies and subjectively in 22 studies. The lack of studies in some of the health outcomes and heterogeneity in others necessitated using a narrative synthesis rather than a metaanalysis. Findings suggest that later sleep timing is associated with poorer emotional regulation, lower cognitive function/academic achievement, shorter sleep duration/ poorer sleep quality, poorer eating behaviours, lower physical activity levels and more sedentary behaviours, but few studies demonstrated associations between sleep timing and adiposity, quality of life/well-being, accidents/injuries, and biomarkers of cardiometabolic risk. The quality of evidence was rated as "very low" across health outcomes using GRADE. CONCLUSION The available evidence, which relies on cross-sectional findings, suggests that earlier sleep timing is beneficial for the health of school-aged children and adolescents. Longitudinal studies and randomized controlled trials are needed to better advance this field of research. (PROSPERO registration no.: CRD42020173585).
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Affiliation(s)
- Caroline Dutil
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Irina Podinic
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Christin M Sadler
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Bruno G da Costa
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Amanda Ross-White
- Queen's University Library, Queen's University, Kingston, Ontario, Canada
| | - Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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11
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Active and sedentary behaviors in youth (6–14 years old): Data from the IAN-AF survey (2015–2016). Porto Biomed J 2022; 7:e161. [PMID: 35146174 PMCID: PMC8824390 DOI: 10.1097/j.pbj.0000000000000161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/04/2021] [Accepted: 06/07/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Strategic health interventions must be guided by effective surveillance systems that monitor population trends and patterns, therefore we aimed to provide youth's (6–14 years) national prevalence estimates of physical activity (PA), active outdoor play (AOP), sedentary behaviur (SB), and structured PA (SPA). Methods: Measures of moderate-to-vigorous PA, SB, AOP, and SPA, were obtained for 719 participants in 2 groups (6–9 and 10–14 years) using diaries and questionnaires. National estimates were calculated, by sex, region, and parental education. Results: While 54% (95%CI: 47.4–61.3) of youth meet PA recommendations, the prevalence is lower for the older group (P = .034). Similarly, AOP decreases with age both on weekends, from 94.3% (95%CI: 90.8–97.8) to 68.7% (95%CI: 62.2–75.1), and on weekdays from 84% (95%CI: 76.5–91.5) to 64.8% (95%CI: 59–70.6). Watching TV for ≥2 h/day is extremely high on weekends [71.3% (95%CI: 65.4–77.2)] and more prevalent in boys than girls on weekdays (P = .043). Higher parental education significantly increased SPA and active time. Time in SB was greater in boys [7.26 h (95%CI: 6.87–7.65)] than girls [6.48 h (95%CI: 6.09–6.87)] and increased with age (P < .001). Conclusions: Almost half of the youth failed to achieve PA guidelines, whereas 71% exceeded recommended TV time on weekends, suggesting the urgency of intervention measures.
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12
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Matsuyama Y, Isumi A, Doi S, Shibata A, Ishii K, Oka K, Fujiwara T. Timing and intensity of physical activity and late sleeping habits among children in Japan. Front Pediatr 2022; 10:915758. [PMID: 36177455 PMCID: PMC9513050 DOI: 10.3389/fped.2022.915758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Little is known about what timing and intensity of physical activity (PA) are beneficial to preventing children's late sleeping habits. We investigated the association between timing and intensity of PA and late sleeping habits among Japanese children. METHODS The amount of PA on a weekday (light (>1.5 to <3.0 metabolic equivalents [METs]); moderate (3.0 to <6.0 METs); and vigorous (6.0 to <20.0 METs) was measured for the whole day, before school, during school, and after school, using accelerometers for population-based fourth-grade elementary school and eighth graders for 7 consecutive days between September and December 2018. Late sleeping habit (going to bed after 10 p.m. for fourth graders and after 11 p.m. for eighth graders) was assessed by questionnaires. The data of 229 fourth graders and 182 eighth graders were analyzed with Poisson regression adjusted for grade, gender, household income, body mass index (BMI), belonging to a sports club, wake-up time on weekdays, and PAs with different intensities. RESULTS Total PA was not associated with late sleeping habits. Light-intensity PA before school was protectively associated with late sleeping habits (prevalence ratio [PR]: 0.82, 95% confidence interval [CI]: 0.68, 0.99) while PA at school or after school was not. CONCLUSION Light-intensity PA before school may enhance the earlier bedtime of children.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
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13
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St Laurent CW, Rodheim K, Spencer RMC. A Systematic Review of the Relationships Between Physical Activity and Sleep in Early Childhood. KINESIOLOGY REVIEW (CHAMPAIGN, ILL.) 2021; 11:121-137. [PMID: 35873529 PMCID: PMC9302480 DOI: 10.1123/kr.2020-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this systematic review was to examine the associations between physical activity and sleep in children aged less than 6 years. Articles were included if participants were primarily aged less than 6 years and study designs were observational or experimental. Study characteristics were extracted, and the Grading Recommendations Assessment, Development and Evaluation framework was used to assess study quality. Thirty-six studies (16 sleep, 16 physical activity, and three fitness outcomes) from 18 countries reported in 29 articles were included. The majority of sleep and physical activity outcome studies reported mixed effects with very low to low quality of evidence. Fitness outcome studies were limited, and therefore, evidence was insufficient. The high prevalence of mixed and null results could be related to study limitations. Importantly, this review points to the critical need for higher quality studies of sleep and physical activity in young children, which would support health recommendations and intervention strategies for healthier child development.
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Affiliation(s)
- Christine W St Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Katrina Rodheim
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Rebecca M C Spencer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
- Institute of Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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14
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de Souza AA, Clark CCT, Mota J, Tassitano RM, Duncan MJ, Martins CMDL. Movement behaviors in short versus adequate nocturnal sleepers: A compositional analysis of preschoolers. Am J Hum Biol 2021; 34:e23694. [PMID: 34726806 DOI: 10.1002/ajhb.23694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/17/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accruing adequate daily amounts of time spent on movement behaviors (physical activity (PA), sedentary behavior (SB), and sleep) in childhood has been associated with positive short and long-term health outcomes. Nonetheless, how waking time is distributed across PA and SB among preschoolers who are short and adequate sleepers at night is unknown. AIM This study investigated: (1) if there are differences in a movement behaviors composition among adequate and short nocturnal sleepers; and (2) the association between preschoolers' time spent in PA, SB, and sleep among adequate and short nocturnal sleepers. METHODS A total of 270 preschoolers (132 boys; 3.97 ± 0.81 years old; 15.48 ± 1.62 kg/m2 ) participated in this study. PA and SB were assessed using accelerometry (model wGT3X). Sleep duration was assessed through a parental-proxy interview, and preschoolers were stratified as short and adequate sleepers, according to attendance to international sleep duration guidelines. Compositional data analysis was used to explore the time-use patterns of behaviors among adequate and short sleepers. RESULTS Short sleepers spent 64 min less time asleep, accumulated 32 min in more sedentary time (p = .005, Cohen's d = 0.36, Bayes Factor: 6.17), and 24 min more in light PA (p = .0005, Cohen's d = 0.44, Bayes Factor: 46.37) compared to adequate sleepers. CONCLUSIONS Being a short sleeper was associated with greater time spent in SB and light PA during their waking hours. The health implications of movement behaviors composition among short sleep preschoolers should be further investigated.
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Affiliation(s)
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Jorge Mota
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Porto, Portugal.,University of Porto, Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | | | - Michael J Duncan
- Centre for Applied Biological and Exercise Sciences, Coventry University, Coventry, UK
| | - Clarice M de L Martins
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Porto, Portugal.,University of Porto, Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.,Federal University of Paraíba, Associated Program of Physical Education UPE/UFPB, Joao Pessoa, Brazil
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15
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Taylor RW, Haszard JJ, Healey D, Meredith-Jones KA, Taylor BJ, Galland BC. Adherence to 24-h movement behavior guidelines and psychosocial functioning in young children: a longitudinal analysis. Int J Behav Nutr Phys Act 2021; 18:110. [PMID: 34433476 PMCID: PMC8385859 DOI: 10.1186/s12966-021-01185-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background A recent paradigm shift has highlighted the importance of considering how sleep, physical activity and sedentary behaviour work together to influence health, rather than examining each behaviour individually. We aimed to determine how adherence to 24-h movement behavior guidelines from infancy to the preschool years influences mental health and self-regulation at 5 years of age. Methods Twenty-four hour movement behaviors were measured by 7-day actigraphy (physical activity, sleep) or questionnaires (screen time) in 528 children at 1, 2, 3.5, and 5 years of age and compared to mental health (anxiety, depression), adaptive skills (resilience), self-regulation (attentional problems, hyperactivity, emotional self-control, executive functioning), and inhibitory control (Statue, Head-Toes-Knees-Shoulders task) outcomes at 5 years of age. Adjusted standardised mean differences (95% CI) were determined between those who did and did not achieve guidelines at each age. Results Children who met physical activity guidelines at 1 year of age (38.7%) had lower depression (mean difference [MD]: -0.28; 95% CI: -0.51, -0.06) and anxiety (MD: -0.23; 95% CI: -0.47, 0.00) scores than those who did not. At the same age, sleeping for 11–14 h or having consistent wake and sleep times was associated with lower anxiety (MD: -0.34; 95% CI: -0.66, -0.02) and higher resilience (MD: 0.35; 95% CI: 0.03, 0.68) scores respectively. No significant relationships were observed at any other age or for any measure of self-regulation. Children who consistently met screen time guidelines had lower anxiety (MD: -0.43; 95% CI: -0.68, -0.18) and depression (MD: -0.36; 95% CI: -0.62, -0.09) scores at 5. However, few significant relationships were observed for adherence to all three guidelines; anxiety scores were lower (MD: -0.42; 95% CI: -0.72, -0.12) in the 20.2% who adhered at 1 year of age, and depression scores were lower (MD: -0.25; 95% CI: -0.48, -0.02) in the 36.7% who adhered at 5 years of age compared with children who did not meet all three guidelines. Conclusions Although adherence to some individual movement guidelines at certain ages throughout early childhood was associated with improved mental health and wellbeing at 5 years of age, particularly reduced anxiety and depression scores, there was little consistency in these relationships. Future work should consider a compositional approach to 24-h time use and how it may influence mental wellbeing. Trial registration ClinicalTrials.gov number NCT00892983
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Affiliation(s)
- Rachael W Taylor
- Department of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand.
