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Ono A, Iwatani Y, Yoshizaki A, Nishimura T, Mohri I, Kagitani-Shimono K, Taniike M. Exploring Lifestyles and Sensory Processing Patterns of Toddlers in Relation to Sleep Patterns Using Body Movement Analysis. Clocks Sleep 2025; 7:25. [PMID: 40407631 PMCID: PMC12101242 DOI: 10.3390/clockssleep7020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Revised: 04/27/2025] [Accepted: 05/07/2025] [Indexed: 05/26/2025] Open
Abstract
This study explored the impact of lifestyle habits and sensory processing patterns on sleep quality by analyzing body movements (BMs) during the first and last 3 h of sleep in toddlers. We collected cross-sectional data about sleep-related habits from 58 toddlers using a mobile application. Actigraphy measured BMs during nighttime sleep and 1 h before bedtime, as well as sleep latency, over 8 consecutive days. The Infant/Toddler Sensory Profile was used to assess the toddlers' sensory processing patterns. The participants had a mean age of 22.0 ± 2.0 months. BMs were significantly lower during the first 3 h of sleep. Longer sleep latency was significantly associated with media use and higher activity levels before bedtime. Ending a nap earlier and consuming a substantial breakfast were correlated with lower BMs during the first 3 h of sleep. Auditory and oral sensory scores were positively correlated with BMs during the first 3 h of sleep. However, no specific factors related to lifestyle habits or sensory processing patterns were found to correlate with BMs during the last 3 h of sleep. Lifestyle habits and sensory processing patterns have a significant impact on toddlers' sleep quality, emphasizing the importance of appropriate routines and environments.
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Affiliation(s)
- Azusa Ono
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan; (A.O.); (Y.I.); (T.N.); (I.M.); (K.K.-S.)
| | - Yoshiko Iwatani
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan; (A.O.); (Y.I.); (T.N.); (I.M.); (K.K.-S.)
| | - Arika Yoshizaki
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan;
| | - Tomoko Nishimura
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan; (A.O.); (Y.I.); (T.N.); (I.M.); (K.K.-S.)
| | - Ikuko Mohri
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan; (A.O.); (Y.I.); (T.N.); (I.M.); (K.K.-S.)
| | - Kuriko Kagitani-Shimono
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan; (A.O.); (Y.I.); (T.N.); (I.M.); (K.K.-S.)
| | - Masako Taniike
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan;
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von Ash T, O'hagan B, Gupta A, Deokule N, Josephson A, Chmielewski S, Chung A. It's Time to Put the Nap in Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC): A Systematic Review Demonstrating the Impact of Child Care on Sleep Outcomes in Early Childhood. Child Obes 2025; 21:255-272. [PMID: 40228049 DOI: 10.1089/chi.2024.0384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2025]
Abstract
Background: Child care-based interventions have largely neglected sleep as an important health behavior for obesity prevention. Child care sleep environments and caregiver practices likely differ from home sleep environments and parent practices. Methods: We summarize findings of past research examining how child care arrangement, dose, and attendance impact young children's sleep using steps outlined by the Preferred Reporting Items for Systematic Reviews and Meta-analyses methodology. Keywords related to sleep and child care were entered into PubMed, PsycINFO, and CINAHL, yielding a total of 3535 articles. Results: Twenty-three studies were included in the data extraction process. There was evidence indicating that child care arrangement type, dose, and attendance impact various sleep outcomes among children 0-5 years old. Considerable variation across studies with regard to child care comparison groups and sleep outcomes assessed made making comparisons across studies difficult. However, child care outside the home and increased time spent in child care were commonly positively associated with daytime sleep and negatively associated with nighttime sleep. Child care outside the home was also associated with 24-hour sleep, with decreased sleep observed among infants and toddlers but increased sleep observed among preschool-age children receiving outside care, especially in settings with mandatory naptime. Conclusion: The findings of this review demonstrate that child care impacts children's sleep. More research is needed to understand best practices for promoting sleep across child care settings and inform intervention efforts. Integrating sleep into evidence-based child care obesity prevention interventions, such as Nutrition and Physical Activity Self-Assessment for Child Care, would assist in efforts to reduce obesity risk among young children.
