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Xue P, Benedict C. Adequate sleep is important for children's cardiometabolic health. Acta Paediatr 2024; 113:1744-1745. [PMID: 38816906 DOI: 10.1111/apa.17312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Affiliation(s)
- Pei Xue
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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2
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Robbins R, Quan S. Sleep Health. NEJM EVIDENCE 2024; 3:EVIDra2300269. [PMID: 39041870 DOI: 10.1056/evidra2300269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
AbstractSleep is what we spend (or should spend) one third of our lives doing. Unfortunately, many individuals fall short of their biological need for sleep many nights of the week. The reasons for this are varied and include professional or personal obligations and social determinants, including loud noises or safety concerns in one's neighborhood. This article reviews the architecture of sleep; evidence for sleep health, including impacts of sleep health on mental and emotional health as well as cognitive function and performance; and strategies for improving sleep health.
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Affiliation(s)
- Rebecca Robbins
- Division of Sleep Medicine, Harvard Medical School, Boston
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham & Women's Hospital, Boston
| | - Stuart Quan
- Division of Sleep Medicine, Harvard Medical School, Boston
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham & Women's Hospital, Boston
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Palao-Loayza L, Yupanqui-Lorenzo DE, Arauco-Lozada T, Caycho-Rodríguez T, Seminario Ortiz HD, Lobos Rivera ME, Cardoza-Sernaqué MA, Pulido-Joo LA, Pulido-Capurro V, Cárcamo-Zepeda E, Mendoza-Sierra MI, Cuellar-Hernández MDL, Torres López A, Torales J, Barrios I. Cross-cultural validation of the Jenkins Sleep Scale in Spanish-speaking countries. J Health Psychol 2024:13591053241261349. [PMID: 39077835 DOI: 10.1177/13591053241261349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
The study aimed to validate the Jenkins Sleep Scale (JSS-4) in six Spanish-Speaking countries. A total of 1726 people participated and were distributed between men (32.4%) and women (67.6%). Confirmatory factor analysis confirmed the unidimensional structure and high reliability of the JSS-4 overall (α = 0.85, ω = 0.81) and within each country. The invariance analysis revealed that JSS-4 exhibited complete invariance across countries, thus establishing a robust foundation for inter-group comparisons. Interestingly, a comparative analysis revealed significant differences in the average levels of sleep difficulties, with particularly high rates in Spain and Chile. Item Response Theory (IRT) showed sufficient discrimination parameters for all items, and a correlation of 0.998 between Confirmatory Factor Analysis (CFA) and IRT highlighted the robustness and reliability of the results obtained. In summary, JSS-4 exhibits strong evidence of validity and consistency in measurement invariance across the six countries.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Julio Torales
- Universidad Nacional de Asunción, Paraguay
- Universidad Nacional de Caaguazú, Paraguay
- Universidad Sudamericana, Paraguay
| | - Iván Barrios
- Universidad Nacional de Asunción, Paraguay
- Universidad Sudamericana, Paraguay
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Rodríguez-Negro J, Llodio I, Yanci J. Physical Activity Habits and Sleep Duration According to Gender: A Cross-Sectional Study of Elementary School Children. Healthcare (Basel) 2024; 12:1400. [PMID: 39057543 PMCID: PMC11276517 DOI: 10.3390/healthcare12141400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/09/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: The main goals of this study were to describe the physical activity (PA) and sleep habits of 8-12-year-old children according to their gender and to evaluate the relationship between PA and sleep habits (i.e., duration and timing). (2) Methods: A total of 236 children (114 boys and 122 girls) completed the Physical Activity Questionnaire for Older Children (PAQ-C) and an ad hoc sleep habits questionnaire. (3) Results: Boys were more physically active than girls (2.62 ± 0.51 vs. 2.46 ± 0.48, p = 0.026) and enacted higher PA levels in school recess (3.82 ± 1.36 vs. 3.56 ± 1.38, p = 0.003), during the afternoon (3.37 ± 1.20 vs. 2.89 ± 1.12, p = 0.003), and during weekends (3.54 ± 1.20 vs. 3.18 ± 0.48, p = 0.009). Per sleep habits, boys had a significantly later bedtime (21:53 ± 2:08 vs. 21:34 ± 2:14, p = 0.009) and a significantly smaller total sleep duration (9.64 ± 0.86 vs. 9.89 ± 0.87 h, p = 0.023) than girls. No significant correlations between PA and sleep habits were found. (4) Conclusions: We found differences in the PA and sleep habits between school-age boys and girls. Institutions and entities should consider designing specific interventions to improve PA and sleep habits according to gender.
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Affiliation(s)
- Josune Rodríguez-Negro
- Faculty of Education and Sport, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Iñaki Llodio
- AKTIBOki: Research Group in Physical Activity, Physical Exercise and Sport, Sports and Physical Exercise Research Group (GIKAFIT), Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain; (I.L.); (J.Y.)
| | - Javier Yanci
- AKTIBOki: Research Group in Physical Activity, Physical Exercise and Sport, Sports and Physical Exercise Research Group (GIKAFIT), Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain; (I.L.); (J.Y.)
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Lederer-Hutsteiner T, Müller KW, Penker M, Stolz E, Greimel ER, Freidl W. The mediating effect of after-midnight use of digital media devices on the association of internet-related addictive behavior and insomnia in adolescents. Front Public Health 2024; 12:1422157. [PMID: 39056075 PMCID: PMC11269230 DOI: 10.3389/fpubh.2024.1422157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
Background There is evidence that overexposure to digital media devices (DMD) can not only lead to addictive patterns of internet use, but also cause insomnia symptoms. The aim of this cross-sectional study among adolescents is to provide an estimate of the prevalence of sleep impairments and to explore the mediating role of after-midnight use of DMD between internet-related addictive behavior (IRAB) and insomnia. Methods 2,712 school students from Styrian schools participated in a population-representative online survey in a supervised school setting in spring 2022. School students were screened using established and validated scales. Data analysis was carried out using multiple imputation, linear multilevel regression and mediation analysis. Results Prevalence estimation indicates high proportions of clinically relevant moderate [12.6% (11.3%; 14.1%)] and severe [3.6% (2.9%; 4.4%)] insomnia, with an additional 30.6% (29.0%; 32.2%) at subthreshold level. DMD are typically used after midnight an average of 1.66 (1.58; 1.75) evenings with subsequent school day per school week. Linear multilevel regression analysis shows significant associations for sleep disparities as outcome variable e.g., with generalized anxiety [b = 0.329 (0.287; 0.371)], after-midnight use of DMD [b = 0.470 (0.369; 0.572)] and IRAB [b = 0.131 (0.097; 0.165)]. Mediation analysis shows a mediated proportion of 18.2% (13.0%; 25.0%) of the association of IRAB and insomnia by after-midnight use of DMD [Indirect effect: b = 0.032 (0.023; 0.040), direct effect: b = 0.127 (0.083; 0.170)]. Conclusions Although the cross-sectional nature of this study limits causal inference, the results indicate a need for policies, which are already in preparation in Styria as part of a respective action plan.
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Affiliation(s)
| | - Kai W Müller
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthias Penker
- Center for Social Research, University of Graz, Graz, Austria
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Elfriede R Greimel
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Wolfgang Freidl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
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Li S, Li X, Wang J, Jiang D, Zhang Y, Lou W, Bao K, Gong Q. Associations between insufficient sleep, skipping breakfast and depressive symptoms in children and adolescents: A school-based cross-sectional study in China. Prev Med 2024; 184:107978. [PMID: 38697227 DOI: 10.1016/j.ypmed.2024.107978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/27/2024] [Accepted: 04/28/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE Insufficient sleep and skipping breakfast are increasingly prevalent among children and adolescents. Both behaviors are associated with the onset of depression. This study aims to examine the independent and joint associations of these two behaviors with depressive symptoms, and investigate whether these associations varied by age or sex. METHODS The Center for Epidemiological Studies Depression Scale (CES-D) was used to evaluate the depressive symptoms. This cross-sectional study including 11,887 students aged 11-19 years using a stratified cluster, multistage sampling method in Ningbo, China. Multiple logistic regressions were conducted to evaluate the independent and joint association between insufficient sleep, skipping breakfast and depressive symptoms. Sensitivity analyses and stratified analyses by age and sex were performed using the same modelling strategies. RESULTS The overall prevalence of depressive symptoms was 15.27%. Skipping breakfast (Odds Ratio (OR) = 2.557, 95% Confidence Interval (CI) = 2.236-2.925) and insufficient sleep (OR = 1.547, 95%CI = 1.390-1.723) was independently associated with depressive symptoms. Compared to students with "sufficient sleep and breakfast every day", the OR was 4.385 (95%CI = 3.649-5.271) for those with "insufficient sleep and skipping breakfast". Meanwhile, the joint association was moderated by age group, with a more apparent association observed in the 11-15-year-old group compared to the 16-19-year-old group. CONCLUSIONS These findings indicated that insufficient sleep and skipping breakfast were independently and jointly associated with depressive symptoms. Insufficient sleep and skipping breakfast could be considered as two of the predictors of depression.
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Affiliation(s)
- Sixuan Li
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315016, Zhejiang Province, China
| | - Xiaoyong Li
- Yinzhou District Center for Disease Control and Prevention, Ningbo 315100, Zhejiang Province, China
| | - Jinghui Wang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315016, Zhejiang Province, China
| | - Danjie Jiang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315016, Zhejiang Province, China
| | - Yan Zhang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315016, Zhejiang Province, China
| | - Wangwei Lou
- Ninghai Center for Disease Prevention and Control, Ningbo 315600, Zhejiang Province, China
| | - Kaifang Bao
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315016, Zhejiang Province, China
| | - Qinghai Gong
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315016, Zhejiang Province, China.
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Kogon AJ, Maqsood AM, LoGuidice J, Amaral S, Meyers K, Mitchell JA. Sleep Duration and Blood Pressure in Youth Referred for Elevated Blood Pressure Evaluation. Pediatrics 2024; 154:e2023062940. [PMID: 38887814 DOI: 10.1542/peds.2023-062940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Sleep promotion is not specifically recommended as a target for hypertension management. We examined associations of sleep duration and timing with blood pressure parameters in patients referred to pediatric nephrology clinic for elevated blood pressure evaluation. METHODS This is a retrospective study of initial ambulatory blood pressure monitoring data and self-report sleep data collected from patients referred to nephrology clinic for the evaluation of elevated blood pressure. Linear and logistic regression modeling determined associations between sleep exposures (duration and timing) and continuous and dichotomous blood pressure outcomes, respectively, adjusted for age, sex, body mass index, and weekday versus weekend status. RESULTS The study sample included 539 patients with mean age 14.6 years and 56% meeting hypertension criteria. Sleep duration averaged 9.1 hours per night. Average timing of sleep onset and offset were 11:06 pm and 8:18 am, respectively. Longer sleep duration was associated with better daytime blood pressure parameters (eg, every extra hour of sleep duration was associated with a reduced odds of wake hypertension [odds ratio, 0.88; 95% CI, 0.79-0.99]). Later sleep onset was associated with worse daytime blood pressure parameters (eg, each additional hour of later sleep onset was associated with higher wake systolic blood pressure index [mean wake blood pressure/95th percentile]) (β = 0.07; 95% CI, 0.02-0.13). Associations were consistent across sex, age, body mass index, and weekday status. CONCLUSIONS Longer sleep duration and earlier sleep onset were associated with lower blood pressure. This suggests that sleep optimization may be an important target for intervention in hypertension management.