| | | | - Dione Healey
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | | | - Barry J Taylor
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
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16
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Huang WY, Ho RST, Tremblay MS, Wong SHS. Relationships of physical activity and sedentary behaviour with the previous and subsequent nights' sleep in children and youth: A systematic review and meta-analysis. J Sleep Res 2021; 30:e13378. [PMID: 34235808 DOI: 10.1111/jsr.13378] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/01/2021] [Accepted: 04/12/2021] [Indexed: 01/11/2023]
Abstract
The interrelationships between sleep and daytime movement behaviours have been examined at interindividual level. Studies of within-person, temporal relationships of daytime physical activity (PA) and sedentary behaviour with the previous and subsequent nights' sleep are increasing. The present systematic review and meta-analysis synthesised the results of studies in school-aged children and youth. Eight databases (MEDLINE, PsycINFO, EMBASE, Global Health, PubMed, Web of Science, SPORTDiscus, and CINAHL) were searched for peer-reviewed articles that examined the association between daytime movement behaviours (including PA, sedentary time, or sedentary recreational screen time) and night-time sleep on the same day, or the association between night-time sleep and daytime movement behaviours the next day, in children and youth. A total of 11 studies comprising 9,622 children and youth aged 5-15 years met the inclusion criteria. Sedentary time was negatively associated with the subsequent night's sleep duration (r = -0.12, 95% confidence interval -0.23 to -0.00; I2 = 93%; p = .04). Positive relationships between PA and the previous or subsequent night's sleep duration were observed only for studies that adjusted for accelerometer wear time. There was some evidence suggesting that a longer sleep duration was associated with less sedentary time and a higher proportion of the daytime spent being physically active and vice versa, although the association was weak and based on a limited number of studies. From a clinical perspective, promotion of either sleep hygiene or daytime PA should be planned with considerations of the virtuous or vicious circle between these behaviours and monitor concurrent effects on the others.
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Affiliation(s)
- Wendy Yajun Huang
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Robin Sze-Tak Ho
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Stephen Heung-Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
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17
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Jindal I, Puyau M, Adolph A, Butte N, Musaad S, Bacha F. The relationship of sleep duration and quality to energy expenditure and physical activity in children. Pediatr Obes 2021; 16:e12751. [PMID: 33191656 DOI: 10.1111/ijpo.12751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/12/2020] [Accepted: 06/20/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Shorter sleep duration has been linked to the risk for obesity in children. The pathways linking sleep duration and quality to the risk of obesity are unclear, particularly the effect of sleep on energetics. OBJECTIVE We investigated the relationship between sleep duration, quality and timing in children, to the basal metabolic rate (BMR), total energy expenditure (TEE) and physical activity (PA). METHODS Fifty nine children in two age-groups (5-11 and 12-18 years) underwent evaluation of body composition (DXA), BMR in a room calorimeter, free-living TEE by doubly labelled water method, sleep and PA (7-day Actiheart monitor) during school break. RESULTS Sleep duration contributed to the variance in BMR (β = 0.11, P = .009) after adjusting for age-group, sex, lean and fat mass, but not to the variance in TEE. Late sleep timing was related to lower PA. In the younger age-group, children who met recommended sleep duration on ≥50% of the 7 days had higher light PA (P = .03) and lower sedentary time (P = .009). CONCLUSION Suboptimal sleep is associated with lower BMR, lower PA, and higher sedentary behaviours in young children. Prospective studies are needed to confirm if insufficient sleep duration or late sleep timing contribute to obesity risk by increasing sedentary behaviours and decreasing BMR.
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Affiliation(s)
- Ishita Jindal
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX.,Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Maurice Puyau
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX
| | - Anne Adolph
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX
| | - Nancy Butte
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX
| | - Salma Musaad
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX
| | - Fida Bacha
- Energy Metabolism Unit, USDA/ARS Children's Nutrition Research Center, Houston, TX.,Department of Pediatrics, Baylor College of Medicine, Houston, TX
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18
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Zhang Z, Sousa-Sá E, Pereira JR, Okely AD, Feng X, Santos R. Correlates of Sleep Duration in Early Childhood: A Systematic Review. Behav Sleep Med 2021; 19:407-425. [PMID: 32496141 DOI: 10.1080/15402002.2020.1772264] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This systematic review aimed to summarize correlates of sleep duration in children under 5 years of age. METHODS Six electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, SPORTDiscus, and Scopus) were searched from inception to May 2019. Observational studies and intervention studies reporting cross-sectional results from baseline data were considered. Data were extracted using a predesigned form and potential correlates were categorized following a sociological framework. RESULTS One-hundred and sixteen studies, representing 329,166 children, met the inclusion criteria, with a high risk of bias in 62 included studies. A total of 83 correlates of sleep duration were identified. Among the associations studied four or more times, correlates of nap duration were child's age and nighttime sleep onset/bedtime; correlates of nighttime sleep duration were household income, parent marital status, parental adiposity level, nighttime sleep duration at younger age, nighttime sleep onset/bedtime, nighttime sleep wakeup time, and frequency of current bedtime routine; correlate of total sleep duration was screen time. CONCLUSIONS Young children from low-income households, single families, or having overweight parents may be at risk for short sleep duration. Promoting healthy sleep duration from an early age appears essential. Effective practices may include encouraging an earlier bedtime, limiting screen time, and establishing a regular bedtime routine. The absence of consistent evidence in the psychological, cognitive, and emotional domain as well as the physical environmental domain warrants further research.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Illawarra Health and Medical Research Institute, Australia
| | - João R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,CIDAF (Uid/dtp/04213/2016), University of Coimbra, Coimbra, Portugal
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Illawarra Health and Medical Research Institute, Australia
| | - Xiaoqi Feng
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Australia.,Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Universidade Lusófona de Humanidades e Tecnologia, Lisboa, Portugal
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19
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van Kooten JAMC, Jacobse STW, Heymans MW, de Vries R, Kaspers GJL, van Litsenburg RRL. A meta-analysis of accelerometer sleep outcomes in healthy children based on the Sadeh algorithm: the influence of child and device characteristics. Sleep 2021; 44:5960427. [PMID: 33161428 DOI: 10.1093/sleep/zsaa231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 09/22/2020] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES Children often experience sleep problems, with a negative impact on mood, behavior, cognitive function, and other aspects of mental and physical health. Accelerometers are widely used to assess sleep, but general reference values for healthy children do not yet exist. The aim of this meta-analysis was to determine mean values for wake after sleep onset (WASO), sleep efficiency (SE), total sleep time (TST) and sleep onset latency (SOL), and to determine the effect of child and accelerometer-characteristics. METHODS A search included studies with healthy children, 0-18 years, reporting WASO, SE, TST, and/or SOL, calculated with the Sadeh algorithm. Meta-analyses with random effects produced pooled estimate means per outcome. Meta-regression analyses determined the effect of age, sex, placement site and accelerometer type. RESULTS Eighty-three studies (9,068 participants) were included. Pooled means were 63 min (95% CI 57 to 69) for WASO, 88% (95% CI 87 to 89) for SE, 477 min (95% CI 464 to 491) for TST and 19 min (95% CI 17 to 22) for SOL. Heterogeneity was high (95%-99%). TST decreased with age and there was an age-effect on SOL. SE differed between wrist and ankle (used in age 0-24 months) placement, and between piezoelectric and MEMS-type accelerometers. No differences were found between boys and girls, although this number of studies was small. CONCLUSIONS We found differences in almost all investigated outcomes and heterogeneity was high. Therefore, we advise to use a study-specific control sample until more robust reference values are available. Future research should narrow the methodological heterogeneity and produce larger datasets, needed to establish these reference values.