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Affiliation(s)
- Tayla von Ash
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Center for Health Equity and Health Promotion, Brown University School of Public Health, Providence, RI, USA
| | - Belinda O'hagan
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Anusha Gupta
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Naomi Deokule
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Alexandra Josephson
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Sumner Chmielewski
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Alicia Chung
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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Lo YP, Tahara Y, Khaing IK, Mochida S, Makino N, Nozawa Y, Furutani A, Kubo T, Shibata S. Association of family meals with sleep and quality of life in Japanese preschool and elementary school children: A cross-sectional study. Chronobiol Int 2024; 41:1430-1441. [PMID: 39506556 DOI: 10.1080/07420528.2024.2422868] [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: 05/28/2024] [Revised: 09/18/2024] [Accepted: 10/24/2024] [Indexed: 11/08/2024]
Abstract
Sleep is crucial for children's health and eating habits. The decline in family meals has raised concerns about its impact on children. Previous research indicated associations between family meals and psychological health and dietary habits, but their relationship with sleep behavior is less understood. This study examined the association between family meals (breakfast and dinner), sleep patterns, and quality of life among Japanese preschoolers and elementary school students (1st to 3rd grade). The cross-sectional study involved 6,177 children aged 3-8 years in Japan. Mothers completed an online survey on family meal habits, sleep patterns, and the KINDL-R questionnaire to assess quality of life. Results showed that family meals were associated with sleep behaviors and KINDL scores. Multiple regression analysis indicated that family breakfast was associated with earlier bedtime and wake-up time, shorter weekend sleep duration, reduced social jet lag, and a morning chronotype, as detected by the Munich ChronoType Questionnaire. Family dinners were linked to later sleep and wake-up times and an evening chronotype. Family breakfast and dinner were associated with higher KINDL scores, with dinner having a stronger positive impact. These findings underscore the significance of family meals in associating sleep patterns and quality of life among Japanese children.
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Affiliation(s)
- Yun-Peng Lo
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yu Tahara
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Inn-Kynn Khaing
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seiko Mochida
- Benesse Educational Research and Development Institute, Benesse Corporation, Tama City, Tokyo, Japan
| | - Naomichi Makino
- University Entrance Examinations, The National Center for University Entrance Examinations, Tokyo, Japan
| | - Yuki Nozawa
- Benesse Educational Research and Development Institute, Benesse Corporation, Tama City, Tokyo, Japan
| | - Akiko Furutani
- Faculty of Home Economics, Aikoku Gakuen Junior College, Edogawa-ku, Tokyo, Japan
| | - Tatsuhiko Kubo
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigenobu Shibata
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
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Mao C, Xi C, Du R, Chen W, Song N, Qian Y, Tian X. Characteristics of gut flora in children who go to bed early versus late. Sci Rep 2024; 14:23256. [PMID: 39370458 PMCID: PMC11456581 DOI: 10.1038/s41598-024-75006-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] [Received: 06/23/2024] [Accepted: 10/01/2024] [Indexed: 10/08/2024] Open
Abstract
Investigating the characteristics of the gut flora in children who go to bed early versus late. The study sample consisted of 88 healthy children aged 2-14 years, with an equal number of boys and girls. The researchers collected faecal samples from all participants and sequenced the genome of their gut flora. Findings indicate that beta diversity was statistically significant at the genus level for both the early and late sleeper groups (P = 0.045). Furthermore, alpha diversity indicators, including Simpson's index (P = 0.0011) and Shannon's index (P = 0.0013), exhibited higher values at the genus level. The differences observed in terms of species diversity, abundance, and metabolic pathways offer potential avenues for implementing pharmacological interventions aimed at addressing sleep disorders in children.
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Affiliation(s)
- Chunmei Mao
- Department of Child Rehabilitation, Gansu Rehabilitation Center Hospital, Lanzhou, 15214075468, Gansu, China
| | - Caiping Xi
- Department of Child Rehabilitation, Gansu Rehabilitation Center Hospital, Lanzhou, 15214075468, Gansu, China
| | - Rong Du
- Department of Child Rehabilitation, Gansu Rehabilitation Center Hospital, Lanzhou, 15214075468, Gansu, China
| | - Wenting Chen
- Department of Child Rehabilitation, Gansu Rehabilitation Center Hospital, Lanzhou, 15214075468, Gansu, China
| | - Na Song
- Department of Child Rehabilitation, Gansu Rehabilitation Center Hospital, Lanzhou, 15214075468, Gansu, China
| | - Yuansong Qian
- Department of Child Rehabilitation, Gansu Rehabilitation Center Hospital, Lanzhou, 15214075468, Gansu, China
| | - Xueping Tian
- Department of Child Rehabilitation, Gansu Rehabilitation Center Hospital, Lanzhou, 15214075468, Gansu, China.