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Affiliation(s)
- Amy J Kogon
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Anam M Maqsood
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jill LoGuidice
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sandra Amaral
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kevin Meyers
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Fong-Isariyawongse J. Revolutionizing Student Athletes' Success: The Transformative Impact of Sleep and the Urgent Call for Later School Start Times. Sports Health 2024; 16:501-503. [PMID: 38900134 PMCID: PMC11195868 DOI: 10.1177/19417381241257949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
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Fong-Isariyawongse J, Kothare SV. Shaping Brighter Futures: The Transformative Impact of Sleep on Children and Adolescent Well-Being. Pediatr Neurol 2024; 156:51-52. [PMID: 38733853 DOI: 10.1016/j.pediatrneurol.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Affiliation(s)
| | - Sanjeev V Kothare
- Division of Pediatric Neurology, Northwell, Cohen Children's Medical Center, New York, New York; Professor of Neurology & Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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Coelho J, Montagni I, Micoulaud-Franchi JA, Taillard J, Philip P, Plancoulaine S, Tzourio C. Why circadian rhythmicity matters: Associations between sleep irregularity and mental health conditions during the Covid-19 health crisis. World J Biol Psychiatry 2024; 25:330-341. [PMID: 38803010 DOI: 10.1080/15622975.2024.2359975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE To assess the association between sleep irregularity, anxiety, and depression while controlling for other sleep dimensions and using a longitudinal design. METHODS Longitudinal cohort study which started in April 2020 during the first French lockdown in the general population. Follow-up questionnaires were completed in June 2020, a period without lockdown measures. Participants were asked about their sleep (regularity, duration, timing, complaints) and their anxiety (General Anxiety Disorder-7) and depressive (Patient Health Questionnaire-9) symptoms. RESULTS A total of 3745 participants were included (mean age: 28.9 years) with 2945 women (78.6%). At baseline, 38.1% (1428) of participants reported irregular sleep timing, 23.8% (891) anxiety and 28.9% (1081) depressive symptoms. In cross-sectional analyses, irregular sleep timing was associated with a 2.5-fold higher likelihood of anxiety and a 4-fold higher likelihood of depressive symptoms compared to regular sleepers. Associations were not explained by the other sleep dimensions and persisted in a longitudinal analysis, with irregular sleep timing at baseline being associated with anxiety (OR = 3.27[1.58-6.76]) and depressive symptoms (OR = 3.45[1.66-7.19]) during follow-up. CONCLUSION The results show a strong association between sleep irregularity and mental health. Furthers studies are needed to explore how sleep regularity could promote good mental health in non-clinical populations.
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Affiliation(s)
- Julien Coelho
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Ilaria Montagni
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Jacques Taillard
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Pierre Philip
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Sabine Plancoulaine
- Université Paris Cité, INSERM, INRAE, Centre de Recherche en Epidémiologie et StatistiquesS (CRESS), Paris, France
| | - Christophe Tzourio
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
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da Silva NC, Giacheti CM, do Couto MCH, de Jesus SS, Ribeiro EM, Verçosa IMC, Pinato L. Association between Sleep and Language Development in Children with Congenital Zika Syndrome. Viruses 2024; 16:1003. [PMID: 39066166 PMCID: PMC11281447 DOI: 10.3390/v16071003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 07/28/2024] Open
Abstract
AIM Congenital Zika Virus Syndrome (CZS) presents notable hurdles to neurodevelopment, with language development emerging as a crucial aspect. This study investigates sleep patterns and language skills in children with CZS, aiming to explore the potential synchronization of sleep development with their neurodevelopment. METHOD We studied cross-sectionally 135 children with CZS aged 0 to 48 months, investigating sleep using the BISQ Questionnaire. Language development was assessed using the Early Language Milestone Scale, while motor development and cognitive and social ability were assessed using the Bayley Scales of Infant and Young Child Development 3rd edition. We also studied longitudinally a cohort of 16 children (initially aged 0 to 12 months) whom we followed for four years, assessing at one-year intervals. RESULTS Sleep disturbances and language deficits were highly frequent in this population. In the 0-12 months group, a late bedtime and frequent nighttime awakenings were associated with poorer auditory expressive skills. At 13-24 months, nighttime awakenings were associated with poorer auditory expressive skills, while among 25-36-month-olds decreased auditory receptive skills were associated with longer sleep onset latency and reduced nighttime sleep duration. CONCLUSION The brain alterations caused by Zika virus infection affect both sleep disturbances and delays in language development. It is possible that sleep disturbance may be a mediating factor in the pathway between CZS and delayed language development, as the three analyzed language skills showed a correlation with sleep parameters.
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Affiliation(s)
- Nathani C. da Silva
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marília 17525-900, Brazil; (N.C.d.S.); (C.M.G.); (M.C.H.d.C.); (S.S.d.J.)
| | - Celia M. Giacheti
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marília 17525-900, Brazil; (N.C.d.S.); (C.M.G.); (M.C.H.d.C.); (S.S.d.J.)
| | - Maria C. H. do Couto
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marília 17525-900, Brazil; (N.C.d.S.); (C.M.G.); (M.C.H.d.C.); (S.S.d.J.)
| | - Stefany S. de Jesus
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marília 17525-900, Brazil; (N.C.d.S.); (C.M.G.); (M.C.H.d.C.); (S.S.d.J.)
| | | | - Islane M. C. Verçosa
- Center for Perfecting Sight See Hope Reviver (CAVIVER), Fortaleza 60110-370, Brazil;
| | - Luciana Pinato
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marília 17525-900, Brazil; (N.C.d.S.); (C.M.G.); (M.C.H.d.C.); (S.S.d.J.)
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Kosola S, Kullberg M, Melander K, Engblom J, Ranta K, Alanko K. Associations of excessive internet use, sleep duration and physical activity with school absences: a cross-sectional, population-based study of adolescents in years 8 and 9. Arch Dis Child 2024; 109:570-575. [PMID: 38627028 PMCID: PMC11228184 DOI: 10.1136/archdischild-2023-326331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/08/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Internet use has increased and sleep and physical activity (PA) have decreased in recent years among adolescents. Besides sleep and PA, another determinant of future health for adolescents is education. Our aim was to evaluate the associations of excessive internet use (EIU), short sleep duration and low PA with both unexcused absences and medical absences during lower secondary school. METHODS The School Health Promotion study is a national survey of adolescents conducted biennially in Finland. We used data collected in 2019, when EIU was assessed for the first time. Cumulative odds ratio analysis was conducted with unexcused absences and medical absences as outcome variables. Besides EIU, sleep duration and PA, the associations of maternal education and parental relations were assessed. RESULTS The mean age of the 86 270 participants was 15.3 years. Girls scored higher than boys on EIU. In all, 34.7% of participants slept less than 8 hours per night during the school week, and 34.3% reported low PA (ie, less than 3 days per week with minimum 1 hour of PA per day). EIU, short sleep and low PA were associated with both unexcused absences and medical absences from school. Longer sleep during weekends showed no association with absences, but good parental relations had the strongest protective association with both unexcused and medical absences. CONCLUSIONS EIU, short sleep duration and low PA were associated with both unexcused and medical absences from school. This has important implications for both the promotion of general health and the support offered to students with alarming school absences.
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Affiliation(s)
- Silja Kosola
- Research, Development and Innovations, Western Uusimaa Wellbeing Services County, Espoo, Finland
- Pediatric Research Center, Helsingin ja uudenmaan sairaanhoitopiiri, Helsinki, Finland
| | - Marianne Kullberg
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Abo, Finland
| | - Katja Melander
- Doctoral Programme in Population Health, University of Helsinki, Helsinki, Finland
- Faculty of Medicine, Tampere University, Tampere, Finland
| | - Janne Engblom
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Klaus Ranta
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Katarina Alanko
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Abo, Finland
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13
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Leman TY, Barden S, Swisher VS, Joyce DS, Kaplan KA, Zeitzer JM, Loo SK, Ricketts EJ. Sleep insufficiency and bedtime irregularity in children with ADHD: A population-based analysis. Sleep Med 2024; 121:117-126. [PMID: 38959718 DOI: 10.1016/j.sleep.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/09/2024] [Accepted: 06/14/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Sleep is impaired in children with attention-deficit/hyperactivity disorder (ADHD). However, population-based examination of indicators of sleep insufficiency and bedtime irregularity is limited. This investigation examined associations between ADHD, weeknight sleep insufficiency, and bedtime irregularity in a nationally-representative child sample, and indicators of these sleep outcomes in ADHD. METHODS Parents of children aged 3-17 years with ADHD (n = 7671) were surveyed through the 2020-2021 National Survey of Children's Health. Inverse probability of treatment weighting generated a weighted matched control sample (n = 51,572). Weighted generalized linear models were performed without and with age-stratification to examine associations between ADHD and sleep, adjusting for sociodemographics in the full sample, and between nineteen sociodemographic and clinical variables and sleep in ADHD. RESULTS Having ADHD was associated with increased odds of sleep insufficiency and bedtime irregularity relative to controls, even after adjusting for sociodemographic variables. In ADHD, older age was associated with lower sleep insufficiency and greater bedtime irregularity. Black race, increased poverty, higher ADHD severity, depression, and increased screen time were associated with greater sleep insufficiency and bedtime irregularity. Adverse childhood experiences (ACEs) were associated with greater sleep insufficiency. Behavioral/conduct problems, female sex, and absence of both ADHD medication use and ASD diagnosis were associated with poorer bedtime irregularity. Age-stratified results are reported in text. CONCLUSIONS Children with ADHD face heightened risk for insufficient sleep and irregular bedtimes. Findings suggest intervention targets (e.g., Black race, poverty, depression, screen time) to improve both sleep insufficiency and bedtime irregularity. Results highlight ACEs and behavioral/conduct problems as targets to improve sleep insufficiency and bedtime regularity, respectively. Age-stratified findings are discussed.
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Affiliation(s)
- Talia Y Leman
- Department of Psychological and Brain Sciences, University of Iowa, USA
| | - Sophia Barden
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Valerie S Swisher
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Daniel S Joyce
- Centre for Health Research and School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Katherine A Kaplan
- Department of Psychiatry and Behavioral Sciences, Stanford University, USA
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, USA
| | - Sandra K Loo
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
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Drews-Botsch C, Cotsonis G, Celano M, Hartmann EE, Zaidi J, Lambert SR. Patching in Children With Unilateral Congenital Cataract and Child Functioning and Parenting Stress. JAMA Ophthalmol 2024; 142:503-510. [PMID: 38635258 PMCID: PMC11190795 DOI: 10.1001/jamaophthalmol.2024.0800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/20/2024] [Indexed: 04/19/2024]
Abstract
Importance Parents may be concerned about the adverse outcomes of occlusion therapy in children treated for unilateral congenital cataract (UCC). Objective To determine whether occlusion therapy in children treated for UCC with poor visual outcomes is negatively associated with poorer child and/or family functioning. Design, Setting, and Participants This cohort study was conducted in 2023 using data collected between 2006 and 2016 in the Infant Aphakia Treatment Study (IATS). IATS participants with a visual acuity (VA) of 20/200 or worse were included. Statistical analysis was performed from July 2022 to October 2023. Exposure Caregivers reported the mean daily minutes of patching during the 12 months prior to the VA assessment at 4.5 years of age. Patching was categorized as minimal (<15 minutes per day), moderate (15 to <120 minutes per day), or extensive (≥120 minutes per day). Main Outcome Measures At 4.25 and 10.5 years of age, caregivers reported stress associated with the parenting role using the Parenting Stress Index and the Ocular Treatment Index and child behavior problems using the Achenbach Child Behavior Checklist. Motor skills were assessed at age 54 months using the Movement Assessment Battery for Children-Second Edition. Children completed the Harter Self-Perception Profile for Children at age 10.5 years. One-way analysis of variance and χ2 tests were used to compare outcomes by amount of patching. Results Patching data were available for 47 of 53 children (88.7%) with a VA of 20/200 or worse. Among these 47 children with patching data included in the study, 20 (42.5%) were female, 27 (57.5%) were male, 12 (25.5%) were reported to have been patched fewer than 15 minutes per day, 11 (23.4%) were patched 16 to 119 minutes per day, and 24 (51.1%) were patched at least 120 minutes per day. Parenting stress, child behavior problems, motor functioning, and child self-perception were similar in all groups. For example, after adjusting for gender and insurance status, there was a nonsignificant difference between mean stress scores of 11.0 (95% CI, -4.5 to 26.5) points for parents who reported minimal patching vs parents who reported patching at least 120 minutes per day, and there was no significant difference in children's report of their global self-worth (0.0 [95% CI, -0.4 to 0.3] points). Conclusions and Relevance Occlusion therapy was not negatively associated with family or child functioning. Although the sample size was limited, these results do not support changes to the current practice guidelines.
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Affiliation(s)
- Carolyn Drews-Botsch
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia
| | - George Cotsonis
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Marianne Celano
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - E. Eugenie Hartmann
- Rebecca D. Considine Research Institute and Vision Center, Akron Children’s Hospital, Akron, Ohio
| | - Jaffer Zaidi
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia
| | - Scott R. Lambert
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
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15
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Orenay OM, Temel B, Capci AK, Bal ZI, Karaosmanoglu N. Evaluation of isotretinoin effects on depression, sleep apnea and sleep quality. Cutan Ocul Toxicol 2024; 43:129-133. [PMID: 38608451 DOI: 10.1080/15569527.2024.2340435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Isotretinoin is used to treat severe acne, treatment-resistant moderate acne, and acne that leads to scarring or psychological distress. It has many side effects and is also associated with depression, sleep apnea, and sleep disturbances. OBJECTIVES In this study, we aimed to evaluate the effects of isotretinoin on depression, sleep apnea, and sleep quality. METHODS A total of 42 patients diagnosed with acne and started isotretinoin treatment were included in the study. In order to compare the effects of isotretinoin, patients were asked to fill out a questionnaire containing the Beck Depression Inventory (BDI), the Berlin Questionnaire (BQ), and the Pittsburg Sleep Quality Index (PSQI) at baseline and third months of treatment. RESULTS There was no statistically significant difference in BDI, BQ, and PSQI scores between the 1st and 3rd months of treatment (p = .53, p = .5, p = .35). CONCLUSION This study showed that isotretinoin had no significant effects on depression and sleep quality.