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Affiliation(s)
- Jojanneke A M C van Kooten
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Amsterdam, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Sofie T W Jacobse
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Amsterdam, the Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Ralph de Vries
- University Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Gertjan J L Kaspers
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Amsterdam, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Raphaële R L van Litsenburg
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Amsterdam, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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20
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Antczak D, Sanders T, Del Pozo Cruz B, Parker P, Lonsdale C. Day-to-day and longer-term longitudinal associations between physical activity, sedentary behavior, and sleep in children. Sleep 2021; 44:5939976. [PMID: 33103724 DOI: 10.1093/sleep/zsaa219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/06/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To determine the day-to-day and longer-term longitudinal associations between daytime physical activity and night-time sleep. METHODS We used data from a 2-year longitudinal study which included three time points (i.e. baseline, year 1, and year 2). Participants were recruited from primary schools and included 1059 children (50% girls) with a mean age of 8.81-years-old (SD = 0.72) at baseline. Sleep variables included sleep duration, sleep efficiency, time in bed, sleep onset, and wake time. Physical activity variables included light, moderate, moderate-to-vigorous, and vigorous physical activity as well as sedentary time. We objectively assessed physical activity and sleep behaviors using the GENEActiv wrist-worn accelerometer over an 8-day period at each timepoint for a potential 21 190 observed days. RESULTS We used fixed-effects multilevel models and parallel latent growth curve modeling to examine day-to-day and longer-term associations, respectively. Day-to-day, physical activity, and sleep variables were significantly, positively, and bidirectionally associated, except for sleep efficiency, which showed little association with physical activity. Longer-term, we found little association between physical activity and sleep variables. CONCLUSIONS Overall, our findings indicate that there is a day-to-day association between the amount of time spent being physically active and improved sleep. The lack of a longer-term association indicates that a focus on children's daily behavior may be most appropriate to help children improve sleep and increase physical activity.
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Affiliation(s)
- Devan Antczak
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Taren Sanders
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Borja Del Pozo Cruz
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Philip Parker
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Chris Lonsdale
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
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21
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Chang Z, Lei W. A Study on the Relationship Between Physical Activity, Sedentary Behavior, and Sleep Duration in Preschool Children. Front Public Health 2021; 9:618962. [PMID: 33898373 PMCID: PMC8059703 DOI: 10.3389/fpubh.2021.618962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/09/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Explore the role of physical activity (PA) and sedentary behavior (SB) in the sleep of preschool children. Method: Preschool children (n = 458) from kindergarten were recruited, measures included accelerometer-derived 24 h activity [SB, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), daytime sleep duration (DSP), and nocturnal sleep duration (NSP)]. A self-made questionnaire was used to supplementary survey on different types of SB. The two-layer chi-square test and the Cochran–Mantel–Haenszel test were used and significance set at p < 0.05. Results: PA is mainly a protective factor for DSP, while SB is mainly a risk factor for NSP of preschool children; Screen-type SB including screen viewing SB and video game SB is a risk factor for NSP, while quiet learning SB have no significant correlation with sleep duration in preschool children; Gender and social economic status are important factors affecting the association of PA, SB, and sleep duration in preschool children. Conclusions: The relationship between sleep duration at different periods and PA and SB of preschool children is different. Future educators need to gradually realize the different factors affecting the sleep of preschool children at different stages, clarify the protective factors and risk factors, in order to improve the sleep duration of preschool children.
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Affiliation(s)
- Zhenya Chang
- College of Physical Education and Health, East China Normal University, Shanghai, China.,Preschool Education School, Changsha Normal University, Hunan, China
| | - Wei Lei
- College of Physical Education, Jiangxi Science and Technology Normal University, Jiangxi, China
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22
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Jeon M, Dimitriou D, Halstead EJ. A Systematic Review on Cross-Cultural Comparative Studies of Sleep in Young Populations: The Roles of Cultural Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042005. [PMID: 33669583 PMCID: PMC7922907 DOI: 10.3390/ijerph18042005] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 01/21/2023]
Abstract
Recent studies have shown that sleep is influenced and shaped by cultural factors, including cultural values, beliefs and practices. However, a systematic understanding of how cultural factors in countries may influence sleep duration and sleep disturbances is still lacking. Therefore, we focused on a comparison of sleep duration and disturbances in young populations between countries. We report cross-cultural differences between the child, parent and environmental factors, and their association with sleep duration and disturbances. The review is based on literature searches of seven databases published until December 2020. Studies were included if they investigated sleep duration and disturbances of individuals up to 18 years across at least two or more countries. The results of this review have shown that sleep duration and disturbances vary between countries and regions and certain factors (e.g., bedtime routines, sleeping arrangement, physical activity and psychological functioning) have been associated with sleep duration or disturbances. This review also demonstrates that certain factors which were associated with sleep duration or disturbances in one country, were not shown in other countries, suggesting a need for recommendations for age-related sleep duration and sleep interventions to consider cultural differences that influence sleep duration or disturbances in individual countries or regions.
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Schroeder K, Kubik MY, Sirard JR, Lee J, Fulkerson JA. Sleep is Inversely Associated with Sedentary Time among Youth with Obesity. Am J Health Behav 2020; 44:756-764. [PMID: 33081874 DOI: 10.5993/ajhb.44.6.2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: Pathways underlying the sleep-obesity relationship in youth are poorly understood. In this study, we examined associations of sleep with sedentary time and moderate-to-vigorous physical activity (MVPA) among youth, stratified by weight category (obesity versus no obesity). A sub-aim examined whether controlling for screen time changed the sleep-sedentary time association. Methods: Methods entailed secondary analysis of baseline data collected June-August 2014-2017 during a school-based healthy weight management trial in Minneapolis/St. Paul, Minnesota. Participants (N = 114) were 8-to-12 years old with BMI ≥ 75th percentile, most of whom were members of racial/ethnic minority groups (57%) or from households receiving economic assistance (55%). Mean nightly sleep duration and daily screen time were measured by survey, MVPA and sedentary time by accelerometer, and height and weight by research staff. Multivariate linear regression examined associations of sleep with sedentary time and MVPA. Results: Sleep was inversely associated with hours of sedentary time (β = -1.34 [-2.11, -0.58] p = .001) and percent of time spent sedentary (β = -2.92 [-4.83, -1.01], p = .004), for youth with obesity only. The association was unchanged by screen time. Sleep was not significantly associated with MVPA in total sample or stratified models. Conclusions: Associations among sleep, activity levels, and obesity may differ based upon movement type (sedentary time vs MVPA) and weight category (obesity vs no obesity).
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Affiliation(s)
- Krista Schroeder
- Krista Schroeder, Assistant Professor, Temple University College of Public Health, Department of Nursing, Philadelphia, PA, United States;,
| | - Martha Y. Kubik
- Martha Y. Kubik, Professor, Temple University College of Public Health, Department of Nursing, Philadelphia, PA, United States
| | - John R. Sirard
- John R. Sirard, Associate Professor, Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, United States
| | - Jiwoo Lee
- Jiwoo Lee, Assistant Professor, Cora Meidl Siehl Endowed Chair in Nursing Research, University of Minnesota School of Nursing, Minneapolis, MN, United States
| | - Jayne A. Fulkerson
- Jayne A. Fulkerson, Professor and Cora Meidl Siehl Endowed Chair in Nursing Research, University of Minnesota School of Nursing, Minneapolis, MN, United States
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St. Laurent CW, Burkart S, Rodheim K, Marcotte R, Spencer RMC. Cross-Sectional Associations of 24-Hour Sedentary Time, Physical Activity, and Sleep Duration Compositions with Sleep Quality and Habits in Preschoolers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7148. [PMID: 33003598 PMCID: PMC7579350 DOI: 10.3390/ijerph17197148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022]
Abstract
Although some studies indicate physical activity and sleep quality are positively associated in children, most reports examined physical activity independent of other 24-h behaviors and focused on older children. The aim of this cross-sectional study was to examine the predicted changes in sleep efficiency and habits when reallocating time between movement behaviors using compositional isotemporal substitution in preschool-aged children. Accelerometers were worn by 288 participants (51.6 ± 9.5 months) for up to 16 days. Sleep outcomes included sleep efficiency, nap frequency, sleep disturbances, and bedtime resistance. Compositional isotemporal substitution analyses demonstrated that the combined effect of 24-h movement behaviors was associated with sleep efficiency (p < 0.001) and nap frequency (p < 0.003). When sleep increased by 30 min at the expense of stationary time or light physical activity, estimates of sleep efficiency and bedtime resistance decreased while nap frequency increased. When stationary time increased by 30 min from moderate to vigorous physical activity, estimated sleep efficiency increased and sleep disturbances decreased. Although this study presents preliminary evidence that 24-h movement behavior compositions in early childhood are associated with sleep quality and nap frequency, estimated effects from theoretical time reallocations across sleep outcomes were mixed.