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Wang SH, Lin KL, Chen CL, Chiou H, Chang CJ, Chen PH, Wu CY, Lin KC. Sleep problems during early and late infancy: Diverse impacts on child development trajectories across multiple domains. Sleep Med 2024; 115:177-186. [PMID: 38367360 DOI: 10.1016/j.sleep.2024.02.018] [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: 09/21/2023] [Revised: 12/20/2023] [Accepted: 02/07/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Child developmental rate holds predictive value for early-stage developmental trajectories, yet few studies explored how sleep problems during different infancy stages impact this rate. This study aims to investigate the correlation between sleep problems and child developmental trajectories. METHODS This study utilized a prospective national cohort of 5006 children in Taiwan. The developmental inventories covering motor, cognitive, language, and socioemotional domains were collected through questionnaire-based in-person home interviews conducted at 3, 12, 24, and 36 months. Sleep problems data, encompassing bedtime regularity, sleep duration, and sleep quality, were collected at 3 and 12 months. Child developmental rate was assessed by analyzing the slope of developmental ability estimates over a period of time. RESULTS Bedtime regularity and high-quality sleep at 3 and 12 months were found to be significantly associated with intercepts across all domains (estimate = -0.196∼0.233, p < 0.033). Children with high-quality sleep at 3 months showed enhanced developmental slopes in socioemotional domains (estimate = 0.032, p < 0.001). Atypical sleep duration at 3 and 12 months had differential detrimental association with child development in various domains (estimate = -0.108∼-0.016, p < 0.048). CONCLUSION The relationship between sleep problems and child development exhibited variability based on the timing of exposure to these issues. Early exposure to low-quality sleep was significantly related to developmental functions and socioemotional developmental rate, potentially leading to increased developmental disparities as children age. Inadequate sleep duration in late infancy and excessive sleep duration in early infancy were both negatively associated with child development trajectories. Policymakers can use these findings to design targeted sleep programs for optimal child development.
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Affiliation(s)
- Szu-Hua Wang
- Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC; School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC
| | - Kuang-Lin Lin
- School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC; Department of Pediatric Neurology, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC; Graduate Institute of Early Intervention, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC.
| | - Hawjeng Chiou
- Department of Business Administration and Department of Educational Psychology and Counseling, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei City, 106, Taiwan, ROC
| | - Chien-Ju Chang
- Department of Child and Family Science, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei City, 106, Taiwan, ROC
| | - Po-Hsi Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei City, 106, Taiwan, ROC; Institute for Research Excellence in Learning Sciences, National Taiwan Normal University, 162, Section 1, Heping E. Rd., Taipei City, 106, Taiwan, ROC
| | - Ching-Yi Wu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Shing St., Kwei-Shan Dist., Taoyuan City, 33305, Taiwan, ROC; Department of Occupational Therapy, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Dist., Taoyuan City, 333, Taiwan, ROC
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, 17, F4, Xu Zhou Road, Taipei 100, Taiwan, ROC; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, 7, Chung-shan South Road, Taipei 100, Taiwan, ROC
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6
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Hu T, Liu S, Zhan J, Xu L, Zhou Y. Association between parents' concerns about eating and sleeping problems and social-emotional development in Chinese children aged 3 to 6 years. Front Public Health 2023; 11:1264219. [PMID: 38045964 PMCID: PMC10693409 DOI: 10.3389/fpubh.2023.1264219] [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: 07/20/2023] [Accepted: 11/03/2023] [Indexed: 12/05/2023] Open
Abstract
Background Parents' parenting beliefs have a major influence on their children's eating and sleeping problems and emotional socialization. However, the relationship between parent's concerns about eating or sleeping problems and social-emotional development is unclear. Methods We used a convenience sampling method to investigate 997 parents of preschool children aged 3 to 6 in Hangzhou, China, and asked them to complete the "Ages & Stages Questionnaire: Social-Emotional (2nd Edition)" (ASQ: SE-2) and the Survey of Concerns about Children's Eating and Sleeping Problems. To examine the relationship between children's social-emotional development and their parents' concerns about their eating or sleeping problems, binary logistic regression was used. Results There were 218 children (21.9%) with a suspected social-emotional development delay, and 273 parents (27.4%) were concerned about their children's eating or sleeping problems, which mainly focused on ill-balanced eating, bad eating habits, and difficulty falling asleep. The rate of suspected social-emotional development delay in children with the co-occurrence of eating and sleeping problems (37.8%) was significantly higher than those with only eating problems (29.7%), only sleeping problems (24.4%), and those with no eating or sleeping problems (18.8%) (p < 0.05). A binary logistic regression analysis showed that parents' concerns about the co-occurrence of eating and sleeping problems (OR = 2.52, p = 0.01) and only eating problems (OR = 1.71, p = 0.004) were risk factors for children's social-emotional development. In addition, boys were more likely than girls to have suspected social-emotional development delay (OR = 1.49, p = 0.01). Conclusion Children whose parents were concerned about only eating or the co-occurrence of eating and sleeping problems were linked to have a higher risk of suspected social-emotional development delay.