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Affiliation(s)
- Ozge Mine Orenay
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Berkay Temel
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Arcan Kivanc Capci
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Zulal Inci Bal
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Nermin Karaosmanoglu
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
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16
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Hoyniak CP, Vogel AC, Puricelli A, Luby JL, Whalen DJ. Day-to-day bidirectional associations between sleep and emotion states in early childhood: Importance of end-of-day mood for sleep quality. Sleep Health 2024; 10:264-271. [PMID: 38423949 PMCID: PMC11162920 DOI: 10.1016/j.sleh.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/16/2023] [Accepted: 12/23/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Poor quality sleep can impact emotions and emotion regulation, resulting in a "sleep-mood" cycle where poor sleep affects mood and vice-versa. This relationship is poorly understood during early childhood, when sleep patterns and emotion displays are rapidly changing. This study aimed to understand the day-to-day effects of poor sleep on emotions in preschoolers by using objective (actigraphy) and subjective (ecological momentary assessment) measures to assess both between- and within-child effects. We hypothesized that disrupted sleep would lead to affect disruptions and vice versa. METHODS This study included 133 preschoolers and their caregivers recruited from the community. Children's sleep was measured via actigraphy (ActiGraph GT3X+) across 1week. Affect was collected concurrently via caregiver report during an ecological momentary assessment protocol. Caregivers reported on their child's affect four times per day: morning, afternoon, early evening, and before bed. RESULTS Multilevel modeling analyses revealed that children with sleep disturbances displayed less positive affect overall, more negative affect in the evenings, and alterations in positive affect lability, and that daytime affect was associated with subsequent nighttime sleep. Within-child associations also showed fluctuations in positive affect correlated with shorter sleep durations and later bedtimes. CONCLUSIONS This study identified both between- and within-child associations between sleep and affect in early childhood, revealing a dynamic and reciprocal relationship between the two. These findings highlight the importance of considering both sleep and affect in early childhood interventions, as promoting positive affect may enhance sleep quality and vice versa.
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Affiliation(s)
- Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Alecia C Vogel
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Alex Puricelli
- Foster and Adoptive Care Coalition, St. Louis, Missouri, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Chen SJ, Li SX, Zhang J, Lam SP, Chan JWY, Chan KCC, Li AM, Morin CM, Wing YK, Chan NY. Subtyping at-risk adolescents for predicting response toward insomnia prevention program. J Child Psychol Psychiatry 2024; 65:764-775. [PMID: 37803887 DOI: 10.1111/jcpp.13904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Previous study has shown that a brief cognitive-behavioral prevention insomnia program could reduce 71% risk of developing insomnia among at-risk adolescents. This study aimed to evaluate the differential response to insomnia prevention in subgroups of at-risk adolescents. METHODS Adolescents with a family history of insomnia and subthreshold insomnia symptoms were randomly assigned to a 4-week insomnia prevention program or nonactive control group. Assessments were conducted at baseline, 1 week, and 6- and 12-month after the intervention. Baseline sleep, daytime, and mood profiles were used to determine different subgroups by using latent class analysis (LCA). Analyses were conducted based on the intention-to-treat approach. RESULTS LCA identified three subgroups: (a) insomnia symptoms only, (b) insomnia symptoms with daytime sleepiness and mild anxiety, and (c) insomnia symptoms with daytime sleepiness, mild anxiety, and depression. The incidence rate of insomnia disorder over the 12-month follow-up was significantly reduced for adolescents receiving intervention in subgroup 3 compared with the controls (hazard ratio [HR] = 0.37; 95% confidence interval [CI]: 0.13-0.99; p = .049) and marginally for subgroup 2 (HR = 0.14; 95% CI: 0.02-1.08; p = .059). In addition, adolescents who received intervention in subgroups 2 and 3 had a reduced risk of excessive daytime sleepiness (subgroup 2: adjusted OR [AdjOR] = 0.45, 95% CI: 0.23-0.87; subgroup 3: AdjOR = 0.32, 95% CI: 0.13-0.76) and possible anxiety (subgroup 2: AdjOR = 0.47, 95% CI: 0.27-0.82; subgroup 3: AdjOR = 0.33, 95% CI: 0.14-0.78) compared with the controls over the 12-month follow-up. CONCLUSIONS Adolescents at risk for insomnia can be classified into different subgroups according to their psychological profiles, which were associated with differential responses to the insomnia prevention program. These findings indicate the need for further phenotyping and subgrouping at-risk adolescents to develop personalized insomnia prevention.
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Affiliation(s)
- Si-Jing Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong, SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Siu Ping Lam
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Kate Ching-Ching Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Charles M Morin
- School of Psychology, Université Laval and Centre de recherche CERVO, Quebec City, QC, Canada
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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18
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Larsson I, Svedberg P, Nygren JM, Malmborg JS. Validity and reliability of the Swedish version of the Children's Sleep Habits Questionnaire (CSHQ-SWE). BMC Pediatr 2024; 24:378. [PMID: 38822278 PMCID: PMC11140946 DOI: 10.1186/s12887-024-04859-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND To translate and culturally adapt the Children's Sleep Habits Questionnaire (CSHQ) to a Swedish version, CSHQ-SWE, and to assess its validity and reliability for use with children with attention deficit hyperactivity disorder (ADHD). METHODS A total of 84 children with ADHD (51 boys and 33 girls; 6-12 years) and parents (7 men and 77 women; 28-51 years) were included in the study. CSHQ was translated and culturally adapted to Swedish, and assessed for concurrent validity with sleep actigraphy (analyzed by Kendall's Tau) and for reliability by internal consistency (analyzed by McDonald's Omega H). Face and content validity was evaluated by parents (n = 4) and healthcare professionals (n = 6) qualitatively (comprehensiveness, relevance, and comprehensibility assessed by interviews and analyzed by thematic analysis) and quantitatively (analyzed by content validity ratio and content validity index for 33 items and four non-scored inquiries). RESULTS Parent-reported sleep problems (CSHQ-SWE total score) were moderately correlated with less "Sleep Efficiency" (Tau = -0.305; p < 0.001) measured by sleep actigraphy. Parent-reported problems with "Sleep Onset Delay" was moderately correlated with measured time for "Sleep Onset Latency" (Tau = 0.433; p < 0.001). Parent-reported problems with "Night Wakings" were weakly correlated with measured time for "Wake After Sleep Onset" (Tau = 0.282; p < 0.001). Parents estimation of "Total daily sleep duration" was moderately correlated with measured "Total Sleep Time" (Tau = 0.386; p < 0.001). Five of the seven subscales reached an acceptable level for internal consistency (McDonald's Omega H > 0.700). Comprehensiveness, relevance, and comprehensibility of CSHQ-SWE were satisfactory overall. Content validity ratio was 0.80 to 1.00 for six items, 0.00 to 0.60 for 22 items, and < 0.00 for nine items. Content validity index was 0.22. CONCLUSIONS CSHQ-SWE demonstrated acceptable concurrent validity with objectively measured sleep and internal consistency, whereas the overall results of face and content validity assessment varied. The instrument needs to be further evaluated regarding construct validity, responsiveness, test-retest reliability, and its generalization to other populations.
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Affiliation(s)
- Ingrid Larsson
- School of Health and Welfare, Halmstad University, Box 823, Halmstad, SE-301 18, Sweden
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Box 823, Halmstad, SE-301 18, Sweden
| | - Jens M Nygren
- School of Health and Welfare, Halmstad University, Box 823, Halmstad, SE-301 18, Sweden
| | - Julia S Malmborg
- School of Health and Welfare, Halmstad University, Box 823, Halmstad, SE-301 18, Sweden.
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19
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Hansen M, Simon KR, He X, Steele N, Thomas ML, Noble KG, Merz EC. Socioeconomic factors, sleep timing and duration, and amygdala resting-state functional connectivity in children. Front Psychiatry 2024; 15:1373546. [PMID: 38840942 PMCID: PMC11150855 DOI: 10.3389/fpsyt.2024.1373546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Reduced sleep health has been consistently linked with increased negative emotion in children. While sleep characteristics have been associated with neural function in adults and adolescents, much less is known about these associations in children while considering socioeconomic context. In this study, we examined the associations among socioeconomic factors, sleep duration and timing, and resting-state functional connectivity (rsFC) of the amygdala in children. Methods Participants were typically-developing 5- to 9-year-olds from socioeconomically diverse families (61% female; N = 94). Parents reported on children's weekday and weekend bedtimes and wake-up times, which were used to compute sleep duration and midpoint. Analyses focused on amygdala-anterior cingulate cortex (ACC) connectivity followed by amygdala-whole brain connectivity. Results Lower family income-to-needs ratio and parental education were significantly associated with later weekday and weekend sleep timing and shorter weekday sleep duration. Shorter weekday sleep duration was associated with decreased amygdala-ACC and amygdala-insula connectivity. Later weekend sleep midpoint was associated with decreased amygdala-paracingulate cortex and amygdala-postcentral gyrus connectivity. Socioeconomic factors were indirectly associated with connectivity in these circuits via sleep duration and timing. Discussion These results suggest that socioeconomic disadvantage may interfere with both sleep duration and timing, in turn possibly altering amygdala connectivity in emotion processing and regulation circuits in children. Effective strategies supporting family economic conditions may have benefits for sleep health and brain development in children.
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Affiliation(s)
- Melissa Hansen
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Katrina R. Simon
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Xiaofu He
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Nick Steele
- Molecular, Cellular and Integrative Neuroscience, Colorado State University, Fort Collins, CO, United States
| | - Michael L. Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Kimberly G. Noble
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
| | - Emily C. Merz
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
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Arnison T, Evans B, Schrooten MGS, Persson J, Palermo TM. Adolescent Girls' Musculoskeletal Pain is More Affected by Insomnia Than Boys, and Through Different Psychological Pathways. THE JOURNAL OF PAIN 2024:104571. [PMID: 38763259 DOI: 10.1016/j.jpain.2024.104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
Prior research has established that insomnia is predictive of pain in adolescents and that psychological mechanisms have a crucial role in this relationship. Adolescent girls report more insomnia and pain than boys, yet little is known of gender differences in how insomnia influences pain. This study assessed gender differences in levels and trajectories of insomnia and pain during adolescence, and whether rumination and negative mood mediated the effect of insomnia on pain. Longitudinal survey data measured on 5 annual occasions (Nbaseline = 2,767) were analyzed in a multigroup longitudinal serial mediation model. A final model was generated with insomnia as the predictor, rumination and depressed mood as mediators, pain as the outcome, and gender as the grouping variable. The results showed that insomnia predicted pain in adolescents, with an effect 3.5 times larger in girls than boys. Depressed mood was the main mediator in boys. In girls, rumination was the only significant mediator. There were significant gender differences in the effects of insomnia on rumination and pain, and in the effects of rumination on depressed mood and pain, with stronger effects in girls. These results highlight that girls and boys should be considered separately when studying the relationship between insomnia and pain. PERSPECTIVE: Levels of insomnia and pain are progressively higher in adolescent girls than boys, across adolescence. The predictive strength of insomnia symptoms for future pain is 3.5 times greater in girls, with distinct gender-specific underlying pathways: rumination partially mediates this effect in girls, while depressed mood does so in boys.
