Association between weekend catch-up sleep and executive functions in Chinese school-aged children

The Connection between Sleep Patterns and Mental Health: Insights from Rural Chinese Students

BACKGROUND

The association between sleep patterns and young students' mental health, which is crucial for their development, remains understudied in rural China. Therefore, the relationship between sleep patterns and mental health among primary and junior high school students in rural China was examined.

METHOD

A total of 1592 primary and junior high school students from rural areas of Gansu Province were surveyed, and the Depression Anxiety and Stress Scale (DASS) was utilized to assess mental health, alongside self-reported data on their daily sleep patterns.

RESULTS

Significant sleep inadequacies were identified: 28% of students received less than 8 h of sleep on weekdays, and 19% went to bed later than recommended. On weekends, 38% of students had delayed bedtimes, though only 7.2% received less than 8 h of sleep. Notably, a "U-shaped" relationship was uncovered between sleep duration and mental health for students on weekends, with optimal mental health correlated with receiving 10-11 h of sleep, while both shorter and longer sleep durations on weekends worsened outcomes. This pattern is absent on weekdays. Additionally, adequate sleep and an earlier bedtime was linked to a 6-8% decrease in mental health risks.

CONCLUSIONS

These findings provide valuable insights for policymakers seeking to enhance student mental well-being in rural settings, emphasizing the importance of implementing measures that promote balanced sleep habits among young students.

Association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children

BACKGROUND

To explore the association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children.

METHODS

This hospital-based cross-sectional study included 453 children, aged 6-12 years. Two myopia participants were selected for each individual with the corresponding premyopia or emmetropia. All children underwent cycloplegic autorefraction and ocular biometric tests. The Children's Sleep Habits Questionnaire (CSHQ) and parental information on behavioral habits were used to assess the association of sleep parameters with myopia and premyopia using logistic regression models.

RESULTS

Both myopia and premyopia exhibited significant late bedtime, short sleep duration, early wakeup time on only weekdays, and longer weekend catch-up sleep than emmetropia children (p < 0.05). In multivariate analysis, late bedtime (more than 24:00 a.m.) on weekdays (Odds ratio, OR = 3.63, 95% CI [0.74, 8.68]) as well as on free days (OR = 1.04, 95% CI [0.02, 8.08]); and early wake-up time only on weekdays (5:00-6:00 a.m., OR = 2.16, 95% CI [0.24, 6.76] and 06:00-07:00 a.m., OR = 2.42, 95% CI [0.51, 8.44]) were associated with increased risk of myopia (all p < 0.05) but not premyopia. After adjusting the confounding factors, when each of the eight CSHQ subscale components was analyzed, only bedtime resistance, night waking, and daytime sleepiness scores were significantly associated with a higher risk for premyopia and myopia (p < 0.05).

CONCLUSIONS

The sleep quality components, including bedtime resistance, night waking, and daytime sleepiness, equally involve a higher risk for myopia as well as premyopia.

Associations of social jetlag with physical activity and sedentary behaviour in children and adolescents: A systematic review and meta-analysis

Sleep and daytime movement behaviours occur co-dependently with each other within a finite 24 h day. Sleep parameters other than sleep duration, such as social jetlag and chronotype, have been linked to health problems and unhealthy behaviours among children and adolescents. Given the increasing number of studies examining sleep timing/chronotype and weight-related behaviours, including physical activity and sedentary behaviour, in the past decade, this systematic review and meta-analysis collated and evaluated the evidence on the relationships of social jetlag and chronotype with physical activity and sedentary behaviour among children and adolescents aged 3-17 years. Seven databases were searched on 16 March 2022, and 52 studies were identified as eligible for inclusion, 47 of which were suitable for the meta-analysis. A positive association was found between social jetlag and screen media use (r = 0.14, 95% CI: 0.04-0.24; I2  = 96%; p = 0.008). The morning chronotype was associated with a higher level of physical activity and a lower level of sedentary behaviour than the evening chronotype. No relationship was found between social jetlag and physical activity. The magnitude of heterogeneity among the included studies was high. Further experimental studies are urgently required to understand how circadian preference or misalignment affects activity behaviours. Interventions to promote an active lifestyle in young populations should consider their circadian preference, especially among individuals with the evening chronotype.