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Affiliation(s)
- Tongxi Hu
- Department of Psychology, Zhejiang Sci-Tech University, Hangzhou, China
| | - Shaoying Liu
- Department of Psychology, Zhejiang Sci-Tech University, Hangzhou, China
| | - Jianying Zhan
- Department of Child Health Care, Hangzhou Women’s Hospital, Hangzhou, China
| | - Luxin Xu
- Hangzhou Qiantang Lingyun Kindergarten, Hangzhou, China
| | - Yanqing Zhou
- Hangzhou Qiantang Xinghua Kindergarten, Hangzhou, China
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Huang SF, Duan HY. Sleeping and Dietary Factors Associated with Chronic Fatigue Syndrome in Taiwanese Preschoolers. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1149. [PMID: 37508645 PMCID: PMC10378476 DOI: 10.3390/children10071149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
The purpose of this research was to investigate the sleeping and dietary factors associated with the prevalence of chronic fatigue syndrome among Taiwanese preschoolers. Five-year-old preschoolers were randomly selected using a stratified multistage random cluster sampling method. The parents of the preschoolers completed a questionnaire containing items related to symptoms of fatigue and sleeping and dietary habits among the preschoolers. A total of 1536 valid questionnaires were returned. After obtaining the data, the researchers analyzed them using descriptive statistics and a chi-square test. The following results were obtained: (1) chronic fatigue syndrome was typically indicated by yawning during the day, feeling tired, and appearing sleepy; (2) the preschoolers with high sleep quality, adequate sleeping time, and a regular sleep schedule exhibited a lower degree of fatigue; (3) half of the preschoolers who ate three nutritionally balanced meals a day at a regular time exhibited a lower degree of fatigue. Among the three dimensions studied, fatigue was most strongly associated with the "sleepy and inactive/blunted responses/lacking in energy" dimension, followed by the "difficulty concentrating" dimension, and, finally, the "localized pain" dimension. In this study, the association between sleeping habits and symptoms of fatigue in preschool children was verified. The associations of dietary factors with symptoms of fatigue were not confirmed. It is suggested that parents establish a good sleep schedule for preschool children based on the study findings.
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Affiliation(s)
- Su-Fen Huang
- Department of Early Childhood Education, National Taitung University, No. 369, Sec. 2, University Road, Taitung City 950309, Taiwan
| | - Hui-Ying Duan
- Department of Infant and Child Care, National Taipei University of Nursing and Health Sciences, No. 365, Min-Te Road, Taipei 112303, Taiwan
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Murata E, Yoshizaki A, Fujisawa TX, Tachibana M, Taniike M, Mohri I. What daily factors affect the sleep habits of Japanese toddlers? J Clin Sleep Med 2023; 19:1089-1101. [PMID: 36789883 PMCID: PMC10235708 DOI: 10.5664/jcsm.10508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023]
Abstract
STUDY OBJECTIVES Good sleep, especially during early childhood, is important for development. In Japan, the mean nocturnal sleep duration of toddlers is < 10 hours, and even if toddlers slept for > 11 hours/day, as recommended by the National Sleep Foundation, some of them showed late bedtime and late wake-up time or took long naps. Therefore, we provisionally assumed the minimal sleep conditions for Japanese toddlers, named Nenne-criteria, such as bedtime before 10:00 pm, nocturnal sleep duration of ≥ 9 hours, and < 1 average time of awakening after sleep onset, and investigated the important factors for good sleep. METHODS We analyzed cross-sectional data from online surveys describing the sleep-related behaviors of 2,124 toddlers and their caregivers. We compared the daily schedules that affect sleep between the Nenne-criteria-meet group and the not-meet group. RESULTS The Nenne-criteria-meet group showed better daytime behaviors than the not-meet group. Structural equation modeling on daily schedules revealed that, to increase sleep pressure at the appropriate time, it is important to restrict media viewing, play outdoors in the morning, have an early nap ending time, avoid hyperarousal-inducing behaviors before bedtime, maintain daily schedules regularly, and decrease social jetlag. CONCLUSIONS The Nenne-criteria are useful for screening Japanese toddlers who require intervention for sleep hygiene. To improve toddlers' sleep, it is important not only to guide the ideal bedtime but also to provide tips for improving daily schedules and to avoid suboptimal sleep-related behaviors. CITATION Murata E, Yoshizaki A, Fujisawa TX, Tachibana M, Taniike M, Mohri I. What daily factors affect the sleep habits of Japanese toddlers? J Clin Sleep Med. 2023;19(6):1089-1101.