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Affiliation(s)
- Tor Arnison
- Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Örebro County, Sweden; School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden.
| | - Brittany Evans
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Martien G S Schrooten
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Jonas Persson
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Stockholm County, Sweden
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology, Pediatrics & Psychiatry, University of Washington School of Medicine, Seattle, Washington
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Voráčová J, Sigmund E, Vorlíček M, Dygrýn J, Sigmundová D. Accelerometer-measured sleep behaviour and parent-child sleep guideline adherence and sleep quality in Czech families with children aged 3-8 years: the FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study. J Sleep Res 2024:e14242. [PMID: 38757216 DOI: 10.1111/jsr.14242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/17/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024]
Abstract
Assessing parent-child relationship in sleep behaviours is important for facilitating changes in the sleep guideline compliance in preschool age children. The aim of this study was to examine accelerometer-measured sleep quantity and quality in families with children aged 3-8 years and investigate the parents' influence on the child's sleep. The data were obtained from the Czech cross-sectional FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study, with a final sample of 374 families. Families were recruited through the enrolment of their children in kindergartens/primary schools between March 2022 and May 2023. The sleep time window and total sleep time were assessed using a wrist-worn ActiGraph accelerometer. Participants wore this device continuously for 24 h/day over a period of 7 consecutive days. Demographic data and potential correlates were obtained via questionnaires completed by parents. Statistical analyses were completed using logistic regression and independent-samples Mann-Whitney U test. In all, 65.5% of children (60% boys, 70.9% girls) and 58.3% of parents (52.4% fathers, 64.3% mothers) achieved the recommended sleep duration. Greater sleep quantity and duration in good-quality sleep were significantly higher in girls/mothers, compared to boys/fathers. Preschoolers were more likely to comply with sleep guidelines if their mother (but not father) met the sleep recommendation and their mothers did not have a higher education level. Adhering to sleep guidelines in children was also associated with children's female gender, absence of screen device in the bedroom, and being more active. Given the high concurrence in mother-child sleep quantity, it is important to promote healthy sleep behaviours in the whole family.
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Affiliation(s)
- Jaroslava Voráčová
- Faculty of Physical Culture, Department of Social Sciences in Kinanthropology, Palacký University Olomouc, Olomouc, Czech Republic
| | - Erik Sigmund
- Faculty of Physical Culture, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Michal Vorlíček
- Faculty of Physical Culture, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jan Dygrýn
- Faculty of Physical Culture, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Dagmar Sigmundová
- Faculty of Physical Culture, Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
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Farley ZS, Ward M, Giuliani NR, Budd EL. Physical activity moderates the association between school start time and sleep duration in a cross-sectional national sample of adolescents. JOURNAL OF ACTIVITY, SEDENTARY AND SLEEP BEHAVIORS 2024; 3:11. [PMID: 39035876 PMCID: PMC11259015 DOI: 10.1186/s44167-024-00050-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/18/2024] [Indexed: 07/23/2024]
Abstract
Background Adolescent insufficient sleep is an endemic issue that may result in compromised functioning throughout the course of the day and is associated with increased risk for a variety of adverse outcomes. Early school start time (SST) has been consistently found to be detrimental to adolescents' sleep achievement on school nights. However, there are logistical barriers to changing SST. Evidence supports daily engagement in moderate-to-vigorous intensity physical activity (MVPA) to enhance adolescents' nightly sleep achievement. However, the role of MVPA in the association between SST and sleep duration is unknown. This study examines the potential moderating effect of MVPA in the association between SST and sleep duration on a typical school day among adolescents. Methods This study examined data (collected in April and October 2014) from a national sample of 1132 adolescents (m age = 14.5 years) living in the United States from the Family Life, Activity, Sun, Health, and Eating study, a cross-sectional, internet-based survey. First, three linear regressions were computed to examine bivariate associations between SST, MVPA, and sleep duration while controlling for participant sex, race and ethnicity, household income, school level, and the presence of a TV in the bedroom. Next, a three-step multiple regression was computed with sleep duration as the dependent variable, and the final step included an interaction term between SST and MVPA. Results Later SST (b 1 = 0.41, p < 0.001) and increased MVPA (b 1 = 0.39, p < 0.001) were both associated with increased sleep duration, while SST and MVPA were not significantly associated. In the final multiple regression model, which included the interaction term, school day MVPA moderated the positive association between SST and school night sleep duration (b 1 = - 3.7, p < 0.05), such that the greater the MVPA on a typical school day, the weaker the positive association between early SST and sleep duration. In post-hoc analysis, the interaction effect was only significant for females and not males. Conclusions The significant buffering effect of MVPA on the association between SST and sleep duration suggests that in the absence of SST changes, promoting MVPA among adolescents may be a promising strategy to mitigate insufficient sleep among US adolescents.
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Affiliation(s)
- Zachary S. Farley
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Mandilyn Ward
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Nicole R. Giuliani
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
- Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, USA
| | - Elizabeth L. Budd
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, USA
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
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Tar Bolacali E, Kaya Şenol D. The effect of a training program on adolescents' stress levels and healthy lifestyle behaviors during the Covid-19 pandemic: A randomized controlled study. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12456. [PMID: 38469992 DOI: 10.1111/jcap.12456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 01/27/2024] [Accepted: 02/13/2024] [Indexed: 03/13/2024]
Abstract
TOPIC Adolescence is the period when people adopt healthy lifestyle behaviors and turn them into habits. Healthy lifestyle behaviors are a significant step toward a long and healthy life. PURPOSE This study investigated the effect of a training program on adolescents' stress levels and healthy lifestyle behaviors during the COVID-19 pandemic. METHODS This randomized controlled study was conducted between May and July 2021. The sample consisted of 100 adolescents living in a city in the south of Turkey. Participants were randomized into intervention and control groups using block randomization. The intervention group participated in an online (Zoom) training program consisting of two 45 min sessions once a week for 8 weeks. Data were collected using the adolescent stress questionnaire (ASQ) and the adolescent lifestyle profile (ALP). RESULTS The results showed that 73% (n: 73) of the participants had developed hygiene habits since the onset of the pandemic. However, the pandemic negatively affected participants' dietary habits (45%, n: 45), physical activity (70%, n: 70), coping mechanisms (68%, n: 68), sleep patterns (54%, n: 54), Internet/social media/video game addiction (64%, n: 64), and interpersonal relationships (57%, n: 57). The intervention group had a lower mean ASQ posttest score and a higher mean ALP posttest score than the control group. The intervention group had a lower mean ASQ posttest score than their pretest score. The intervention group also had a higher mean ALP posttest score than their pretest score. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The training program helped adolescents feel less stress and adopt more healthy lifestyle behaviors. Pediatric nurses should identify risk factors and design and implement appropriate plans to help adolescents go through future pandemics with as little damage as possible. Parents and educators should support adolescents against the adverse impacts of events such as the COVID 19 pandemic.
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Affiliation(s)
- Edanur Tar Bolacali
- Department of Medical Services and Techniques, First and Emergency Aid Program, Vocational School of Health Services, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Derya Kaya Şenol
- Mıdwıfery Department, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
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Yepez CE, Anderson CE, Frost E, Whaley SE, Koleilat M. Sleep Duration Is Associated with Household Food Insecurity and Sugar-Sweetened Beverage Intake Among Women, Infants and Children Participating Children Ages 0-5. Am J Health Promot 2024; 38:492-502. [PMID: 38155440 DOI: 10.1177/08901171231225289] [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] [Indexed: 12/30/2023]
Abstract
PURPOSE To determine associations between child and household characteristics and sleep duration among low-income children in Los Angeles County. DESIGN Cross-sectional study. SETTING Survey data collected in 2017 and 2020 in Los Angeles County, California. SAMPLE Special Supplemental Nutrition Program for Women, Infants and Children (WIC) households with children ages 4-60 months. MEASURES Sleep duration for children 4-60 months old (less than recommended (LTR), recommended range, more than recommended (MTR)), household food insecurity (HFI), sociodemographics, and daily servings of sugar-sweetened beverages (SSB). ANALYSIS Multinomial logistic regression, stratified by child age, was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for associations between household/child characteristics and LTR or MTR sleep compared to recommended duration among WIC participating children 4-60 months old. RESULTS The final sample included 3512 children ages 4-23 months and 6035 children ages 24-60 months. In the study population, 32% (3-5 years old) to 44% (4-11months) of children under 5 did not meet the recommended hours of sleep per night. HFI was associated with higher odds of LTR (OR 1.27, CI 1.12-1.45) and MTR (OR 1.46, CI 1.15-1.87) sleep among 24-60 month-old children. Each additional daily SSB serving was associated with higher odds of LTR sleep (4-23 months: OR 1.10, CI 1.02-1.19; 24-59 months: OR 1.12, CI 1.08-1.17). CONCLUSIONS HFI and SSB intake are associated with not getting the recommended amount of sleep among low-income WIC participating children. Nutrition assistance program participants may benefit from receiving information about recommended sleep duration for young children and how to establish sleep routines to optimize sleep duration.
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Affiliation(s)
- Catherine E Yepez
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Christopher E Anderson
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Erin Frost
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, CA, USA
| | - Shannon E Whaley
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Maria Koleilat
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, CA, USA
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Inoue M, Nakajima S, Inada N, Oi H, Sato N, Miyazaki Y, Takashina H, Tagaya H, Adachi Y, Kuga H. Development of the Parenting Behavior Checklist to Promote Preschoolers' Sleep (PCPP). Behav Sleep Med 2024; 22:275-284. [PMID: 37545146 DOI: 10.1080/15402002.2023.2241590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
OBJECTIVES To develop the Parenting Behavior Checklist to Promote Preschoolers' sleep (PCPP), quantify sleep-promoting parenting behaviors for children, and examine the scale's reliability and validity. METHODS The PCPP was developed based on the recommendations of the ABCs of SLEEPING for children's sleep, which is strongly supported by research evidence. Its validity and reliability were evaluated using data from 140 participants. Structural validity was estimated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency was evaluated by Cronbach's α. Hypothesis testing was evaluated by analyzing the correlations between each factor of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) and the PCPP. RESULTS Regarding structural validity, EFA was conducted because CFA showed a poor model fit. The PCPP comprised one factor and six items. The JSQ-P subfactors of insomnia or circadian rhythm sleep-wake disorders, undesirable morning symptoms and behaviors, and insufficient sleep were moderately negatively correlated with the PCPP; the subfactor of undesirable daytime behaviors related to sleep problems was weakly negatively correlated with the PCPP. Thus, the sleep-promoting parenting behaviors listed in the PCPP were associated with better sleep in children. CONCLUSIONS The PCPP showed sufficient reliability and validity. Future studies should use the scale to examine more effective interventions regarding sleep-promoting parental behaviors for children.
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Affiliation(s)
- Mari Inoue
- Graduate School of Medical Science, Kitasato University, Kanagawa, Japan
| | - Shun Nakajima
- Faculty of Liberal Arts, Department of Psychology, Teikyo University, Tokyo, Japan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki, Japan
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naoko Inada
- Faculty of Liberal Arts, Department of Psychology, Teikyo University, Tokyo, Japan
- Faculty of Psychology and Sociology, Taisho University, Tokyo, Japan
| | - Hitomi Oi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naoko Sato
- Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Yuri Miyazaki
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hikari Takashina
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hirokuni Tagaya
- Graduate School of Medical Science, Kitasato University, Kanagawa, Japan
| | | | - Hironori Kuga
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
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Cardoso S, Correia D, Vilela S. Associations between chronotype, diet quality and timing of energy intake in Portuguese children and adolescents: The potential role of summer holidays. Chronobiol Int 2024; 41:647-657. [PMID: 38606916 DOI: 10.1080/07420528.2024.2339970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
Later chronotypes may be associated with lower diet quality and later timing of energy intake in paediatric age. Period of data collection of these variables may affect these parameters and inter-relationship. We aimed to assess the cross-sectional association of chronotype with a diet quality score (HEI) and caloric midpoint (time of achieving 50% of total daily energy intake), considering summer holidays, using data from the National Food, Nutrition and Physical Activity Survey 2015-2016 for 578 participants (6-14 years of age). Chronotype was estimated by the midpoint of sleep and categorized as Early, Intermediate and Late, using physical activity diaries, while outcomes using two food diaries/24 h recalls. Associations of chronotype with outcomes were assessed by linear regressions adjusted for sex, age, parental education (model 1), BMI, sports practice (model 2), and summer holidays (no/yes) (model 3). In model 2, a Late vs. Early chronotype was negatively associated with HEI (β ˆ = -0.74; 95% CI: -1.47, -0.07) and positively with caloric midpoint (β ˆ = 0.35; 95% CI: 0.02, 0.69). However, associations lost significance in model 3. The association between chronotype and dietary habits may be benefit from being studied considering school terms and summer holidays. Future larger prospective studies are needed to clarify the role of summer holidays on this inter-relationship.