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Affiliation(s)
- Christine W. St. Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA;
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA;
| | - Katrina Rodheim
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA;
| | - Robert Marcotte
- Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, USA;
| | - Rebecca M. C. Spencer
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA;
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Kim Y, Umeda M, Lochbaum M, Sloan RA. Examining the day-to-day bidirectional associations between physical activity, sedentary behavior, screen time, and sleep health during school days in adolescents. PLoS One 2020; 15:e0238721. [PMID: 32881930 PMCID: PMC7470331 DOI: 10.1371/journal.pone.0238721] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/21/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Adolescence is a vulnerable period for experiencing poor sleep health. Growing studies have demonstrated lifestyle behaviors including physical activity (PA), screen time (SCT), and sedentary behaviors (SED) as the potential factors associated with sleep health in adolescents; yet, the evidence is inconclusive and the directionality of temporal associations across school days are not well understood. This study examined the day-to-day bidirectional associations of lifestyle behaviors with sleep health parameters in adolescents. METHODS A total of 263 adolescents (58% boys) in 6th - 8th grades wore an accelerometer for 24-hour across the three consecutive school days and completed recording SCT in time-diary and answering sleep quality (SQ) questions for each day. Sleep-wake patterns as well as time spent in moderate- and vigorous-intensity PA (MVPA) and SED were objectively quantified from the wrist-worn accelerometry data across the two segments of the day (during and after school hours). Mixed model analyses were conducted to test bidirectional associations between lifestyle factors and sleep health parameters in each temporal direction across the days. Additionally, indirect associations across the days were tested using an autoregressive cross-lagged model analysis in the framework of path analysis. RESULTS MVPA minutes in a day did not predict sleep health parameters that night. The bidirectional associations were partially observed between SED and sleep health, but the significance and direction of the associations largely varied by the time segment of a day as well as types of sleep health parameters. Additionally, greater SCT during the day was associated with lower SQ that night (b = -0.010; P = .018), and greater SQ was associated with greater MVPA during school hours (b = 6.45; P = .028) and lower SED after school hours (b = -39.85; P = .029) the next day. Lastly, there were significant indirect associations of SCT with sleep health parameters across the days indicating multi-day lagged effects of SCT on sleep health the later nights. CONCLUSION This study highlights the importance of lowering SCT for better sleep health in adolescents during school days. Additionally, perceived SQ is shown to be a potential significant predictor promoting healthy behaviors the next day independent of sleep-wake patterns. Further studies are warranted to confirm the observed temporal associations between SCT, SQ, and behavioral outcomes in this vulnerable population.
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Affiliation(s)
- Youngdeok Kim
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Masataka Umeda
- Department of Kinesiology, University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Marc Lochbaum
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas United States of America
- Education Academy, Vytautas Magnus University, Kaunas, Lithuania
| | - Robert A. Sloan
- Department of Social and Behavioral Medicine, Kagoshima University Graduate Medical School, Kagoshima, Japan
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26
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Gába A, Dygrýn J, Štefelová N, Rubín L, Hron K, Jakubec L, Pedišić Ž. How do short sleepers use extra waking hours? A compositional analysis of 24-h time-use patterns among children and adolescents. Int J Behav Nutr Phys Act 2020; 17:104. [PMID: 32795287 PMCID: PMC7427741 DOI: 10.1186/s12966-020-01004-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/29/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To examine compositional associations between short sleep duration and sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) among children and adolescents. METHODS Multi-day 24-h data on sleep, SB, LPA and MVPA were collected using accelerometers among 343 children (8-13 years old) and 316 adolescents (14-18 years old). Children and adolescents with sleep duration of < 9 and < 8 h, respectively, were classified as short sleepers. Robust compositional regression analysis was used to examine the associations between short sleep duration and the waking-time composition. RESULTS Seventy-one percent of children and 75.3% of adolescents were classified as short sleepers. In children, being a short sleeper was associated with higher SB by 95 min/day (p < 0.001) and lower MVPA by 16 min/day (p = 0.002). Specifically, it was associated with a higher amount of time spent in long sedentary bouts (βilr1 = 0.46, 95% confidence interval [CI] = 0.29 to 0.62) and lower amounts of time spent in sporadic SB (βilr1 = - 0.17, 95% CI = -0.24 to - 0.10), sporadic LPA (βilr1 = - 0.09, 95% CI = -0.14 to - 0.04) and sporadic MVPA (βilr1 = - 0.17, 95% CI = -0.25 to - 0.10, p < 0.001 for all), relative to the remaining behaviours. In adolescents, being a short sleeper was associated with a higher amount of time spent in SB by 67 min/day (p = 0.001) and lower LPA by 2 min/day (p = 0.035). Specifically, it was associated with more time spent in sedentary bouts of 1-9 min (βilr1 = 0.08, 95% CI = 0.02 to 0.14, p = 0.007) and 10-29 min (βilr1 = 0.10, 95% CI = 0.02 to 0.18, p = 0.015), relative to the remaining behaviours. CONCLUSIONS Among children and adolescents, short sleep duration seems to be highly prevalent and associated with less healthy waking time. Public health interventions and strategies to tackle the high prevalence of short sleep duration among children and adolescents are warranted.
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Affiliation(s)
- Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Nikola Štefelová
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lukáš Rubín
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.,Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Karel Hron
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lukáš Jakubec
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Željko Pedišić
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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27
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Pereira JR, Zhang Z, Sousa-Sá E, Santos R, Cliff DP. Correlates of sedentary time in young children: A systematic review. Eur J Sport Sci 2020; 21:118-130. [PMID: 32154761 DOI: 10.1080/17461391.2020.1741689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Young children appear to spend large portions of their waking time being sedentary. Understanding the correlates of sedentary time would assist in developing effective interventions among young children. The purpose of this systematic review was to summarize the current literature on the correlates of objectively measured sedentary time in young children aged 1-5.99y. Methods: This review was registered with PROSPERO (registration no. CRD42017081374) and aligned with the PRISMA Statement for systematic reviews. Five electronic databases (MEDline, CINAHL Complete, PsycINFO, SportDiscus, Scopus) were searched up to October 26, 2017 for studies investigating correlates of sedentary time measured using objective devices. A semiquantitative approach was used to synthesize data. Results: Forty-five studies were retrieved comprising 13,430 participants, and 84 correlates of sedentary time in young children were evaluated. The associations between sex, sleep habits, daily patterns (childcare vs. non-childcare hours), childcare type and sedentary time were indeterminate. Thirty-nine correlates were consistently unrelated. Forty-one potential correlates were examined in too few studies (<4) to make confident conclusions. Parental sedentary behaviour was reported 3 times and maternal sedentary behaviour was reported once. Out of these four studies, three were positively associated with child sedentary time. Conclusions: Despite reviewing 45 studies that evaluated associations for 84 correlates, this review was unable to identify any consistent correlates of sedentary time in young children. Additional research is needed in this area to provide robust evidence of the correlates of sedentary time in young children, particularly for those examined in only a small number of studies.
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Affiliation(s)
- J R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Faculty of Physical Education and Sport, Lusófona University, Lisboa, Portugal.,Research Unit for Sport and Physical Activity - CIDAF, University of Coimbra, Coimbra, Portugal
| | - Z Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - E Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - R Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| | - D P Cliff
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
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28
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Ward AL, Reynolds AN, Kuroko S, Fangupo LJ, Galland BC, Taylor RW. Bidirectional associations between sleep and dietary intake in 0–5 year old children: A systematic review with evidence mapping. Sleep Med Rev 2020; 49:101231. [DOI: 10.1016/j.smrv.2019.101231] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 01/11/2023]
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29
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Janssen X, Martin A, Hughes AR, Hill CM, Kotronoulas G, Hesketh KR. Associations of screen time, sedentary time and physical activity with sleep in under 5s: A systematic review and meta-analysis. Sleep Med Rev 2020; 49:101226. [PMID: 31778942 PMCID: PMC7034412 DOI: 10.1016/j.smrv.2019.101226] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 01/23/2023]
Abstract
Sleep is crucial to children's health and development. Reduced physical activity and increased screen time adversely impact older children's sleep, but little is known about these associations in children under 5 y. This systematic review examined the association between screen time/movement behaviors (sedentary behavior, physical activity) and sleep outcomes in infants (0-1 y); toddlers (1-2 y); and preschoolers (3-4 y). Evidence was selected according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and synthesized using vote counting based on the direction of association. Quality assessment and a Grading of Recommendations, Assessment, Development and Evaluation was performed, stratified according to child age, exposure and outcome measure. Thirty-one papers were included. Results indicate that screen time is associated with poorer sleep outcomes in infants, toddlers and preschoolers. Meta-analysis confirmed these unfavorable associations in infants and toddlers but not preschoolers. For movement behaviors results were mixed, though physical activity and outdoor play in particular were favorably associated with most sleep outcomes in toddlers and preschoolers. Overall, quality of evidence was very low, with strongest evidence for daily/evening screen time use in toddlers and preschoolers. Although high-quality experimental evidence is required, our findings should prompt parents, clinicians and educators to encourage sleep-promoting behaviors (e.g., less evening screen time) in the under 5s.