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Affiliation(s)
- Emi Murata
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Arika Yoshizaki
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Takashi X. Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Masaya Tachibana
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Masako Taniike
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Ikuko Mohri
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
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Eysenbach G, Leung T, Yamamoto T, Fujisawa TX, Hanaie R, Hirata I, Matsumoto S, Mohri I, Taniike M. Improving Children's Sleep Habits Using an Interactive Smartphone App: Community-Based Intervention Study. JMIR Mhealth Uhealth 2023; 11:e40836. [PMID: 36641237 PMCID: PMC9960041 DOI: 10.2196/40836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/16/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Sleep problems are quite common among young children and are often a challenge for parents and a hinderance to children's development. Although behavioral therapy has proven effective in reducing sleep problems in children, a lack of access to professionals who can provide effective support is a major barrier for many caregivers. Therefore, pediatric sleep experts have begun developing apps and web-based services for caregivers. Despite the substantial influence of cultural and familial factors on children's sleep, little effort has gone into developing cultural or family-tailored interventions. OBJECTIVE This study aimed to examine the effectiveness of the interactive smartphone app "Nenne Navi," which provides culturally and family-tailored suggestions for improving sleep habits in young Japanese children through community-based long-term trials. The study also aimed to investigate the association between app-driven improvements in sleep and mental development in children. METHODS This study adopted a community-based approach to recruit individuals from the Higashi-Osaka city (Japan) who met ≥1 of the following eligibility criteria for sleep problems: sleeping after 10 PM, getting <9 hours of nighttime sleep, and experiencing frequent nighttime awakenings. A total of 87 Japanese caregivers with young children (mean 19.50, SD 0.70 months) were recruited and assigned to the app use group (intervention group) or the video-only group (control group). Both groups received educational video content regarding sleep health literacy. The caregivers in the intervention group used the app, which provides family-tailored suggestions, once per month for 1 year. RESULTS A total of 92% (33/36) of the caregivers in the app use group completed 1 year of the intervention. The participants' overall evaluation of the app was positive. The wake-up time was advanced (base mean 8:06 AM; post mean 7:48 AM; F1,65=6.769; P=.01 and sleep onset latency was decreased (base mean 34.45 minutes; post mean 20.05 minutes; F1,65=23.219; P<.001) significantly in the app use group at the 13th month compared with the video-only group. Moreover, multiple regression analysis showed that decreased social jetlag (β=-0.302; P=.03) and increased sleep onset latency SD (β=.426; P=.02) in children predicted a significant enhancement in the development of social relationships with adults. At 6 months after the completion of the app use, all the caregivers reported continuation of the new lifestyle. CONCLUSIONS The present findings suggest that the app "Nenne Navi" has high continuity in community use and can improve sleep habits in young Japanese children and that interventions for sleep habits of young children may lead to the enhancement of children's social development. Future studies must focus on the effectiveness of the app in other regions with different regional characteristics and neuroscientific investigations on how changes in sleep impact brain development.
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Affiliation(s)
| | | | - Tomoka Yamamoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, Yoshida-gun, Fukui, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Ryuzo Hanaie
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Ikuko Hirata
- Department of Pediatrics, Osaka University Hospital, Suita, Osaka, Japan
| | | | - Ikuko Mohri
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Masako Taniike
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
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10
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Tada Y, Ueda Y, Sasaki K, Sugiura S, Suzuki M, Funayama H, Akiyama Y, Haraikawa M, Eto K. Mealtime Regularity Is Associated with Dietary Balance among Preschool Children in Japan—A Study of Lifestyle Changes during the COVID-19 Pandemic. Nutrients 2022; 14:nu14142979. [PMID: 35889937 PMCID: PMC9324239 DOI: 10.3390/nu14142979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/16/2022] Open
Abstract
The novel coronavirus-19 (COVID-19) pandemic has considerably impacted children’s lives. The aim of this study was to determine whether the pandemic affected mealtime regularity among preschool children and whether maintaining regular mealtimes or changes in mealtime regularity during the pandemic were related to dietary balance, including chronological relationships. This online cross-sectional survey involving individuals registered with a company that provides meals to children aged 2−6 years was conducted in February 2021. Using a 40-point scale, a healthy diet score (HDS) was developed to evaluate children’s dietary balance. The participants were divided into four groups based on their responses, and multiple regression analyses were performed with the HDS as the dependent variable. Maintaining regular mealtimes was associated with practices such as waking and going to bed earlier, less snacking, and eating breakfast every day. Even after adjusting for basic attributes, lifestyle habits, household circumstances, and other factors, regular mealtimes were still positively correlated with the HDS. These findings indicate that maintaining regular mealtimes is associated with higher HDS scores and better lifestyle habits. Furthermore, as the changed HDS was higher in the group whose mealtimes became regular during the pandemic, adopting regular mealtimes may lead to a more balanced diet.