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Affiliation(s)
- Sofia Cardoso
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Daniela Correia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
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Thompson L, Baker A, Almeida I, Slavish D, Blumenthal H. Disengagement coping and sleep problems among trauma-exposed adolescents. ANXIETY, STRESS, AND COPING 2024; 37:379-393. [PMID: 38093577 PMCID: PMC10990797 DOI: 10.1080/10615806.2023.2292180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/03/2023] [Indexed: 04/05/2024]
Abstract
BACKGROUND The formation of healthy sleep patterns is a critical component of positive adolescent development. Dysregulated sleep habits can put youth at risk for the development of a multitude of inimical outcomes, particularly among those who are exposed to a traumatic event. DESIGN AND METHODS The present study investigated the links between voluntary disengagement coping (e.g., avoidance, denial, wishful thinking) and sleep outcomes among 86 trauma-exposed and non-exposed adolescents between the ages of 12-17 (Mage = 15.44, SD = 1.51; 41.9% female). RESULTS The relationship between voluntary disengagement coping and sleep outcomes was significant only among trauma-exposed adolescents, such that greater use of voluntary disengagement strategies was associated with greater sleep disturbances and greater daytime dysfunction. CONCLUSIONS Targeting disengagement coping may be an important strategy to improve sleep health among trauma-exposed adolescents. Continued efforts in improving the efficacy of trauma-exposed adolescent intervention strategies are needed.
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Affiliation(s)
- Linda Thompson
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Alexandria Baker
- University of Rochester, Department of Psychology, Rochester, NY, United States
| | - Isamar Almeida
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Danica Slavish
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
| | - Heidemarie Blumenthal
- University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX, 76203, United States
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28
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Kuki A, Terui A, Sakamoto Y, Osato A, Mikami T, Nakamura K, Saito M. Prevalence and factors of sleep problems among Japanese children: a population-based study. Front Pediatr 2024; 12:1332723. [PMID: 38638584 PMCID: PMC11024267 DOI: 10.3389/fped.2024.1332723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Background High prevalence of sleep problems in not only children with neurodevelopmental disorders (NDS) but also non NDS has been established. However, there are few studies that have looked into population-based and age-specific prevalence of sleep problems of children. Moreover, there are even fewer studies that have investigated the correlation of demographic and lifestyle-related factors affecting sleep problems in children. Considering these, the purpose of this study is to assess the correlation of the prevalence of sleep problems and selected socio-demographic and lifestyle-related factors in 5-year-old Japanese children in population-based study. Methods Study children (SC) were recruited from two cohorts of the Hirosaki City 5-Year-Old Child Developmental Health Checkup Study. The first cohort consisted of 281 (162 males, 119 females) children recruited from 2014 to 2015, and the second cohort consisted of 2055 (1,068 males, 987 females) children from 2018 to 2019. In total there were 2,336 SC participants (1,230 males and 1,106 females). To determine the prevalence of sleep problems the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) was utilized, and sleep problems are defined by a total score of ≥86. To determine socio-demographic and lifestyle-related factors affecting sleep, 10 factors (NDS diagnosis, birth month, childcare place, income, number of siblings, bedtime, waking time, sleeping hours, sleep onset delay, and screen time) were selected. Finally, to determine the correlation between prevalence of sleep problems and the selected demographic and lifestyle-related factors, data was analyzed using chi-square test. Results The prevalence rate of sleep problems in 5-year-olds was 18% (369/2,055). Further, the prevalence of sleep problems was high in participants with ASD (50.4%), ADHD (39.8%), <2 million yen of income (30.5%), no siblings (24.2%), >22:00 of bedtime (30.7%), >7:30 of waking time (30.7%), <9 h of sleeping hours (25.3%), >30 min of sleep onset delay (35.3%), and ≥2 h of screen time (21.1%). Conclusion The findings report 18% prevalence rate of sleep problems in 5-year-old children. Further, the findings establish a significant correlation of sleep problems and NDS, specific socio-demographic, and lifestyle-related factors. In considering the identified modifiable lifestyle-related factors contributing to sleep problems among the participants (i.e., bed/waking times and screen times), sleep programs to address these concerns are suggested.
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Affiliation(s)
- Asami Kuki
- School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Ai Terui
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Yui Sakamoto
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Ayako Osato
- Department of Clinical Psychological Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Japan
| | - Tamaki Mikami
- Department of Clinical Psychological Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Manabu Saito
- Department of Clinical Psychological Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Japan
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29
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Galland BC, Haszard JJ, Jackson R, Morrison S, Meredith-Jones K, Elder DE, Beebe D, Taylor RW. Predictors for achieving optimal sleep in healthy children: Exploring sleep patterns in a sleep extension trial. Sleep Health 2024; 10:213-220. [PMID: 37980245 DOI: 10.1016/j.sleh.2023.09.012] [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: 01/10/2023] [Revised: 07/19/2023] [Accepted: 09/24/2023] [Indexed: 11/20/2023]
Abstract
STUDY OBJECTIVES Earlier bedtimes can help some children get more sleep, but we don't know which children, or what features of their usual sleep patterns could predict success with this approach. Using data from a randomized crossover trial of sleep manipulation, we sought to determine this. METHODS Participants were 99 children aged 8-12years (49.5% female) with no sleep disturbances. Sleep was measured by actigraphy at baseline and over a restriction or extension week (1 hour later or earlier bedtime respectively), randomly allocated and separated by a washout week. Data were compared between baseline (week 1) and extension weeks only (week 3 or 5), using linear or logistic regression analyses as appropriate, controlling for randomization order. RESULTS One hour less total sleep time than average at baseline predicted 29.7 minutes (95% CI: 19.4, 40.1) of sleep gained and 3.45 (95% CI: 1.74, 6.81) times higher odds of successfully extending sleep by >30 minutes. Per standardized variable, less total sleep time and a shorter sleep period time were the strongest predictors (significant odds ratios (ORs) of 2.51 and 2.28, respectively). Later sleep offset, more variability in sleep timing and lower sleep efficiency also predicted sleep gains. The sleep period time cut-point that optimized prediction of successful sleep gains was <8 hours 28 minutes with 75% of children's baseline sleep in that range. CONCLUSIONS Children with a baseline sleep period time <8½ hours a night obtained the most sleep from earlier bedtimes maintained over a week, demonstrating experimentally the value of earlier bedtimes to improve sleep. CLINICAL TRIALS REGISTRY Australian New Zealand Clinical Trial Registry, ACTRN12618001671257, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true.
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Affiliation(s)
- Barbara C Galland
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand.
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Dawn E Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Dean Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Druzian GS, Tebar WR, Beretta VS, Leite EG, Leocci IC, Santos AB, Antunes EP, Casonatto J, Ferrari G, Fernandes RA, Morelhão PK, Christofaro DGD. Parent-child associations of sleep quality: is physical activity a confounder? The EPI-FAMILY health study. Sleep Med 2024; 116:51-55. [PMID: 38428342 DOI: 10.1016/j.sleep.2024.02.036] [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: 11/08/2023] [Revised: 02/20/2024] [Accepted: 02/24/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION The incidence of sleep deprivation has increased in pediatric populations, however, the relationship with physical activity (PA) remains uncertain and lacks evidence. Although some studies have shown that parents' lifestyle habits can influence this process, one point that requires further clarification in the literature is whether parents' sleep quality is linked to that of their children and whether parents' physical activity could play an important role in these possible relationships. OBJECTIVES To investigate the relationship of sleep quality between parents and children and verify the role of physical activity in this association. METHODS This is a cross-sectional study. Sleep quality was assessed using the Mini Sleep Questionnaire. The amount of sleep was estimated by the number of hours slept. PA domains (occupational activities, leisure, and active commuting) were assessed using the Baecke questionnaire, while moderate to vigorous PA (MVPA) was assessed with an accelerometer. Socioeconomic status was obtained through a questionnaire. The relationship of sleep quality between parents and children was carried out using hierarchical models with Binary Logistic Regression, where the factors were inserted one by one (1. unadjusted model; 2. sociodemographic variables; 3. children's PA; 4. parents' PA). RESULTS The study sample consisted of 102 children and adolescents (6-17 years), 92 mothers, and 69 fathers. Poor sleep quality of mothers was associated with their children's sleep quality (OR = 3.95; 95%CI = 1.33-11.38; P = 0.013). After inserting mothers' PA intensity into the final model, the associations remained significant (OR = 8.05; 1.33-48.59; P = 0.023). No relationship was observed between poor sleep quality of fathers and their children's sleep quality. CONCLUSION The relationship between poor sleep quality of mothers and that of their children remained significant, regardless of confounding variables.
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Affiliation(s)
- Gustavo S Druzian
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - William R Tebar
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Vitor S Beretta
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Enrique G Leite
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Isabella C Leocci
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Amanda B Santos
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Ewerton P Antunes
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | | | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Rômulo A Fernandes
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Priscila K Morelhão
- Universidade Federal de São Paulo (UNIFESP). Departamento de Psicobiologia, São Paulo, SP, Brazil; Sleep Institute, São Paulo, SP, Brazil
| | - Diego G D Christofaro
- Universidade Estadual Paulista (UNESP). Departamento de Educação Física, Presidente Prudente, SP, Brazil.
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Wong P, Meltzer LJ, Barker D, Honaker SM, Owens JA, Saletin JM, Seixas A, Wahlstrom KL, Wolfson AR, Carskadon MA. The associations between instructional approach, sleep characteristics and adolescent mental health: Lessons from the COVID-19 pandemic. Sleep Health 2024; 10:221-228. [PMID: 38262777 DOI: 10.1016/j.sleh.2023.11.013] [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: 06/13/2022] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVES To test whether adolescents' mental health during the COVID-19 pandemic is associated with the combination of their instructional approach(es) and their sleep patterns. DESIGN Cross-sectional. SETTING Adolescents were recruited through social media outlets in October and November 2020 to complete an online survey. PARTICIPANTS Participants were 4442 geographically and racially diverse, community-dwelling students (grades 6-12, 51% female, 36% non-White, 87% high schoolers). MEASUREMENTS Participants completed items from the PROMIS Pediatric Depressive Symptoms and Anxiety scales. Participants reported their instructional approach(es), bedtimes, and wake times for each day in the past week. Participants were categorized into five combined instructional approach groups. Average sleep opportunity was calculated as the average time between bedtime and waketime. Social jetlag was calculated as the difference between the average sleep midpoint preceding non-scheduled and scheduled days. RESULTS Emotional distress was elevated in this sample, with a large proportion of adolescents reporting moderate-severe (T-score ≥ 65) levels of depressive symptoms (49%) and anxiety (28%). There were significant differences between instructional approach groups, such that adolescents attending all schooldays in-person reported the lowest depressive symptom and anxiety T-scores (P < .001, ηp2 = .012), but also the shortest sleep opportunity (P < .001, ηp2 = .077) and greatest social jetlag (P < .001, ηp2 = .037) of all groups. Adolescents attending school in person, with sufficient sleep opportunity (≥8-9 hours/night) and limited social jetlag (<2 hours) had significantly lower depressive (ηp2 = .014) and anxiety (ηp2 = .008) T-scores than other adolescents. CONCLUSIONS Prioritizing in-person education and promoting healthy sleep patterns (more sleep opportunity, more consistent sleep schedules) may help bolster adolescent mental health.
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Affiliation(s)
- Patricia Wong
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/E. P. Bradley Hospital, Sleep for Science Research Lab, Providence, Rhode Island.
| | - Lisa J Meltzer
- Division of Pediatric Behavioral Health, Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - David Barker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sarah M Honaker
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Judith A Owens
- Boston Children's Hospital, Harvard Medical School Division of Sleep Medicine, Boston, Massachusetts
| | - Jared M Saletin
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/E. P. Bradley Hospital, Sleep for Science Research Lab, Providence, Rhode Island
| | - Azizi Seixas
- Department of Informatics and Health Data Science, University of Miami Miller School of Medicine, Miami, Florida
| | - Kyla L Wahlstrom
- Department of Organizational Leadership, Policy and Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota
| | - Amy R Wolfson
- Department of Psychology, Loyola University Maryland, Baltimore, Maryland
| | - Mary A Carskadon
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/E. P. Bradley Hospital, Sleep for Science Research Lab, Providence, Rhode Island
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Dalferth TF, Nunes ML, Furini CRG. Sleep deprivation in early life: Cellular and behavioral impacts. Neurosci Biobehav Rev 2024; 159:105597. [PMID: 38387838 DOI: 10.1016/j.neubiorev.2024.105597] [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: 09/18/2023] [Revised: 02/08/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024]
Abstract
Sleep deprivation has become increasingly prevalent in contemporary society, and the consequences of this reality such as cognitive impairment and metabolic disorders, are widely investigated in the scientific scenario. However, the impact of sleep deprivation on the health of future generations is a challenge, and researchers are focusing their attention on this issue. Thus, this review aims to describe the impact of sleep deprivation in early life in animal models, particularly rodents, discussing the molecular physiology impacted by prolonged wakefulness in early life, as well as the changes that interfere with neurodevelopmental processes. Additionally, it explores the changes impacting metabolic mechanisms and discusses both the short- and long-term consequences of these processes on endocrine, behavioral, and cognitive functions. Finally, we briefly address some strategies to mitigate the adverse effects of sleep deprivation.