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Affiliation(s)
- Xanne Janssen
- University of Strathclyde, School of Psychological Science and Health, Glasgow, UK.
| | - Anne Martin
- University of Glasgow, MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
| | - Adrienne R Hughes
- University of Strathclyde, School of Psychological Science and Health, Glasgow, UK
| | - Catherine M Hill
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, UK; Institute of Education, University College London, UK; Southampton Children's Hospital, UK
| | | | - Kathryn R Hesketh
- UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, UK
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30
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Sleep duration associates with moderate-to-vigorous intensity physical activity and body fat in 1- to 3-year-old children. Infant Behav Dev 2019; 58:101392. [PMID: 31778860 DOI: 10.1016/j.infbeh.2019.101392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 11/22/2022]
Abstract
Sleep during early childhood is important for many developmental outcomes and shows promise as an important correlate of both obesity risk and physical activity behaviors. This was a cross-sectional study concerning the relationships between sleep and moderate- to - vigorous intensity physical activity and body fat percentage in a sample of 1- to 3-year-old children (N = 50; ages 27.512 ± 10.363 months). Sleep was measured with a caregiver questionnaire. Sedentary time, light, moderate, vigorous, and moderate- to - vigorous intensity physical activity were measured with Actigraph wT3x-BT accelerometers. Body fat was measured using Air Displacement Plethysmography with the BodPod Pediatric Option. Moderate- to - vigorous intensity physical activity and body fat percentage both associated with sleep duration, controlling for age and accelerometer wear time. These factors combined explained 54.3 % of the variance in sleep duration present in the sample. These results suggest the presence of relationships between sleep and physical activity and body composition constructs in this sample. Sleep may be an important variable in efforts to both promote early childhood physical activity and healthy body composition.
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31
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Ward AL, Galland BC, Haszard JJ, Meredith-Jones K, Morrison S, McIntosh DR, Jackson R, Beebe DW, Fangupo L, Richards R, Te Morenga L, Smith C, Elder DE, Taylor RW. The effect of mild sleep deprivation on diet and eating behaviour in children: protocol for the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized cross-over trial. BMC Public Health 2019; 19:1347. [PMID: 31640636 PMCID: PMC6805447 DOI: 10.1186/s12889-019-7628-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 09/13/2019] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger. METHODS The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8-12 years, with normal reported sleep duration of 8-11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1-2 h per night. DISCUSSION Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618001671257 . Registered 10 October 2018.
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Affiliation(s)
- Aimee L. Ward
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C. Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | | | | | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Dean W. Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Division of Behavioral Medicine and Clinical Psychology Cincinnati Children’s Hospital Medical Center, Ohio, USA
| | - Louise Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Lisa Te Morenga
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Claire Smith
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Dawn E. Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
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32
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Sleep and weight-related factors in youth: A systematic review of recent studies. Sleep Med Rev 2019; 46:87-96. [DOI: 10.1016/j.smrv.2019.04.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/11/2019] [Accepted: 04/18/2019] [Indexed: 12/28/2022]
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33
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Spaeth AM, Hawley NL, Raynor HA, Jelalian E, Greer A, Crouter SE, Coffman DL, Carskadon MA, Owens JA, Wing RR, Hart CN. Sleep, energy balance, and meal timing in school-aged children. Sleep Med 2019; 60:139-144. [PMID: 30905623 DOI: 10.1016/j.sleep.2019.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine associations among objectively-measured nocturnal sleep time, bedtime and obesogenic behaviors, including dietary intake, timing of intake, and physical activity, in a diverse sample of school-aged children who presented for behavioral treatment to enhance sleep duration. METHODS Eighty-seven children (8-11 y, 66.7% female, zBMI: 0.86 ± 1.0) who self-reported sleeping <9.5 h/night were studied for one week using wrist actigraphy to estimate sleep; hip-worn accelerometers to measure physical activity; and 24 h dietary recalls to capture dietary intake and meal timing. Pearson and Spearman's rho correlations and linear regressions controlling for age, gender and race were used for statistical analyses. RESULTS AND CONCLUSION Mean bedtime was 10:31 PM (±58.2 min) and mean nocturnal sleep time was 7.7 h (±37.5 min). Although later bedtime was associated with shorter sleep time (r = -0.61, p < 0.001), the two variables were differentially related to obesity risk factors. Later bedtime, but not sleep time, correlated with greater daily fat intake, later first meal of the day, and greater after-dinner intake (all p < 0.05). Nocturnal sleep time, but not bedtime, correlated with zBMI (p = 0.04). Both sleep time and later bedtime were associated with a later last meal of the day (all p < 0.05). Findings remained consistent after controlling for demographic factors. In short-sleeping school-aged children, bedtime may be more predictive of dietary obesity risk factors whereas sleep duration may be more predictive of zBMI. Results suggest that health providers should consider both bedtime and sleep duration for reducing obesity risk in children. CLINICAL TRIAL Enhancing Sleep Duration: Effects on Children's Eating and Activity Behaviors, NCT03186508, https://clinicaltrials.gov/ct2/show/NCT03186508.
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Affiliation(s)
- Andrea M Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA.
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Hollie A Raynor
- Department of Nutrition, College of Education, Health and Human Sciences, The University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, School of Medicine, Brown University, Providence, RI, USA
| | - Ashley Greer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Scott E Crouter
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee-Knoxville, Knoxville, TN, USA
| | - Donna L Coffman
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Mary A Carskadon
- Department of Psychiatry and Human Behavior, School of Medicine, Brown University, Providence, RI, USA
| | - Judith A Owens
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, School of Medicine, Brown University, Providence, RI, USA
| | - Chantelle N Hart
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA; Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
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34
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Kobel S, Wartha O, Dreyhaupt J, Kettner S, Steinacker JM. Cross-sectional associations of objectively assessed sleep duration with physical activity, BMI and television viewing in German primary school children. BMC Pediatr 2019; 19:54. [PMID: 30744602 PMCID: PMC6369549 DOI: 10.1186/s12887-019-1429-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 02/07/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The global incidence of overweight and obesity has increased dramatically among children and adolescents over the past decades. Insufficient sleep duration and physical inactivity are known risk factors for overweight and obesity in children. To engage children in a healthier lifestyle knowledge about associations of sleep duration and behavioural aspects in children are vital. Therefore, this study investigated the mentioned associations in German primary school children. METHODS Data of 308 first and second graders (7.1 ± 0.6 years) was used; children's anthropometric data were taken during a school visit. Children's physical activity (PA) and sleep duration were assessed objectively (Actiheart©, CamNtech Ltd., Cambridge, UK); children's daily television time and socio-demographic data were collected via parental questionnaire. Linear mixed-effects regression models as well as logistic regressions were used to determine associations of PA, television viewing, age, gender, BMI z-scores and socio-economic variables on sleep duration. RESULTS In linear regression models young age and not having a migration background were significantly associated with long sleep duration (p < 0.001). In logistic regressions, long night time sleep (≥10:08 h; compared to medium and short sleep duration) was significantly associated with not reaching the PA guideline (OR 0.60 [0.36;0.99]), daily television viewing of less than one hour (OR 0.44 [0.24;0.80]), young age (OR 0.38 [0.21;067]), a high parental education level (OR 0.52 [0.27;0.99]) and the lack of migration background (OR 0.21 [0.10;0.48]). However, if controlling for age, gender, parental education level and migration background, reaching the PA guideline stayed no longer significantly associated with a tertiary sleep level. CONCLUSIONS Children in the highest sleep category showed a negative association with reaching the PA guideline and a positive association with daily television viewing. This therefore adds to previously primarily subjectively assessed associations of sleep and risk factors for obesity (related behaviours) with a detailed insight based on objective data. Hence, interventions trying to decrease children's BMI and television viewing should also aim at extending children's night-time sleep and inform parents about the importance of sufficient sleep during childhood. TRIAL REGISTRATION DRKS-ID: DRKS00000494 .
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Affiliation(s)
- Susanne Kobel
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, D-89075 Ulm, Germany
| | - Olivia Wartha
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, D-89075 Ulm, Germany
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstr. 13, D-89075 Ulm, Germany
| | - Sarah Kettner
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, D-89075 Ulm, Germany
| | - Jürgen M. Steinacker
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Leimgrubenweg 14, D-89075 Ulm, Germany
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Wang YC, Chen LC, Tung YC, Lee CC, Tsai SY. Physical activity and objectively assessed sleep in 6-month-old infants in Taiwan. Res Nurs Health 2019; 42:128-135. [PMID: 30620090 DOI: 10.1002/nur.21929] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 11/24/2018] [Indexed: 12/24/2022]
Abstract
Adequate physical activity is associated with improved sleep in adults. Such associations, however, vary greatly across studies in pediatric populations, with no studies involving infants found in the literature. This prospective observational study was designed, therefore, to examine the association between physical activity and sleep patterns in infants. A total of 183 healthy infants aged 6 months wore an actigraph for 7 days to measure physical activity and sleep. Parents and caregivers completed a sleep-activity diary over the same period documenting the different types of infant activities. Daily mean time spent in screen-time-or-limited physical activity, including screen-based (e.g., watching television or other electronic devices) and non-screen based activity (e.g., quiet play or restricted infant movement when carried by caregivers or seated in high chairs, swings, or bouncer seats), was 6.68 hr (SD = 1.99), which represented 47.50% of daytime waking hours (SD = 13.73). We found that 65 (35.5%) infants engaged in some screen time during the study, with 10 (5.5%) infants having an average daily screen time >30 min. In our multivariate linear regression model, more hours of screen-time-or-limited physical activity per day were significantly associated with a decrease in total daily 24 hr sleep duration (p < 0.01). Findings from our study suggest that reducing screen-time-or-limited physical activity might be an approach for promoting adequate sleep and lengthening infant daily sleep duration.