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Affiliation(s)
- Yuki Tada
- Department of Nutritional Science, Faculty of Applied Bioscience, Tokyo University of Agriculture, Sakuragaoka 1-1-1, Setagaya 156-8502, Tokyo, Japan
- Correspondence: ; Tel.: +81-(0)3-5477-2670
| | - Yukari Ueda
- Department of Health and Nutrition, Faculty of Health and Nutrition, Osaka Shoin Women’s University, Hishiyanishi 4-2-26, Higashiosaka 577-8550, Osaka, Japan;
| | - Kemal Sasaki
- Department of Food and Health Sciences, Jissen Women’s University, Osakaue 4-1-1, Hino 191-8510, Tokyo, Japan;
| | - Shiro Sugiura
- Maternal and Child Health Center, Aichi Children’s Health and Medical Center, Morioka 7-426, Obu 474-8710, Aichi, Japan;
| | - Mieko Suzuki
- Department of Early Childhood Care and Development, Tamagawa University, Tamagawagakuen 6-1-1, Machida 194-8610, Tokyo, Japan;
| | - Hiromi Funayama
- Department of Pediatric Dentistry, Tsurumi University School of Dental Medicine, Tsurumi 2-1-3, Tsurumi, Yokohama 230-8501, Kanagawa, Japan;
| | - Yuka Akiyama
- Department of Health Sciences, University of Yamanashi, Shimokato 1110, Chuo 409-3898, Yamanashi, Japan;
| | - Mayu Haraikawa
- Department of Child Studies, Seitoku University, Iwase 550, Matsudo 271-8555, Chiba, Japan;
| | - Kumi Eto
- School of Nutrition Sciences, Kagawa Nutrition University, Chiyoda 3-9-21, Sakado 350-0288, Saitama, Japan;
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11
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Tsai SY, Tung YC, Wu WW, Lee CC. Sleep pattern regularity and measures of infant weight and length during the first 6 months. J Pediatr Nurs 2022; 64:e102-e108. [PMID: 34996681 DOI: 10.1016/j.pedn.2021.12.022] [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: 09/14/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine the association between sleep pattern regularity and measures of weight and length in infants. DESIGN AND METHODS This was a prospective observational study conducted in a university-affiliated children's hospital in northern Taiwan. A total of 316 healthy infants recruited during their 6-month well-child checkups had their weight and recumbent length measured, and wore an actigraph on the ankle for a week. Based on average weekday, weekend, and all-week sleep durations, infants were categorized into 3 groups: regular sleep, weekend catch-up sleep, and weekend sleep curtailment. General linear model analyses were performed with the 3 sleep regularity groups as the primary predictor variable of interest and infant anthropometry as the dependent variable. RESULTS At risk of overweight, overweight, and obese was present in a total of 62 (19.6%) infants. In both unadjusted and adjusted models, infants in the weekend catch-up sleep group (30.4%) and those in the weekend sleep curtailment group (34.5%) had significantly higher weight-to-length ratios, body mass index, weight-for-age z-scores, and weight velocity of 6-month increments z-scores when compared with infants in the regular sleep group (35.1%, all p < 0.05). CONCLUSIONS Differences in weekday-weekend sleep exist as early as in the first 6 months of life, and both catch-up sleep and sleep curtailment over the weekend is associated with higher measures of weight and length in infants. PRACTICE IMPLICATIONS Sleep assessments in well-child checkups should include not only global assessments of average sleep duration but also address sleep patterns and their regularity.
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Affiliation(s)
- Shao-Yu Tsai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Yi-Ching Tung
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan
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12
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A longer time spent at childcare is associated with lower diet quality among children aged 5-6 years, but not those aged 1.5-2 and 3-4 years: Dietary Observation and Nutrient intake for Good health Research in Japanese young children (DONGuRI) study. Public Health Nutr 2022; 25:657-669. [PMID: 33317648 PMCID: PMC9991545 DOI: 10.1017/s1368980020003286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the association between the amount of time spent at childcare and diet quality in 668 Japanese children aged 1·5-6 years. DESIGN A cross-sectional design was used. Dietary information was collected using dietary records (1 d for children aged 1·5-2 years and 2 d for children aged 3-6 years). Diet quality was assessed by counting the number of nutrients not meeting the Japanese Dietary Reference Intakes (DRI). Each child's guardian reported the average amount of time spent at childcare per d for the previous 1 month. SETTING In total, 315 childcare centres located in twenty-four areas in Japan. PARTICIPANTS In total, 753 children aged 1·5-6 years who attend childcare facilities. RESULTS After adjustment for potential confounders, OR for the low diet quality (≥ 5 of twenty nutrients not meeting DRI) in long (≥10 h/d) v. medium (8-10 h/d) childcare hours was 4·81 (95 % CI 1·96, 11·8) among children aged 5-6 years. There was no significant association in children aged 1·5-2 and 3-4 years. CONCLUSION This study showed that long time spent at childcare was strongly associated with low diet quality among children aged 5-6 years, but not those aged 1·5-2 and 3-4 years. More research is needed to clarify different associations in each age group.