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Affiliation(s)
- Thais F Dalferth
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, Porto Alegre, RS 90619-900, Brazil; Laboratory of Cognition and Memory Neurobiology, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690 - 3rd floor, Porto Alegre, RS 90610-000, Brazil
| | - Magda L Nunes
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, Porto Alegre, RS 90619-900, Brazil; Brain Institute (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690, Porto Alegre, RS 90610-000, Brazil
| | - Cristiane R G Furini
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, Porto Alegre, RS 90619-900, Brazil; Laboratory of Cognition and Memory Neurobiology, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690 - 3rd floor, Porto Alegre, RS 90610-000, Brazil.
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Gaskin CJ, Venegas Hargous C, Stephens LD, Nyam G, Brown V, Lander N, Yoong S, Morrissey B, Allender S, Strugnell C. Sleep behavioral outcomes of school-based interventions for promoting sleep health in children and adolescents aged 5 to 18 years: a systematic review. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae019. [PMID: 38584765 PMCID: PMC10996385 DOI: 10.1093/sleepadvances/zpae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/24/2024] [Indexed: 04/09/2024]
Abstract
Study Objectives Insufficient sleep is common among children and adolescents, and can contribute to poor health. School-based interventions potentially could improve sleep behavior due to their broad reach, but their effectiveness is unclear. This systematic review focused on the effects of school-based interventions on sleep behavior among children and adolescents aged 5 to 18 years. Methods Five electronic databases were searched for randomized controlled trials of sleep health interventions initiated or conducted in school settings and in which behavioral sleep outcomes were measured. Cochrane risk of bias tools were used to assess study quality. Results From the 5303 database records and two papers from other sources, 21 studies (22 papers) met the inclusion criteria for this review. These studies involved 10 867 children and adolescents at baseline from 13 countries. Most studies (n = 15) were conducted in secondary schools. Sleep education was the most common intervention, either alone (n = 13 studies) or combined with other initiatives (stress management training, n = 2; bright light therapy, n = 1; health education, n = 1). Interventions were typically brief in terms of both the intervention period (median = 4 weeks) and exposure (median = 200 minutes). Behavioral outcomes included actigraphy-measured and self-reported sleep patterns, and sleep hygiene. All outcomes had high risk of bias or some concerns with bias. Sleep education interventions were typically ineffective. Later school start times promoted longer sleep duration over 1 week (1 study, high risk of bias). Conclusions Current evidence does not provide school-based solutions for improving sleep health, perhaps highlighting a need for complex, multi-component interventions (e.g. whole-of-school approaches) to be trialed.
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Affiliation(s)
- Cadeyrn J Gaskin
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | | | - Lena D Stephens
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Gunchmaa Nyam
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Victoria Brown
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Natalie Lander
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Serene Yoong
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | | | - Steven Allender
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
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Merianos AL, Stone TM, Mahabee-Gittens EM, Jandarov RA, Choi K. Tobacco Smoke Exposure and Sleep Duration among U.S. Adolescents. Behav Sleep Med 2024; 22:234-246. [PMID: 37417788 PMCID: PMC10772738 DOI: 10.1080/15402002.2023.2232498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
OBJECTIVES Tobacco smoke exposure (TSE) and poor sleep are public health problems with their own set of consequences. This study assessed whether TSE was associated with sleep duration among U.S. adolescents. METHOD We conducted a secondary analysis of 2013-2018 National Health and Nutrition Examination Survey data including 914 nontobacco-using adolescents ages 16-19 years. TSE measures included cotinine and self-reported home TSE groups including no home TSE, thirdhand smoke (THS) exposure, and secondhand smoke (SHS)+THS exposure. Sleep duration was assessed in hours and categorically as insufficient sleep (recommended hours). Weighted multiple linear regression and multinomial regression models were conducted. RESULTS Adolescents with higher log-cotinine levels had higher number of sleep hours (β = 0.31, 95%CI = 0.02,0.60) and were at increased odds of reporting excess sleep (AOR = 1.41, 95%CI = 1.40,1.42), but were at reduced odds of reporting insufficient sleep (AOR = 0.88, 95%CI = 0.87,0.89). Compared to adolescents with no home TSE, adolescents with home THS exposure and home SHS+THS exposure were at increased odds of reporting insufficient sleep (AOR = 2.27, 95%CI = 2.26,2.29; AOR = 2.75, 95%CI = 2.72,2.77, respectively) and excess sleep (AOR = 1.89, 95%CI = 1.87,1.90; AOR = 5.29, 95%CI = 5.23,5.34, respectively). CONCLUSIONS TSE may affect insufficient and excess sleep duration among adolescents. Eliminating TSE may promote adolescent respiratory and sleep health.
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Affiliation(s)
| | - Timothy M. Stone
- Division of Biostatistics and Bioinformatics, Department of
Environmental and Public Health Sciences, College of Medicine, University of
Cincinnati, 160 Panzeca Way, Cincinnati, OH, 45267, USA
| | - E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati
Children’s Hospital Medical Center, College of Medicine, University of
Cincinnati, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH, 45229, USA
| | - Roman A. Jandarov
- Division of Biostatistics and Bioinformatics, Department of
Environmental and Public Health Sciences, College of Medicine, University of
Cincinnati, 160 Panzeca Way, Cincinnati, OH, 45267, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on
Minority Health and Health Disparities, Bethesda, Maryland, USA
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Fjell AM, Walhovd KB. Individual sleep need is flexible and dynamically related to cognitive function. Nat Hum Behav 2024; 8:422-430. [PMID: 38379065 DOI: 10.1038/s41562-024-01827-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/15/2024] [Indexed: 02/22/2024]
Abstract
Given that sleep deprivation studies consistently show that short sleep causes neurocognitive deficits, the effects of insufficient sleep on brain health and cognition are of great interest and concern. Here we argue that experimentally restricted sleep is not a good model for understanding the normal functions of sleep in naturalistic settings. Cross-disciplinary research suggests that human sleep is remarkably dependent on environmental conditions and social norms, thus escaping universally applicable rules. Sleep need varies over time and differs between individuals, showing a complex relationship with neurocognitive function. This aspect of sleep is rarely addressed in experimental work and is not reflected in expert recommendations about sleep duration. We recommend focusing on the role of individual and environmental factors to improve our understanding of the relationship between human sleep and cognition.
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Affiliation(s)
- Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway.
- Center for Computational Radiology and Artificial Intelligence, Oslo University Hospital, Oslo, Norway.
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Center for Computational Radiology and Artificial Intelligence, Oslo University Hospital, Oslo, Norway
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Lee J, Barger B. Factors Predicting Poor Mental and Physical Health in Parents of Children with Autism Spectrum Disorder: Results from 2016 to 2019 National Survey of Children's Health. J Autism Dev Disord 2024; 54:915-930. [PMID: 36562931 DOI: 10.1007/s10803-022-05870-y] [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] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Although poor health has been reported in parents of children with autism spectrum disorder (ASD), most studies excluded fathers and focused on mental health. We combined 2016-2019 data from the National Surveys of Children's Health to determine child and parent characteristics that predict poor mental and physical health in fathers (n = 818) and mothers (n = 2111) of children with ASD. For fathers of children with ASD, higher parenting stress was significantly associated with greater odds of poor physical health, whereas racial and ethnic minorities and living at 400% above the federal poverty were significantly associated with lower odds of poor mental health. For mothers of children with ASD, greater child sleep problems were significantly associated with greater odds of poor physical health, and two-parent household living 400% above the poverty line was significantly associated with reported lower odds of poor mental health. Continued efforts to reduce parenting stress and improve child sleep problems, along with expanding existing services and coverages of ASD services, especially for low-income families, may help reduce the burden on these families, preventing adverse future health outcomes in this population.
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Affiliation(s)
- Jiwon Lee
- School of Nursing, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, 140 Decatur Street, Urban Life Building Suite 911, Atlanta, GA, 30303, USA.
| | - Brian Barger
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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Zink J, O'Connor SG, Blachman-Demner DR, Wolff-Hughes DL, Berrigan D. Examining the Bidirectional Associations Between Sleep Duration, Screen Time, and Internalizing Symptoms in the ABCD Study. J Adolesc Health 2024; 74:496-503. [PMID: 37855753 PMCID: PMC10872986 DOI: 10.1016/j.jadohealth.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/10/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE The likelihood of meeting sleep duration and screen time guidelines decreases as children develop toward adolescence. Simultaneously, the prevalence of internalizing symptoms increases. The purpose of this paper was to examine the bidirectional associations between sleep duration and screen time with internalizing symptoms in a one-year longitudinal study starting in late childhood. METHODS Participants were 10,828 youth (47.8% female) enrolled in the Adolescent Brain Cognitive Development Study. At baseline (mean age 9.9 years) and one-year follow-up (mean age 10.9 years), youth self-reported screen time for weekdays and weekend days. Responses were separately dichotomized as >2 versus ≤2 hours/day (meeting behavioral guidelines). Caregiver-reported youth sleep duration was dichotomized as <9 versus 9-11 hours/night (meeting behavioral guidelines). Caregivers reported internalizing symptoms via the child behavior checklist. The withdrawn/depressed, anxious/depressed, and somatic symptom child behavior checklist subscale t-scores were separately dichotomized as ≥65 (borderline clinical levels of symptoms and above) versus <65. Analyses were gender-stratified. RESULTS In females, longer baseline sleep duration was protective against withdrawn/depressed symptoms (odds ratio [OR] 0.6, 95% confidence interval [CI] 0.4-0.8) and somatic complaints (OR 0.8, 95% CI 0.6-0.97) one year later. In females, greater baseline weekend screen time was associated with increased risk of withdrawn/depressed symptoms (OR 1.6, 95% CI 1.1-2.2) one year later. No other significant associations were observed. DISCUSSION Longitudinal associations between sleep duration, weekend screen time, and internalizing symptoms were unidirectional (behavior preceding internalizing symptoms), among females only, and specific to withdrawn/depressed and somatic symptoms. These prospective study findings warrant attention and inform future research in this cohort.
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Affiliation(s)
- Jennifer Zink
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
| | - Sydney G O'Connor
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Dara R Blachman-Demner
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland
| | - Dana L Wolff-Hughes
- Division of Cancer Control and Population Sciences, Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - David Berrigan
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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Yin X, Zhang F, Bi C, Liu Y, Guo Y, Sun P, Hong J. Association between soybean product consumption and executive function in Chinese Tibetan children and adolescents. Front Nutr 2024; 11:1348918. [PMID: 38487627 PMCID: PMC10937359 DOI: 10.3389/fnut.2024.1348918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/15/2024] [Indexed: 03/17/2024] Open
Abstract
Objective This sought to explore the association between soybean product consumption and executive function (EF) in Chinese Tibetan adolescents in high-altitude areas. Methods A total of 1,184 Tibetan children and adolescents were tested on demographic variables, soybean product consumption, and executive function in Lhasa and Nagchu regions of Tibet, China, using stratified whole population sampling. One-way ANOVA, linear regression analysis, and logistic regression analysis were used to analyze the associations existing between soybean product consumption and executive function. Results The proportions of Hardly ever, Occasionally, and Often in Soy Consumption among Tibetan children and adolescents in high altitude areas of Tibet, China were 21.7, 50.3, and 28.0%, respectively. The difference in 2 back reaction time among Tibetan children and adolescents with different soybean product consumption was statistically significant (F = 6.374, p = 0.002). The difference in conversion function reaction time was also statistically significant (F = 8.129, p < 0.001). Taking the soybean product consumption ≥6 t/w group as the reference group, after adjusting the relevant factors, those with soybean product consumption ≤1 t/w showed a statistically significant increase in Inhibit Function Dysfunction (OR = 1.844, 95% CI: 1.152, 2.951) and Conversion Function Dysfunction (OR = 2.008, 95% CI: 1.106, 3.646) had an increased risk of Conversion Function Dysfunction (OR = 2.008, 95% CI: 1.106, 3.646), which was significantly different (p < 0.05). Conclusion There is an association between soybean product consumption and inhibitory control and translational flexibility of brain executive functions in Chinese Tibetan children and children and adolescents at high altitude.