Association of Sleep Duration and Weekend Catch-Up Sleep with Suicidal Ideation among Adolescents with Atopic Dermatitis

Atopic dermatitis (AD) is a prevalent allergic disease in children that often causes sleep disturbance and which is associated with diminished quality of life and heightened susceptibility to depression and suicidality. In this study, we investigate the relationship between weekend catch-up sleep (WCUS) and mental health in a sample of 71,434 adolescents with AD and 221,057 without AD using multivariate logistic regression analysis. We hypothesized that adolescents with AD experience shorter total and daytime sleep due to pruritus, with compensatory longer WCUS. We found that the lifetime prevalence of AD was 24.4%, and that adolescents with AD slept less overall, with significantly shorter weekday and weekend sleep durations but longer weekend catch-up sleep (WCUS). Sleep dissatisfaction was markedly higher in the AD group. Interestingly, our results suggest that prolonged WCUS is a protective factor against suicidal ideation in adolescents with AD. The study highlights the importance of addressing sleep patterns in adolescents with AD to enhance mental health. Overall, our findings indicate a need for increased awareness and intervention strategies to ensure sufficient sleep and reduce the risk of suicidal ideation in this population.

Relationships between Sleep Duration, Timing, Consistency, and Chronotype with Myopia among School-Aged Children

Background

The role of sleep in childhood myopia has been a research focus; however, the existing evidence is conflicting on sleep duration and timing, and as yet, no studies involve sleep consistency and chronotype. This study is done to make multiple-perspective analyses on the associations between sleep variables and myopia.

Methods

A population-based cross-sectional study was conducted in Shanghai, China, which included 10,142 school-aged children (7–12 years old, 53.2% boys). The Chinese version of the Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep variables. Propensity score matching was adopted to balance the difference of covariates between nonmyopic and myopic groups. Logistic regression models were implemented to examine the associations between sleep variables and myopia.

Results

Sleep duration and timing, mainly during weekdays, were correlated with myopia in a dose-dependent pattern, in which longer sleep duration was associated with decreased risk of myopia (9-10 hours/day: odds ratio (OR) = 0.87; ≥10 hours/day: OR = 0.77; by comparison with <9 hours/day); later bedtime (9 pm to 9:30 pm: OR = 1.46; 9:30 pm to 10 pm: OR = 1.51; 10 pm and after: OR = 2.08; by comparison with before 9 pm) and later wake-up time (7 am and after: OR = 1.36; by comparison with before 6:30 am) increased the risk (all P < 0.05). Moreover, longer weekend catch-up sleep duration and intermediate and evening chronotype were positively correlated with myopia, while social jetlag was associated with a lower odds of myopia. All these findings were also similarly observed in the matching sample.

Conclusions

Multiple dimensions of sleep were involved in childhood myopia. In addition to sleep duration and timing, sleep consistency and chronotype were also strictly related to myopia. More studies are needed to enrich the current evidence, thus further clarifying the association between sleep and childhood myopia.

Association Between Dairy Intake and Executive Function in Chinese Children Aged 6–12 Years

Association between dairy intake and executive function remains controversial, especially among children, a population with fast-developing executive functions. This study aimed to explore this topic. Additionally, we further distinguished the role of dairy intake types (full- or low-fat milk or yogurt) in this relationship. This survey included 5,138 children aged 6–12 years. Dairy intakes were assessed by validated questionnaires. Executive function was measured by the behavior rating inventory of executive function (BRIEF; Parent Version), and lower T-scores of BRIEF indices indicated superior executive function performance. Results showed that children with higher dairy intake had statistically better performance in Shift (46.58 ± 7.48 vs. 45.85 ± 7.10), Initiate (48.02 ± 8.58 vs. 47.14 ± 8.33), and Working Memory (50.69 ± 8.82 vs. 49.89 ± 8.73). In the analysis of multivariate linear regression, we found that for every one unit increase in full-fat dairy intake, T-scores for Shift (β = −0.350 (95% confidence interval [CI]: (−0.660, −0.039) and Initiate (β = −0.486 (95% CI: (−0.845, −0.127) were decreased and for every one unit increase in low-fat dairy intake, T-score for Organizations of Materials (β = −0.940 (95% CI: (−1.690, −0.189) was decreased. After distinguishing dairy into milk and yogurt, we observed that only milk intake, not yogurt, was significantly associated with better executive function performance in Shift (β = −0.390 (95% CI (−0.745, −0.035) and Initiate (β = −0.509 (95% CI (−0.917, −0.101) after adjusting for potential confounding factors. This study shows that a higher intake of dairy, irrespective of fat content, is related to better executive function performance among children aged 6–12. In addition, a significantly positive relationship between dairy intake and executive function’s indices of Shift and Initiate only was observed in milk, not in yogurt.