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13
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de Souza AA, Mota JAPS, da Silva GMG, Tassitano RM, Clark CCT, Duncan MJ, Martins CMDL. Associations between Movement Behaviours and Obesity Markers among Preschoolers Compliant and Non-Compliant with Sleep Duration: A Latent Profile Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9492. [PMID: 34574417 PMCID: PMC8472778 DOI: 10.3390/ijerph18189492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/02/2021] [Accepted: 09/02/2021] [Indexed: 11/20/2022]
Abstract
This study identifies physical activity (PA) and sedentary behaviour (SB) clusters in preschoolers compliant (C) or non-compliant (NC) with sleep recommendations; and associates these clusters with obesity markers. PA and SB were objectively assessed (Actigraph WGT3-X) in 272 preschoolers (4.4 ± 0.7 years old). Sleep duration was parent-reported, and preschoolers were classified as C (3-4 years old: 600-780 min/day; 5 years old: 540-660 min/day) or NC with sleep recommendations. Body mass index (BMI) and waist circumference (WC) were assessed according to international protocols. Moderate to vigorous physical activity (MVPA) and light physical activity (LPA) were categorized as low/high (<60 min/>60 min/day or <180 min/180 min/day, respectively). SB was defined according to mean values between clusters. Latent profile analysis was performed. Associations between the observed clusters and obesity markers were determined using linear regression (RStudio; 1.3.1073). Four cluster solutions for C and NC preschoolers were identified. A negative association between C/Low MVPA cluster and BMI, and a positive association between NC/Low MVPA and BMI (β = -0.8, 95%CI = -1.6;-0.1, and β = 0.9, 95%CI = 0.1;1.7, respectively) were observed. No association was seen for SB clusters. Adequate sleep duration may have a protective role for preschoolers' BMI, even if the children do not comply with MVPA recommendations.
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Affiliation(s)
- Alesandra A. de Souza
- Department of Physical Education, Federal University of Tocantins, Tocantinopolis 77900-000, Brazil
| | - Jorge A. P. S. Mota
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, 4050-313 Porto, Portugal; (J.A.P.S.M.); (C.M.d.L.M.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-091 Porto, Portugal
| | - Gustavo M. G. da Silva
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia (ISMAI), 4475-690 Maia, Portugal;
| | - Rafael M. Tassitano
- Department of Physical Education, Federal Rural University of Pernambuco, Recife 50010-000, Brazil;
| | - Cain C. T. Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5FB, UK;
| | - Michael J. Duncan
- Centre for Applied Biological and Exercise Sciences, Coventry University, Coventry CV1 5FB, UK;
| | - Clarice M. de L. Martins
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, 4050-313 Porto, Portugal; (J.A.P.S.M.); (C.M.d.L.M.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-091 Porto, Portugal
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14
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Which Is More Important for Health: Sleep Quantity or Sleep Quality? CHILDREN-BASEL 2021; 8:children8070542. [PMID: 34202755 PMCID: PMC8304732 DOI: 10.3390/children8070542] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 01/13/2023]
Abstract
Sleep is one of the basic physiological processes for human survival. Both sleep quantity and sleep quality are fundamental components of sleep. This review looks at both sleep quantity and sleep quality, considering how to manage the complex but probably unavoidable physiological phenomenon of sleep. The need for sleep has marked variations between individuals, in addition to the effects of variable conditions. Studies on sleep quality started later than those on sleep quantity, beginning in 1989 when Ford and Kamerow revealed that insomnia increases the risk of psychiatric disorders. According to the nationwide research team on the quality of sleep (19FA0901), sleep quality is superior to sleep quantity as an index for assessing sleep, and that restfulness obtained through sleep is a useful index for assessing sleep quality. We should pay more attention to obtaining sleep of good quality (restfulness, no sleepiness, no need for more sleep, sufficient objective sleep depth, etc.), although there have not been enough studies on the associations between sleep quality and health or disorders in children and adolescents. Further studies using the deviation from an individual’s optimal sleep quantity may show us another aspect of the effects of sleep quantity on various life issues.