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Affiliation(s)
- Yi-Ching Wang
- Disease Control Division, Department of Health, New Taipei City Government, Taipei, Taiwan
| | - Li-Chiou Chen
- School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan
| | - Yi-Ching Tung
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan
| | - Shao-Yu Tsai
- School of Nursing, National Taiwan University, Taipei, Taiwan
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Pereira JR, Cliff DP, Sousa-Sá E, Zhang Z, Santos R. Prevalence of objectively measured sedentary behavior in early years: Systematic review and meta-analysis. Scand J Med Sci Sports 2018; 29:308-328. [PMID: 30456827 DOI: 10.1111/sms.13339] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/28/2018] [Accepted: 11/12/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND The early years have been identified as a critical period during which sedentary habits may be established, as this behavior appears to track throughout life. OBJECTIVE The purpose of this systematic review and meta-analysis is to summarize the current literature on the prevalence of sedentary behavior in children aged 1-5.99 years, reporting differences between boys and girls, weekdays and weekend days, childcare hours and nonchildcare hours, and between time spent indoors and outdoors while children attended childcare. METHODS Five databases were searched until 26.10.2017 and meta-analyses were conducted to estimate prevalence and calculate mean differences in prevalence between groups. RESULTS Fifty studies representing 14 598 children (2-5.99 years) were included. Children spent 51.4% of their waking time in sedentary behaviors. Boys spent less time being sedentary than girls (estimate difference = -1.4%; 95%CI = -2.0: -0.7; P < .001). No significant differences were found between weekdays/weekend days (estimate difference = -0.4; 95%CI = -2.0: 1.2; P = .61) nor between childcare hours/nonchildcare hours (estimate difference = %; 95%CI = -0.9: 6.6; P = .136). While attending childcare centers, children were more sedentary indoors than outdoors (estimate difference = 14.4%; 95%CI = 11.8: 16.9; P < .001). CONCLUSIONS Our results suggest that young children spend a significant portion of their waking hours in sedentary behaviors. While at childcare, young children accumulated more sedentary behavior indoors than outdoors. Girls were more likely to be more sedentary than boys. No significant differences were found between weekdays and weekends, or between childcare and nonchildcare hours. There is a need for higher-quality studies with strong designs, using age and device appropriate cut-off points, to improve evidence-base and to better establish prevalence of sedentary behavior in young children.
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Affiliation(s)
- João Rafael Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia.,Research Unit for Sport and Physical Activity - CIDAF (uid/dtp/03213/2016) University of Coimbra, Coimbra, Portugal
| | - Dylan P Cliff
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Universidade Lusófona, Lisboa, Portugal
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Temporal associations between circadian sleep and activity patterns in Mexican American children. Sleep Health 2018; 5:201-207. [PMID: 30928122 DOI: 10.1016/j.sleh.2018.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 10/23/2018] [Accepted: 10/27/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to examine the relationship between circadian sleep and activity behaviors (sedentary time [SED], light-intensity physical activity [LPA], and moderate- to vigorous-intensity physical activity [MVPA]) across 3 consecutive days. METHODS This study included 308 Mexican American children aged 8-10 years from the San Francisco Bay Area. Minutes of sleep duration, SED, LPA, and MVPA were estimated using hip-worn accelerometers from Wednesday night to Saturday night. A cross-lagged panel model was used to estimate paths between sleep duration the prior night and subsequent behaviors, and paths between behaviors to subsequent sleep duration across the 3 days. We adjusted for child age, sex, body mass index, and household income. RESULTS Overall, children were 8.9 (SD 0.8) years old; the weighted average for weekday and weekend combined was 9.6 (SD 0.7) hours per night in sleep duration, 483 (SD 74) min/d SED, 288 (SD 61) min/d LPA, and 63 (SD 38) min/d MVPA. Cross-lagged panel analyses showed that, over 3 days, for every 1-hour increase in sleep duration, there were an expected 0.66-hour (40-minute) decrease in SED, 0.37-hour (22-minute) decrease in LPA, and 0.06-hour (4-minute) decrease in MVPA. For every 1-hour increase in LPA, there was an expected 0.25-hour (15-minute) decrease in sleep duration. CONCLUSION An additional hour of sleep the night before corresponded to an hour decrease in combined SED and LPA the next day in Mexican American children. For every hour of LPA, there was an associated 15-minute decrease in sleep. Encouraging longer sleep may help to reduce SED and LPA, and help offset LPA's negative predictive effect on sleep.
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Parsons AA, Ollberding NJ, Smith L, Copeland KA. Sleep matters: The association of race, bedtime, outdoor time, and physical activity with preschoolers' sleep. Prev Med Rep 2018; 12:54-59. [PMID: 30181946 PMCID: PMC6120424 DOI: 10.1016/j.pmedr.2018.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 08/16/2018] [Accepted: 08/21/2018] [Indexed: 11/29/2022] Open
Abstract
Sleep is necessary for optimal functioning. Little is known about the extent to which race and opportunities to be active influence sleep in preschool-aged children attending full-day child care. Participants (n = 359) in this cross-sectional study attended 30 randomly selected, childcare centers in Cincinnati, OH. Data collection occurred from November 2009 to January 2011. Hierarchical linear regression and generalized estimating equations tested for associations between nighttime sleep duration and race, outdoor/indoor active time, actual physical activity (PA), screen time, daytime nap, and bedtime after 9 pm. Participants slept a mean ± SD of 1.5 ± 0.8 h at childcare and 9.7 ± 1.0 h at bedtime. White children (β = 0.57 ± 0.14, p < 0.01) and children identifying as Other race (β = 0.40 ± 0.15, p < 0.01) slept more hours than Black children at nighttime. White children were less likely to nap at childcare than Black children. Inside PA time provided was associated with increased nighttime sleep duration (β = 0.092 ± 0.04 h per 30 min PA, p < 0.03). There was no association between outdoor time or moderate to vigorous PA and nighttime sleep. Black children slept less at night on average, but were more likely to engage in nap sleep at childcare resulting in similar overall sleep duration. Additional studies in diverse populations that explore the effects of nighttime versus nap time sleep on child health and well-being are needed.
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Affiliation(s)
- Allison A. Parsons
- Division of Critical Care, Cincinnati Children's Hospital Medical Center (CCHMC), 3333 Burnet Ave, Cincinnati, OH 45229, United States of America
| | - Nicholas J. Ollberding
- Division of Biostatistics and Epidemiology, CCHMC, 3333 Burnet Ave, Cincinnati, OH 45229, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, United States of America
| | - Laurie Smith
- Division of Biostatistics and Epidemiology, CCHMC, 3333 Burnet Ave, Cincinnati, OH 45229, United States of America
| | - Kristen A. Copeland
- Division of General and Community Pediatrics, CCHMC, 3333 Burnet Ave, Cincinnati, OH 45229, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, United States of America
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Taylor RW, Haszard JJ, Meredith-Jones KA, Galland BC, Heath ALM, Lawrence J, Gray AR, Sayers R, Hanna M, Taylor BJ. 24-h movement behaviors from infancy to preschool: cross-sectional and longitudinal relationships with body composition and bone health. Int J Behav Nutr Phys Act 2018; 15:118. [PMID: 30477518 PMCID: PMC6260686 DOI: 10.1186/s12966-018-0753-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/14/2018] [Indexed: 12/02/2022] Open
Abstract
Background New physical activity guidelines for children address all movement behaviors across the 24-h day (physical activity, sedentary behavior, sleep), but how each component relates to body composition when adjusted for the compositional nature of 24-h data is uncertain. Aims To i) describe 24-h movement behaviors from 1 to 5 years of age, ii) determine cross-sectional relationships with body mass index (BMI) z-score, iii) determine whether movement behaviors from 1 to 5 years of age predict body composition and bone health at 5 years. Methods 24-h accelerometry data were collected in 380 children over 5–7 days at 1, 2, 3.5 and 5 years of age to determine the proportion of the day spent: sedentary (including wake after sleep onset), in light (LPA) and moderate-to-vigorous physical activity (MVPA), and asleep (including naps). BMI was determined at each age and a dual-energy x-ray absorptiometry (DXA) scan measured fat mass, bone mineral content (BMC) and bone mineral density (BMD) at 5 years of age. 24-h movement data were transformed into isometric log-ratio co-ordinates for multivariable regression analysis and effect sizes back-transformed. Results At age 1, children spent 49.6% of the 24-h day asleep, 38.2% sedentary, 12.1% in LPA, and 0.1% in MVPA, with corresponding figures of 44.4, 33.8, 19.8 and 1.9% at 5 years of age. Compositional time use was only related significantly to BMI z-score at 3.5 years in cross-sectional analyses. A 10% increase in mean sleep time (65 min) was associated with a lower BMI z-score (estimated difference, − 0.25; 95% CI, − 0.42 to − 0.08), whereas greater time spent sedentary (10%, 47 min) or in LPA (10%, 29 min) were associated with higher BMI z-scores (0.12 and 0.08 respectively, both p < 0.05). Compositional time use from 1 to 3.5 years was not related to future BMI z-score or percent fat. Although MVPA at 2 and 3.5 years was consistently associated with higher BMD and BMC at 5 years, actual differences were small. Conclusions Considerable changes in compositional time use occur from 1 to 5 years of age, but there is little association with adiposity. Although early MVPA predicted better bone health, the differences observed had little clinical relevance. Trial registration ClinicalTrials.gov number NCT00892983. Electronic supplementary material The online version of this article (10.1186/s12966-018-0753-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rachael W Taylor
- Departments of Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand.