Does Prior Night's Sleep Impact Next Day's Executive Functioning? It Depends on an Individual's Average Sleep Quality

Executive functioning (EF) is a series of fundamental goal-directed cognitive abilities that enable effective learning. Differences in daily sleep quality may covary with fluctuations in EF among youth. Most studies linking sleep to EF rely on between-person differences and average effects for the sample. This study employed an intensive longitudinal design and examined the within-person relations between self-reported prior night's sleep quality and next day's EF. Students from Grades 4 to 12 (M age= 14.60, SD = 2.53) completed three behavioral EF tasks repeatedly across approximately one semester. The final analytic sample included 2898 observations embedded in 73 participants. Although, on average, sleep did not significantly covary with EF, there was heterogeneity in within-person sleep-EF relations. Moreover, individuals' average sleep quality moderated within-person effects. For individuals with low mean sleep quality, a better-than-usual sleep quality was linked to better EF performance. However, for individuals with high mean sleep quality, better-than-usual sleep quality was linked to worse EF performance. Understanding person-specific relations between sleep and EF can help educators optimize EF and learning on a daily basis and produce positive academic outcomes across longer time periods.

Evidence of sleep duration and weekend sleep recovery impact on suicidal ideation in adolescents with allergic rhinitis

STUDY OBJECTIVES

Sleep problems are common in allergic rhinitis (AR) and are a modifiable risk factor for suicidal ideation. However, the effect of sleep duration and weekend catch-up sleep (WCUS)-sleep time on weekends that exceeds sleep time on weekdays-on suicidal ideation for adolescents with AR is unknown. The objective of this study was to explore whether sleep duration and WCUS have an impact on suicidal ideation among adolescents with AR.

METHODS

From the annual Korean Youth Risk Behavior Web-Based Surveys (completed from 2013-2017), data were obtained from a stratified, multistage, clustered sample. Using self-reported questionnaires, students provided doctor-diagnosed AR and sleep time.

RESULTS

Among 134,417 and 262,653 adolescents with and without AR, respectively, those with AR compared with those without AR had more sleep dissatisfaction (46.6% vs 40.8%), slept less (sleep duration: 6.71 ± 1.37 hours vs 7.01 ± 1.48 hours), and had longer WCUS (3.46 ± 0.11 hours vs 2.11 ± 0.14 hours). After adjustment, the odds ratio of patients with sleep dissatisfaction was a 1.22 (95% confidence interval, 1.17-1.28) times higher risk of suicidal ideation than in those with sleep satisfaction. For average sleep duration (defining 7-8 hours as the reference), the odds ratio of short sleep (≤ 5 hours) was 1.45 (95% confidence interval, 1.32-1.53). Notably, long WCUS (≥ 2 hours) was significantly associated with decreased suicidal ideation (odds ratio, 0.85; 95% confidence interval, 0.81-0.92).

CONCLUSIONS

Although further research is needed to clarify this association, under the condition of sleep deprivation, WCUS at a certain extent may be associated with a low risk for suicidal ideation in adolescents with AR.

CITATION

Kim CW, Jeong SC, Hwang SW, Jo SH, Kim SH. Evidence of sleep duration and weekend sleep recovery impact on suicidal ideation in adolescents with allergic rhinitis. J Clin Sleep Med. 2021;17(8):1521-1532.