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Affiliation(s)
- Xiaojian Yin
- Department of Physical Education, Shanghai Institute of Technology, Shanghai, China
| | - Feng Zhang
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai, China
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Cunjian Bi
- Sports Health Promotion Center, Chizhou University, Chizhou, China
| | - Yuan Liu
- Physical Education College of Shanghai University, Shanghai, China
| | - Yaru Guo
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai, China
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Pengwei Sun
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai, China
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Jun Hong
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai, China
- College of Physical Education and Health, East China Normal University, Shanghai, China
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Vilela S, Vaz A, Oliveira A. Sleep timing behaviour, sleep duration and adherence to obesogenic dietary patterns from pre-school to school age: results from the Portuguese birth cohort Generation XXI. J Sleep Res 2024:e14172. [PMID: 38375691 DOI: 10.1111/jsr.14172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/21/2024]
Abstract
In an obesogenic environment, short sleeping may increase opportunistic eating. The timing of sleep might also influence the drive to eat. This study investigated the prospective association of sleep timing and duration with diet in 5286 children from the Portuguese birth cohort Generation XXI, evaluated at 4 and 7 years of age. At 4 years, sleep duration was categorised into ≤10 and >10 h. Four sleep timing categories were generated based on the median split for sleep-onset and -offset times: 'Early Sleep-Early Wake'; 'Early Sleep-Late Wake'; 'Late Sleep-Early Wake'; 'Late Sleep-Late Wake'. At 7 years, diet was obtained by a food frequency questionnaire and three dietary patterns were included: 'Healthier', 'Energy-Dense Foods (EDF)' and 'Snacking'. The Healthy Eating Index was used to evaluate diet quality. Multinomial logistic regression models and generalised linear models were performed. Children who had a late sleep, independently of the time of waking up, had higher odds of following the 'EDF' pattern, compared with the 'Healthier'. Boys who had late sleep and/or late wake had also higher odds of following the 'Snacking' pattern and had poorer diet quality. In both sexes, a late sleep or late wake were associated with a lower diet quality, compared to the group 'Early Sleep-Early Wake', and independently of nap behaviour. In boys, shorter sleep duration was associated with a poorer diet. In conclusion, pre-schoolers with late bedtimes or wake-up times have worse dietary patterns and poorer diet quality at the age of 7 years, which seems to be independent of sleep duration.
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Affiliation(s)
- Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
| | - Andreia Vaz
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- Departamento de Saúde Pública e Ciências Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Rawcliffe AJ, Tyson H, Hinde K, Jacka K, Holland R, Chapman S, Roberts AJ. Sleep duration and perceptions of sleep quality in British Army recruits during basic training - an observational analysis. Front Neurol 2024; 15:1321032. [PMID: 38426172 PMCID: PMC10903264 DOI: 10.3389/fneur.2024.1321032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Sleep is critical to the health, wellbeing and performance of military personnel during basic training. This two-part study evaluated sleep-wake patterns and sleep disturbances in junior soldiers (JS) and infantry recruits in Autumn 2021 (study 1), and non-infantry recruits in spring 2022 (study 2). Methods During studies 1 and 2, validated wearable technology combined with a sleep diary was used to quantify sleep-wake indices, sleep disturbances and perceptions of sleep quality. Sleep diary data was analysed descriptively. A series of repeated-measures ANOVAs examined differences in objective sleep-wake indices. Correlation analysis determined associations between time in bed (TIB) and total sleep time (TST). Results Significant (p < 0.05) differences in most sleep-wake indices were observed between weeks of basic training for all cohorts. Strong positive correlations between TIB and TST were observed for each cohort across basic training (r = 0.681 - 0.970, p < 0.001), with longer TST associated with greater TIB. The mean±SD sleep duration (hours and mins [hm]) for JS (06:22 ± 00:27hm), non-infantry (05:41 ± 00:47hm) and infantry (05:46 ± 00:34hm) recruits across basic training was consistently below national recommendations. The mean±SD bed and wake times for JS (bedtime: 23:01 ± 00:32hm; awake: 05:34 ± 00:10hm), non-infantry (bedtime: 23:38 ± 01:09hm; awake: 04:47 ± 00:58hm), and infantry (bedtime: 23:13 ± 00:29hm; awake: 05:38 ± 00:26hm) recruits varied across weeks of basic training, with over 80% reporting "fairly bad" or "very bad" sleep quality and frequent periods of "dozing off" during daytime activity. The most commonly reported sleep disturbing factors identified during basic training involved: late-night military admin (e.g., ironing, boot cleaning, kit set up etc), early morning wake times, extraneous noise, light and hot room temperatures within the primary sleeping environment, bed/mattress discomfort, muscle soreness and feelings of stress and anxiety. Discussion/Conclusion Our findings contribute to the existing evidence that long-term sleep loss is pervasive during initial military training programmes. The average sleep durations indicate chronic and unrecoverable sleep loss which would be expected to significantly impair physical and cognitive military performance, and increase the risk of injury, illness and attrition rates during basic training. Changes in the design and scheduling of basic training programmes to enable, at the least, minimum sleep recommendations to be met, and to improve sleep hygiene in the primary sleeping environment are warranted.
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Affiliation(s)
- Alex J. Rawcliffe
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, United Kingdom
| | - Hayley Tyson
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Katrina Hinde
- Human Sciences Group, Defence Science and Technology Laboratory, Salisbury, United Kingdom
| | - Kimberley Jacka
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Rachel Holland
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Shaun Chapman
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Andrew J. Roberts
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
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Blanco E, Hyde ET, Martinez SM. Assessing sleep behaviors in Latino children and adolescents: what is known, what are we missing, and how do we move forward? Curr Opin Pediatr 2024; 36:17-22. [PMID: 37933679 PMCID: PMC10825877 DOI: 10.1097/mop.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
PURPOSE OF REVIEW Sleep health is a commonly overlooked component of pediatric cardiometabolic risk. Disparities in sleep duration and meeting of pediatric sleep guidelines have been well documented among at-risk populations in the United States, including Latinos. However, sleep research often fails to describe or account for contextual and cultural factors impacting the ability for Latino families to meet guidelines. The current review focuses on recent findings related to measurement of sleep duration, understanding of contextual factors that impact sleep hygiene, and interventions designed to increase sleep duration and quality among U.S. Latino families with infants, young children, and adolescents. RECENT FINDINGS Ten studies focusing on sleep health in U.S. Latino children, using different study designs were identified. Overall, cross-sectional studies confirmed inadequate sleep among Latino children, intervention studies demonstrated promise of culturally-sensitive health behavior education for improving sleep in early childhood, and qualitative studies highlighted neighborhood and cultural factors that impact sleep quality. IMPLICATIONS FOR CLINICAL PRACTICE AND RESEARCH Rather than new prevalence studies on adherence to sleep recommendations among Latino families, research focusing on adapting clinical guidelines to accommodate the realities of many Latino families (e.g., co-sleeping and bedsharing) will advance our knowledge. A shift towards objective measurement of the 24-h period as well as evaluating specific contextual barriers that make It challenging to meet sleep guidelines for Latino children is needed.
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Affiliation(s)
- Estela Blanco
- Centro de Investigación en Sociedad y Salud, Núcleo Milenio de Sociomedicina y Escuela de Salud Pública, Universidad Mayor, Santiago, Chile
| | - Eric T. Hyde
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Public Health (Epidemiology)
| | - Suzanna M. Martinez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
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Jayawardena R, Weerasinghe K, Madhujith T, Hills AP, Kalupahana N. Perceptions of the importance of sports nutrition knowledge and barriers in implementing them: a qualitative study among track and field stakeholders in Sri Lanka. BMC Nutr 2024; 10:17. [PMID: 38263161 PMCID: PMC10804860 DOI: 10.1186/s40795-023-00817-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Integrating the core aspects of sports nutrition knowledge [SNK] into the multidisciplinary team is critical to improving an athlete's performance and well-being. Conducting in-depth interviews with members of the sports-related team is a comprehensive method of gathering information on various aspects of SNK. This qualitative study aimed to examine the opinions and beliefs of stakeholders in athletics regarding the importance of SNK. METHODS Fifteen professional track and field athletes and stakeholders were recruited into the study. Separate in-depth interviews were conducted to collect information within four key themes. Practical difficulties in getting an appropriate meal were included in an additional theme. Thematic analysis was performed using NVIVO v10.0. RESULTS All participants were mindful of the importance of proper food habits for overall athletic outcomes and reported different opinions on meal timing and composition. The opinions on supplements were heterogeneous and both positive and negative claims were reported. Beliefs regarding hydration demonstrated that the cohort was well aware of the significance of adequate hydration plus the signs and consequences of dehydration with many reporting experiences of the negative consequences of dehydration. All respondents reported that both alcohol and smoking may have an adverse impact on performance and health. CONCLUSIONS All respondents emphasized the importance of proper food habits for sports performance and well-being, but also identified barriers to optimizing nutrition.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
| | - Kalani Weerasinghe
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Terrence Madhujith
- Department of Food Science and Technology, Faculty of Agriculture, University of Peradeniya, Peradeniya, Sri Lanka
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham Drive, Launceston, TAS, Australia
| | - Nishan Kalupahana
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Restrepo C, Lobbezoo F, Castrillon E, Svensson P, Santamaria A, Manfredini D. Correlations between sleep architecture and sleep-related masseter muscle activity in children with sleep bruxism. J Oral Rehabil 2024; 51:110-116. [PMID: 36790219 DOI: 10.1111/joor.13430] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/29/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Sleep bruxism (SB) occurring during No-REM (nREM) sleep and increase in microarousals per hour have been described in adults, but not in children. OBJECTIVE To assess the correlation between sleep architecture and masseter muscle activity related to sleep bruxism (SB/MMA) in children. MATERIALS AND METHODS Forty-three children aged 7-12 years (mean age: 9.4 ± 1.3) with confirmed SB underwent a two-night polysomnographic (PSG) study in a sleep laboratory, for accommodation (first night) and data collection (second night). Data on sleep architecture (total sleep duration (TSD), sleep efficiency (SE), sleep onset latency (SOL), REM and nREM sleep duration and proportion and microarousals/hour during REM and nREM sleep) and episodes/hour of SB/MMA were recorded. Single and multiple-variable linear regression analyses were performed to assess the correlation between data on sleep architecture (predictors) and SB/MMA (dependent variable). RESULTS Shorter TSD, REM and nREM stage 1 sleep duration, longer SOL and more microarousals/hour during REM and nREM sleep were found to be positive predictors of SB/MMA in children in the multiple-variable regression analysis (R2 = 0.511). CONCLUSION Within the limitations of this study, it can be concluded that SB/MMA is correlated with altered sleep architecture in children (shorter total sleep duration (TSD), shorter nREM and REM sleep and higher microarousals during REM and nREM sleep). Nevertheless, the clinical significance of these findings need to be demonstrated in future studies.
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Keenan L, Bramham J, Dinca M, Coogan AN, Downes M. Sleep and daytime functioning in children with tourette syndrome: A two-week case-control study with actigraphy and cognitive assessments. Sleep Med 2024; 113:313-327. [PMID: 38101103 DOI: 10.1016/j.sleep.2023.11.1137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023]
Abstract
There is increasing recognition of the high prevalence of sleep issues in children with Tourette syndrome (TS), a condition characterised by motor and vocal tics. Overnight polysomnography (PSG) has been the primary mode of sleep assessment in the TS literature, despite the extensive use of actigraphy in other neurodevelopmental populations. As a result, there are existing research gaps surrounding day-to-day variability of sleep in TS and links to daytime functioning. This study adopts a naturalistic, intensive longitudinal design to examine sleep in children with TS while considering potential links to tic severity and daytime functioning. Participants were 34 children aged between 8 and 12 years (12 with TS, 22 neurotypical controls). Wrist actigraphs tracked sleep-wake cycles across two weeks and a battery of scales and cognitive assessments measured sleep disturbances and daytime functioning. Mixed models using N = 476 nights of actigraphy data found that relative to controls, children with TS had significantly increased time in bed, increased sleep onset latency, reduced sleep efficiency, lower subjective sleep quality, but comparable actual sleep time. Higher self-report tic severity at bedtime did not predict increased sleep onset latency. In the sleep disturbance scale, 83.33 % of children with TS met the clinical cut-off for a sleep disorder. Parent-report emotional, behavioural, and executive difficulties were greater in the TS group relative to controls, but performance on cognitive tasks was comparable between groups. Together, findings highlight sleep disturbances as an important clinical factor to consider in the management of TS, though further research is required to substantiate findings in larger-scale studies. This study demonstrates the feasibility of assessing sleep via actigraphy in children with TS, supporting more widespread use in the future.