| | - Jillian J Haszard
- Departments of Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Kim A Meredith-Jones
- Departments of Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Barbara C Galland
- Departments of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Anne-Louise M Heath
- Departments of Human Nutrition, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Julie Lawrence
- Departments of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Andrew R Gray
- Departments of Biostatistics Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Rachel Sayers
- Departments of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Maha Hanna
- Departments of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Barry J Taylor
- Departments of Office of the Dean, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Robust Compositional Analysis of Physical Activity and Sedentary Behaviour Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102248. [PMID: 30322203 PMCID: PMC6210094 DOI: 10.3390/ijerph15102248] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 12/22/2022]
Abstract
Although there is an increasing awareness of the suitability of using compositional data methodology in public health research, classical methods of statistical analysis have been primarily used so far. The present study aims to illustrate the potential of robust statistics to model movement behaviour using Czech adolescent data. We investigated: (1) the inter-relationship between various physical activity (PA) intensities, extended to model relationships by age; and (2) the associations between adolescents’ PA and sedentary behavior (SB) structure and obesity. These research questions were addressed using three different types of compositional regression analysis—compositional covariates, compositional response, and regression between compositional parts. Robust counterparts of classical regression methods were used to lessen the influence of possible outliers. We outlined the differences in both classical and robust methods of compositional data analysis. There was a pattern in Czech adolescents’ movement/non-movement behavior—extensive SB was related to higher amounts of light-intensity PA, and vigorous PA ratios formed the main source of potential aberrant observations; aging is associated with more SB and vigorous PA at the expense of light-intensity PA and moderate-intensity PA. The robust counterparts indicated that they might provide more stable estimates in the presence of outlying observations. The findings suggested that replacing time spent in SB with vigorous PA may be a powerful tool against adolescents’ obesity.
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Zhang Z, Sousa-Sá E, Pereira J, Chaput JP, Okely A, Feng X, Santos R. Correlates of nocturnal sleep duration, nocturnal sleep variability, and nocturnal sleep problems in toddlers: results from the GET UP! Study. Sleep Med 2018; 53:124-132. [PMID: 30508780 DOI: 10.1016/j.sleep.2018.08.035] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore the correlates of nocturnal sleep duration, nocturnal sleep variability, and nocturnal sleep problems in a sample of Australian toddlers. METHODS Participants were 173 toddlers (average age 19.7 ± 4.1 months) from the GET UP! STUDY Nocturnal sleep duration, nocturnal sleep variability, nap(s) and physical activity were measured using 24-h accelerometry (Actigraph GT3X+) over seven consecutive days. Nocturnal sleep problems were assessed using the Tayside Children's Sleep Questionnaire. Screen time was reported by the parents. Logistic regression models were used to examine the associations between potential correlates (ie, age, sex, socio-economic status, weight status, physical activity, screen time, nap(s), bedtimes, and wake-up times) and nocturnal sleep characteristics. RESULTS Older children were more likely to have greater sleep variability (OR: 1.97; 95% CI: 1.08-3.61). Less physical activity (OR: 2.38; 95% CI: 1.27-4.45), shorter nap(s) (OR: 2.42, 95% CI: 1.29-4.55), and later wake-up times (OR: 4.42; 95% CI: 2.32-8.42) were associated with higher odds of having longer nocturnal sleep duration. Late bedtimes were associated with shorter nocturnal sleep duration (OR: 0.09; 95% CI: 0.04-0.18) and with greater nocturnal sleep variability (OR: 1.97; 95% CI: 1.06-3.68). None of the potential correlates were associated with nocturnal sleep problems. CONCLUSION The present study identifies several correlates of nocturnal sleep duration (total physical activity, nap(s), bedtime, and wake-up time) and nocturnal sleep variability (age and bedtime), whereas no correlates were identified for nocturnal sleep problems. The association between late bedtimes and shorter nocturnal sleep duration and greater nocturnal variability suggests that these may be modifiable targets for future sleep interventions in early childhood. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12616000471482, 11/04/2016, retrospectively registered.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - João Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; CIDAF (uid/dtp/04213/2016), University of Coimbra, Coimbra, Portugal
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Anthony Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Australia
| | - Xiaoqi Feng
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Australia; Population Wellbeing and Environment Research Lab, Faculty of Social Science, University of Wollongong, NSW, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Australia; Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.
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Galland BC, Short MA, Terrill P, Rigney G, Haszard JJ, Coussens S, Foster-Owens M, Biggs SN. Establishing normal values for pediatric nighttime sleep measured by actigraphy: a systematic review and meta-analysis. Sleep 2018; 41:4954015. [DOI: 10.1093/sleep/zsy017] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Indexed: 01/25/2023] Open
Affiliation(s)
- Barbara C Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | | | - Philip Terrill
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Gabrielle Rigney
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Jillian J Haszard
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Scott Coussens
- School of Psychology, Flinders University, Adelaide, Australia
- Cognitive Neuroscience Laboratory, University of South Australia, Adelaide, Australia
| | - Mistral Foster-Owens
- Department of Paediatrics, The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia
| | - Sarah N Biggs
- Department of Paediatrics, The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia
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Hart CN, Hawley N, Davey A, Carskadon M, Raynor H, Jelalian E, Owens J, Considine R, Wing RR. Effect of experimental change in children's sleep duration on television viewing and physical activity. Pediatr Obes 2017; 12:462-467. [PMID: 27417142 PMCID: PMC8136410 DOI: 10.1111/ijpo.12166] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 05/30/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Paediatric observational studies demonstrate associations between sleep, television viewing and potential changes in daytime activity levels. OBJECTIVE(S) To determine whether experimental changes in sleep lead to changes in children's sedentary and physical activities. METHODS Using a within-subject counterbalanced design, 37 children 8-11 years old completed a 3-week study. Children slept their typical amount during a baseline week and were then randomized to increase or decrease mean time in bed by 1.5 h/night for 1 week; the alternate schedule was completed the final week. Children wore actigraphs on their non-dominant wrist and completed 3-d physical activity recalls each week. RESULTS Children reported watching more television (p < 0.001) and demonstrated lower daytime actigraph-measured activity counts per epoch (p = 0.03) when sleep was decreased (compared with increased). However, total actigraph-measured activity counts accrued throughout the entire waking period were higher when sleep was decreased (and children were awake for longer) than when it was increased (p < 0.001). CONCLUSION(S) Short sleep during childhood may lead to increased television viewing and decreased mean activity levels. Although additional time awake may help to counteract negative effects of short sleep, increases in reported sedentary activities could contribute to weight gain over time.
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Affiliation(s)
- C. N. Hart
- Center for Obesity Research and Education, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, USA
| | - N. Hawley
- Department of Chronic Disease Epidemiology, Yale University, New Haven, USA
| | - A. Davey
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, USA
| | - M. Carskadon
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, USA,Centre for Sleep Research, University of South Australia, Adelaide, Australia
| | - H. Raynor
- Department of Nutrition, University of Tennessee, Knoxville, USA
| | - E. Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, USA,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, USA
| | - J. Owens
- Department of Neurology and Center for Pediatric Sleep Disorders, Boston Children's Hospital, Boston, USA
| | - R. Considine
- Department of Medicine, Indiana University School of Medicine, Indianapolis, USA
| | - R. R. Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, USA,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, USA
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Harrex HAL, Skeaff SA, Black KE, Davison BK, Haszard JJ, Meredith-Jones K, Quigg R, Saeedi P, Stoner L, Wong JE, Skidmore PML. Sleep timing is associated with diet and physical activity levels in 9-11-year-old children from Dunedin, New Zealand: the PEDALS study. J Sleep Res 2017; 27:e12634. [DOI: 10.1111/jsr.12634] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 10/04/2017] [Indexed: 01/13/2023]
Affiliation(s)
| | - Sheila A. Skeaff
- Department of Human Nutrition; University of Otago; Dunedin New Zealand
| | | | | | | | | | - Robin Quigg
- Department of Preventative and Social Medicine; University of Otago; Dunedin New Zealand
| | - Pouya Saeedi
- Department of Human Nutrition; University of Otago; Dunedin New Zealand
| | - Lee Stoner
- Department of Exercise and Sports Science; University of North Carolina; Chapel Hill NC USA
| | - Jyh E. Wong
- Faculty of Health Sciences; Universiti Kebangsaan Malaysia; Kuala Lumpur Malaysia
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Cross-sectional associations between sleep duration, sedentary time, physical activity, and adiposity indicators among Canadian preschool-aged children using compositional analyses. BMC Public Health 2017; 17:848. [PMID: 29219077 PMCID: PMC5773862 DOI: 10.1186/s12889-017-4852-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Sleep duration, sedentary behaviour, and physical activity are three co-dependent behaviours that fall on the movement/non-movement intensity continuum. Compositional data analyses provide an appropriate method for analyzing the association between co-dependent movement behaviour data and health indicators. The objectives of this study were to examine: (1) the combined associations of the composition of time spent in sleep, sedentary behaviour, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) with adiposity indicators; and (2) the association of the time spent in sleep, sedentary behaviour, LPA, or MVPA with adiposity indicators relative to the time spent in the other behaviours in a representative sample of Canadian preschool-aged children. Methods Participants were 552 children aged 3 to 4 years from cycles 2 and 3 of the Canadian Health Measures Survey. Sedentary time, LPA, and MVPA were measured with Actical accelerometers (Philips Respironics, Bend, OR USA), and sleep duration was parental reported. Adiposity indicators included waist circumference (WC) and body mass index (BMI) z-scores based on World Health Organization growth standards. Compositional data analyses were used to examine the cross-sectional associations. Results The composition of movement behaviours was significantly associated with BMI z-scores (p = 0.006) but not with WC (p = 0.718). Further, the time spent in sleep (BMI z-score: γsleep = −0.72; p = 0.138; WC: γsleep = −1.95; p = 0.285), sedentary behaviour (BMI z-score: γSB = 0.19; p = 0.624; WC: γSB = 0.87; p = 0.614), LPA (BMI z-score: γLPA = 0.62; p = 0.213, WC: γLPA = 0.23; p = 0.902), or MVPA (BMI z-score: γMVPA = −0.09; p = 0.733, WC: γMVPA = 0.08; p = 0.288) relative to the other behaviours was not significantly associated with the adiposity indicators. Conclusions This study is the first to use compositional analyses when examining associations of co-dependent sleep duration, sedentary time, and physical activity behaviours with adiposity indicators in preschool-aged children. The overall composition of movement behaviours appears important for healthy BMI z-scores in preschool-aged children. Future research is needed to determine the optimal movement behaviour composition that should be promoted in this age group.