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Affiliation(s)
- Lisa Keenan
- School of Psychology, University College Dublin, Ireland
| | | | - Maria Dinca
- School of Psychology, University College Dublin, Ireland
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Guerlich K, Avraam D, Cadman T, Calas L, Charles MA, Elhakeem A, Fernández-Barrés S, Guxens M, Heude B, Ibarluzea J, Inskip H, Julvez J, Lawlor DA, Murcia M, Salika T, Sunyer J, Tafflet M, Koletzko B, Grote V, Plancoulaine S. Sleep duration in preschool age and later behavioral and cognitive outcomes: an individual participant data meta-analysis in five European cohorts. Eur Child Adolesc Psychiatry 2024; 33:167-177. [PMID: 36749392 PMCID: PMC10805899 DOI: 10.1007/s00787-023-02149-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/22/2023] [Indexed: 02/08/2023]
Abstract
Short sleep duration has been linked to adverse behavioral and cognitive outcomes in schoolchildren, but few studies examined this relation in preschoolers. We aimed to investigate the association between parent-reported sleep duration at 3.5 years and behavioral and cognitive outcomes at 5 years in European children. We used harmonized data from five cohorts of the European Union Child Cohort Network: ALSPAC, SWS (UK); EDEN, ELFE (France); INMA (Spain). Associations were estimated through DataSHIELD using adjusted generalized linear regression models fitted separately for each cohort and pooled with random-effects meta-analysis. Behavior was measured with the Strengths and Difficulties Questionnaire. Language and non-verbal intelligence were assessed by the Wechsler Preschool and Primary Scale of Intelligence or the McCarthy Scales of Children's Abilities. Behavioral and cognitive analyses included 11,920 and 2981 children, respectively (34.0%/13.4% of the original sample). In meta-analysis, longer mean sleep duration per day at 3.5 years was associated with lower mean internalizing and externalizing behavior percentile scores at 5 years (adjusted mean difference: - 1.27, 95% CI [- 2.22, - 0.32] / - 2.39, 95% CI [- 3.04, - 1.75]). Sleep duration and language or non-verbal intelligence showed trends of inverse associations, however, with imprecise estimates (adjusted mean difference: - 0.28, 95% CI [- 0.83, 0.27] / - 0.42, 95% CI [- 0.99, 0.15]). This individual participant data meta-analysis suggests that longer sleep duration in preschool age may be important for children's later behavior and highlight the need for larger samples for robust analyses of cognitive outcomes. Findings could be influenced by confounding or reverse causality and require replication.
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Affiliation(s)
- Kathrin Guerlich
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Lindwurmstr. 4, 80337, Munich, Germany
| | - Demetris Avraam
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tim Cadman
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lucinda Calas
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004, Paris, France
| | - Marie-Aline Charles
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004, Paris, France
- Ined, Inserm, Joint unit Elfe, Aubervilliers, France
| | - Ahmed Elhakeem
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Silvia Fernández-Barrés
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Mònica Guxens
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004, Paris, France
| | - Jesús Ibarluzea
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, 20014, San Sebastian, Spain
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastian, Spain
- Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jordi Julvez
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus (Tarragona), Catalonia, Spain
| | - Deborah A Lawlor
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Mario Murcia
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Servicio de Análisis de Sistemas de Información Sanitaria, Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain
| | - Theodosia Salika
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Jordi Sunyer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
- Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
- Parc de Salut Mar, Barcelona, Catalonia, Spain
| | - Muriel Tafflet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004, Paris, France
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Lindwurmstr. 4, 80337, Munich, Germany
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Lindwurmstr. 4, 80337, Munich, Germany.
| | - Sabine Plancoulaine
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004, Paris, France.
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Kapos FP, Vandeleur DM, Tham SW, Palermo TM, Groenewald CB. Comparing the prevalence of chronic pain in school-aged children in the United States from 2019 to 2020: a nationally representative study examining differences associated with the COVID-19 pandemic. Pain 2024; 165:233-242. [PMID: 37556380 PMCID: PMC10841312 DOI: 10.1097/j.pain.0000000000003020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/15/2023] [Indexed: 08/11/2023]
Abstract
ABSTRACT The coronavirus disease 19 (COVID-19) pandemic negatively affected children's health in the United States (US), with more severe disruption for marginalized groups. However, potential impact on pediatric chronic pain has not been assessed at the population level. This study aimed to (1) estimate differences in the US national prevalence of pediatric chronic pain during the first year of the COVID-19 pandemic (2020), relative to one year earlier (2019); (2) determine whether differences in prevalence varied across sociodemographic groups; and (3) explore changes in child, caregiver, and family factors associated with chronic pain prevalence. Using data of children 6 to 17 years from the National Survey of Children's Health 2019 and 2020 (n = 50,518), we compared weighted percentages of sample characteristics by year and conducted a series of directed-acyclic graph-informed survey-weighted Poisson regressions. The estimated national prevalence (95% CI) of pediatric chronic pain was 10.8% (9.9, 11.9%) in 2019, decreasing to 7.6% (6.9, 8.3%) in 2020. Contrary to hypotheses, the adjusted prevalence of chronic pain was 31% lower in 2020 than in 2019 (aPR = 0.69, 95% CI: 0.61, 0.79), adjusting for child age, sex, race or ethnicity, caregiver education, neighborhood park or playground, and census region. The 2019 to 2020 change in chronic pain prevalence was similar by age ( P = 0.34), sex ( P = 0.94), race or ethnicity ( P = 0.41), caregiver education ( P = 0.49), neighborhood park or playground ( P = 0.22), and census region ( P = 0.20). Exploratory analyses identified 3 potential contributors to the unexpected decrease in the national prevalence of pediatric chronic pain: lower prevalence of bullying, more frequent family meals, and higher family resilience.
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Affiliation(s)
- Flavia P. Kapos
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
| | - Daron M. Vandeleur
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - See Wan Tham
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - Tonya M. Palermo
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - Cornelius B. Groenewald
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
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Fornaro M, Caiazza C, De Simone G, Rossano F, de Bartolomeis A. Insomnia and related mental health conditions: Essential neurobiological underpinnings towards reduced polypharmacy utilization rates. Sleep Med 2024; 113:198-214. [PMID: 38043331 DOI: 10.1016/j.sleep.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/05/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
Insomnia represents a significant public health burden, with a 10% prevalence in the general population. Reduced sleep affects social and working functioning, productivity, and patient's quality of life, leading to a total of $100 billion per year in direct and indirect healthcare costs. Primary insomnia is unrelated to any other mental or medical illness; secondary insomnia co-occurs with other underlying medical, iatrogenic, or mental conditions. Epidemiological studies found a 40-50% comorbidity prevalence between insomnia and psychiatric disorders, suggesting a high relevance of mental health in insomniacs. Sleep disturbances also worsen the outcomes of several psychiatric disorders, leading to more severe psychopathology and incomplete remission, plausibly contributing to treatment-resistant conditions. Insomnia and psychiatric disorder coexistence can lead to polypharmacy, namely, the concurrent use of two or more medications in the same patient, regardless of their purpose or rationale. Polypharmacy increases the risk of using unnecessary drugs, the likelihood of drug interactions and adverse events, and reduces the patient's compliance due to regimen complexity. The workup of insomnia must consider the patient's sleep habits and inquire about any medical and mental concurrent conditions that must be handled to allow insomnia to be remitted adequately. Monotherapy or limited polypharmacy should be preferred, especially in case of multiple comorbidities, promoting multipurpose molecules with sedative properties and with bedtime administration. Also, non-pharmacological interventions for insomnia, such as sleep hygiene, relaxation training and Cognitive Behavioral Therapy may be useful in secondary insomnia to confront behaviors and thoughts contributing to insomnia and help optimizing the pharmacotherapy. However, insomnia therapy should always be patient-tailored, considering drug indications, contraindications, and pharmacokinetics, besides insomnia phenotype, clinical picture, patient preferences, and side effect profile.
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Affiliation(s)
- Michele Fornaro
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Claudio Caiazza
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy.
| | - Giuseppe De Simone
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy; Laboratory of Molecular and Translational Psychiatry, University School of Medicine of Naples Federico II, Naples, Italy
| | - Flavia Rossano
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Andrea de Bartolomeis
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy; Laboratory of Molecular and Translational Psychiatry, University School of Medicine of Naples Federico II, Naples, Italy
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48
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Dai Y, Liu J. Neighborhood predictors of short sleep duration and bedtime irregularity among children in the United States: results from the 2019-2020 National Survey of Children's Health. World J Pediatr 2024; 20:73-81. [PMID: 36867306 PMCID: PMC9982789 DOI: 10.1007/s12519-023-00694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/27/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Environmental factors may contribute to short sleep duration and irregular bedtime in children. Neighborhood factors and children's sleep duration and bedtime regularity remain a less investigated area. The aim of this study was to investigate the national and state-level proportions of children with short sleep duration and irregular bedtime and their neighborhood predictors. METHODS A total of 67,598 children whose parents completed the National Survey of Children's Health in 2019-2020 were included in the analysis. Survey-weighted Poisson regression was used to explore the neighborhood predictors of children's short sleep duration and irregular bedtime. RESULTS The prevalence of short sleep duration and irregular bedtime among children in the United States (US) was 34.6% [95% confidence interval (CI) = 33.8%-35.4%] and 16.4% (95% CI = 15.6%-17.2%) in 2019-2020, respectively. Safe neighborhoods, supportive neighborhoods, and neighborhoods with amenities were found to be protective factors against children's short sleep duration, with risk ratios ranging between 0.92 and 0.94, P < 0.05. Neighborhoods with detracting elements were associated with an increased risk of short sleep duration [risk ratio (RR) = 1.06, 95% CI = 1.00-1.12] and irregular bedtime (RR = 1.15, 95% CI = 1.03-1.28). Child race/ethnicity moderated the relationship between neighborhood with amenities and short sleep duration. CONCLUSIONS Insufficient sleep duration and irregular bedtime were highly prevalent among US children. A favorable neighborhood environment can decrease children's risk of short sleep duration and irregular bedtime. Improving the neighborhood environment has implications for children's sleep health, especially for children from minority racial/ethnic groups.
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Affiliation(s)
- Ying Dai
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104-6096, USA
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104-6096, USA.
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Vandendriessche A, Deforche B, Dhondt K, Altenburg TM, Verloigne M. Combining participatory action research with intervention mapping to develop and plan the implementation and evaluation of a healthy sleep intervention for adolescents. Health Promot Perspect 2023; 13:316-329. [PMID: 38235009 PMCID: PMC10790120 DOI: 10.34172/hpp.2023.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/28/2023] [Indexed: 01/19/2024] Open
Abstract
Background Adolescents' sleep deteriorated over the last decades, urging the need to develop effective interventions. Using participatory action research (PAR) is a promising and unique approach to target adolescents' sleep. This study aims to describe the process and results of combining PAR and intervention mapping (IM) to guide future researchers on developing and planning of the implementation and evaluation of interventions promoting healthy sleep in adolescents. Methods In each of three intervention schools (two with general and technical education and one with technical and vocational education), an action team including adolescents (age 13- 15 years, n=max. 12) and a researcher was composed to develop and plan the intervention. During weekly sessions (n=ranging from 23 to 34 per school), the action team went through the six steps of IM. A short PAR was performed with parents (n=7) to develop parental intervention components. Results Combining PAR and IM resulted in interventions focusing on the importance of healthy sleep, regular sleep patterns and associated behaviors: screen behaviors, physical activity, dietary behavior and relaxation. Several differences in the participatory process (i.e. more guidance needed during brainstorms in the vocational/technical school) and developed intervention (i.e. less intrusive intervention components in the vocational/technical school) were observed between schools. Conclusion Combining PAR with IM resulted in more extensive interventions than other existing school-based sleep interventions. Future studies should investigate whether a participatory developed sleep intervention could be transferred to another setting using a shorter participatory process.
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Affiliation(s)
- Ann Vandendriessche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Movement and Nutrition for Health and Performance Research Group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Karlien Dhondt
- Department of Psychiatry: Pediatric Sleep Center, Ghent University Hospital, Ghent, Belgium
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maïté Verloigne
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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50
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Gorovoy SB, Tubbs AS, Grandner MA. Sleep disorders symptoms in children, adolescents, and emerging adults: Reducing mortality and population health burden through improved identification, referral, and treatment. Sleep Health 2023; 9:991-992. [PMID: 37648647 PMCID: PMC11041109 DOI: 10.1016/j.sleh.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 09/01/2023]
Affiliation(s)
- Suzanne B Gorovoy
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA.
| | - Andrew S Tubbs
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
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