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Duraccio KM, Jensen CD. Associations between physical and sedentary activity regularity and sleep in preschoolers and kindergartners. Sleep Health 2017; 3:263-268. [DOI: 10.1016/j.sleh.2017.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/13/2017] [Accepted: 04/03/2017] [Indexed: 11/27/2022]
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Interrelationship between Sleep and Exercise: A Systematic Review. Adv Prev Med 2017; 2017:1364387. [PMID: 28458924 PMCID: PMC5385214 DOI: 10.1155/2017/1364387] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/13/2017] [Indexed: 01/08/2023] Open
Abstract
Although a substantial body of literature has explored the relationship between sleep and exercise, comprehensive reviews and definitive conclusions about the impact of exercise interventions on sleep are lacking. Electronic databases were searched for articles published between January 2013 and March 2017. Studies were included if they possessed either objective or subjective measures of sleep and an exercise intervention that followed the guidelines recommended by the American College of Sports Medicine. Thirty-four studies met these inclusion criteria. Twenty-nine studies concluded that exercise improved sleep quality or duration; however, four found no difference and one reported a negative impact of exercise on sleep. Study results varied most significantly due to participants' age, health status, and the mode and intensity of exercise intervention. Mixed findings were reported for children, adolescents, and young adults. Interventions conducted with middle-aged and elderly adults reported more robust results. In these cases, exercise promoted increased sleep efficiency and duration regardless of the mode and intensity of activity, especially in populations suffering from disease. Our review suggests that sleep and exercise exert substantial positive effects on one another; however, to reach a true consensus, the mechanisms behind these observations must first be elucidated.
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Farmer VL, Williams SM, Mann JI, Schofield G, McPhee JC, Taylor RW. The effect of increasing risk and challenge in the school playground on physical activity and weight in children: a cluster randomised controlled trial (PLAY). Int J Obes (Lond) 2017; 41:793-800. [PMID: 28186099 DOI: 10.1038/ijo.2017.41] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 12/20/2016] [Accepted: 01/31/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND To investigate whether changing the play environment in primary schools to one that includes greater risk and challenge increases physical activity and reduces body mass index (BMI). SUBJECTS/METHODS A 2-year cluster randomised controlled trial was undertaken in 16 New Zealand schools (years 1-8). Intervention schools (n=8) redesigned their play environments to encourage imaginative and independent free play by increasing opportunities for risk and challenge (for example, rough-and-tumble play), reducing rules and adding new playground components (for example, loose parts). Control schools (n=8) were asked to not change their play environment. A qualified playworker rated all school play environments at baseline and 1 year. Primary outcomes were moderate-to-vigorous physical activity (7-day accelerometry) and BMI z-score, collected in 840 children at baseline, 1 and 2 years. Data were analysed using generalised estimating equations. RESULTS Multiple changes were made to the school play environments resulting in a significant difference in overall play evaluation score between intervention and control schools of 4.50 (95% confidence interval: 1.82 to 7.18, P=0.005), which represents a substantial improvement from baseline values of 19.0 (s.d. 3.2). Overall, schools liked the intervention and reported many benefits, including increased physical activity. However, these beliefs did not translate into significant differences in objectively measured physical activity, either as counts per minute (for example, 35 (-51 to 120) during lunch break) or as minutes of moderate-to-vigorous physical activity (0.4, -1.1 to 2.0). Similarly, no significant differences were observed for BMI, BMI z-score or waist circumference at 1 or 2 years (all P>0.321). CONCLUSIONS Altering the school play environment to one that promoted greater risk and challenge for children did not increase physical activity, nor subsequently alter body weight. Although schools embraced the concept of adding risk and challenge in the playground, our findings suggest that children may have been involved in different, rather than additional activities.
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Affiliation(s)
- V L Farmer
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - S M Williams
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - J I Mann
- Department of Medicine, University of Otago, Dunedin, New Zealand.,Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - G Schofield
- Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
| | - J C McPhee
- Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
| | - R W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Hager ER, Calamaro CJ, Bentley LM, Hurley KM, Wang Y, Black MM. Nighttime Sleep Duration and Sleep Behaviors among Toddlers from Low-Income Families: Associations with Obesogenic Behaviors and Obesity and the Role of Parenting. Child Obes 2016; 12:392-400. [PMID: 27447782 PMCID: PMC5041548 DOI: 10.1089/chi.2015.0252] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Shortened sleep duration is associated with poor health and obesity among young children. Little is known about relationships among nighttime sleep duration, sleep behaviors, and obesogenic behaviors/obesity among toddlers. This study characterizes sleep behaviors/duration and examines relationships with obesogenic behaviors/obesity among toddlers from low-income families. METHODS Mothers of toddlers (age 12-32 months) were recruited from urban/suburban sites serving low-income families. Mothers provided demographic information and completed the Brief Infant Sleep Questionnaire (BISQ); a 6-item Toddler Sleep Behavior Scale was derived (TSBS-BISQ, higher score reflects more recommended behaviors). Toddler weight/length were measured; obesity defined as ≥95th percentile weight-for-length. Measures of obesogenic behaviors: physical activity [accelerometry, minutes/day in Moderate-to-Vigorous Physical Activity (MVPA)] and diet quality [24-hour recall, Healthy Eating Index 2005 (HEI-2005)]. Bivariate and adjusted multivariable models examined associations between nighttime sleep behaviors/duration and obesogenic behaviors/obesity. RESULTS Sample included 240 toddlers (mean age = 20.2 months), 55% male, 69% black, 59% urban. Toddlers spent 55.4 minutes/day in MVPA, mean HEI-2005 score was 55.4, 13% were obese. Mean sleep duration was 9.1 hours, with 35% endorsing 5-6 recommended sleep behaviors (TSBS-BISQ). In multivariable models, MVPA was positively related to sleep duration; obese toddlers had a shorter nighttime sleep duration than healthy weight toddlers [odds ratio = 0.69, p = 0.014]. Nighttime sleep duration was associated with high TSBS-BISQ scores, F = 6.1, p = 0.003. CONCLUSIONS Toddlers with a shorter nighttime sleep duration are at higher risk for obesity and inactivity. Interventions to promote healthy sleep behaviors among toddlers from low-income families may improve nighttime sleep duration and reduce obesogenic behaviors/obesity.
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Affiliation(s)
- Erin R. Hager
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | | | | | - Kristen M. Hurley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Yan Wang
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
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Kim Y, Umeda M, Lochbaum M, Stegemeier S. Physical Activity, Screen-Based Sedentary Behavior, and Sleep Duration in Adolescents: Youth Risk Behavior Survey, 2011-2013. Prev Chronic Dis 2016; 13:E131. [PMID: 27634781 PMCID: PMC5027845 DOI: 10.5888/pcd13.160245] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This study examined the concurrent associations of physical activity and screen-based sedentary behavior with sleep duration among adolescents by using data from the national Youth Risk Behavior Survey 2011–2013. Using latent class analysis, we identified 4 latent subgroups of adolescents with various levels of physical activity and screen-based sedentary behavior. The subgroup with high levels of physical activity and low levels of sedentary behavior generally showed greater odds of having sufficient sleep (≥8 hours/night) than the other subgroups. Findings imply that concurrent achievement of a high level of physical activity and low level of screen-based sedentary behavior is necessary to promote sufficient sleep among adolescents.
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Affiliation(s)
- Youngdeok Kim
- Box 43011, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409.
| | - Masataka Umeda
- Department of Kinesiology, Health, and Nutrition, University of Texas at San Antonio
| | - Marc Lochbaum
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Steven Stegemeier
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
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