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15
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Tao S, Wu X, Li S, Ma L, Yu Y, Sun G, Zhang Y, Li T, Tao F. Circadian rhythm abnormalities during the COVID-19 outbreak related to mental health in China: a nationwide university-based survey. Sleep Med 2021; 84:165-172. [PMID: 34153799 DOI: 10.1016/j.sleep.2021.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 02/06/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE/BACKGROUND School closure and home quarantine has been implemented worldwide during the coronavirus disease 2019 (COVID-19) outbreak. The study aims to assess the associations of circadian rhythm abnormalities (CRA) during the COVID-19 outbreak with mental health in Chinese undergraduates. METHODS A nationwide cross-sectional university-based survey was conducted from 4th February to 12th, 2020. Based on different geographical locations and purposive sampling approach, 19 universities from 16 provinces or municipalities in the mainland of China were selected. A total of 14,789 participants were recruited by using multistage stratified random sampling. The data of CRA were collected by self-reported questionnaires consist of four items involved rest-activity cycle, diet rhythm, wake up rhythm and sleep rhythm. The Patient Health Questionnaire and the Generalized Anxiety Disorder were applied to evaluate the symptoms of depression and anxiety. Chi-square test and ordinal logistic regression models were used to describe the distributions and associations of CRA and mental health. RESULTS A total of 11,787 students [female: 6731(57.1%)] aged 15-26 years old (M = 20.45, SD = 1.76) were analyzed (response rate: 79.7%). The results showed the percentage of CRA were 17.5-28.7%. The prevalence of depression and anxiety were significantly higher in students with single CRA. Students who reported the coexistence of four CRA were more likely to be with the symptoms of depression (OR: 4.43, 95% CI: 3.91-5.03) and anxiety (OR: 3.11, 95% CI: 2.70-3.60). Dose-response relationships were found between multiple CRA and mental problems. CONCLUSION Circadian rhythm abnormalities are positively associated with mental health among university studies. Mental health care is needed for college students during the COVID-19 epidemic period.
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Affiliation(s)
- Shuman Tao
- Department of Nephrology, The Second Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Xiaoyan Wu
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Shiyue Li
- School of Health Sciences, Wuhan University, Wuhan, 430071, Hubei, China.
| | - Le Ma
- School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, China.
| | - Yizhen Yu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Hangkong Road 13, Wuhan, 430030, Hubei, China.
| | - Guilong Sun
- South-Central Minzu University, 182 Minyuan Road, Wuhan, 430074, Hubei, China.
| | - Yi Zhang
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Tingting Li
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Fangbiao Tao
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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16
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Guo YF, Liao MQ, Cai WL, Yu XX, Li SN, Ke XY, Tan SX, Luo ZY, Cui YF, Wang Q, Gao XP, Liu J, Liu YH, Zhu S, Zeng FF. Physical activity, screen exposure and sleep among students during the pandemic of COVID-19. Sci Rep 2021; 11:8529. [PMID: 33879822 PMCID: PMC8058040 DOI: 10.1038/s41598-021-88071-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/22/2021] [Indexed: 12/21/2022] Open
Abstract
This study aimed to determine the levels of health-related behaviours (physical activity, screen exposure and sleep status) among Chinese students from primary, secondary and high schools during the pandemic of COVID-19, as well as their changes compared with their status before the pandemic. A cross-sectional online survey of 10,933 students was conducted among 10 schools in Guangzhou, China, between 8th and 15th March, 2020. After getting the informed consent from student's caregivers, an online questionnaire was designed and used to obtain time spending on health-related behaviours during the pandemic of COVID-19, as well as the changes compared with 3 months before the pandemic, which was completed by students themselves or their caregivers. Students were stratified by regions (urban, suburban, exurban), gender (boys and girls), and grades (lower grades of primary school, higher grades of primary schools, secondary schools and high schools). Data were expressed as number and percentages and Chi-square test was used to analyse difference between groups. Overall, the response rate of questionnaire was 95.3% (10,416/10,933). The median age of included students was 13.0 (10.0, 16.0) years and 50.1% (n = 5,219) were boys. 41.4%, 53.6% and 53.7% of total students reported less than 15 min per day in light, moderate and vigorous activities and 58.7% (n = 6,113) reported decreased participation in physical activity compared with the time before pandemic. Over 5 h of screen time spending on online study was reported by 44.6% (n = 4,649) of respondents, particular among high school students (81.0%). 76.9% of students reported increased screen time compared with the time before pandemic. Inadequate sleep was identified among 38.5% of students and the proportion was highest in high school students (56.9%). Our study indicated that, during the COVID-19 pandemic, the school closure exerted tremendous negative effects on school-aged children's health habits, including less physical activity, longer screen exposure and irregular sleeping pattern.
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Affiliation(s)
- Yang-Feng Guo
- Department of Common Chronic Disease Control and Prevention, Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510630, China
| | - Min-Qi Liao
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Wei-Li Cai
- Department of Common Chronic Disease Control and Prevention, Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510630, China
| | - Xiao-Xuan Yu
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Shu-Na Li
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Xing-Yao Ke
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Si-Xian Tan
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Ze-Yan Luo
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Yun-Feng Cui
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Qian Wang
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Xu-Ping Gao
- Department of Child & Adolescent Psychiatry, National Clinical Research Centre for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Peking University Sixth Hospital (Institute of Mental Health), No.51 Huayuan Bei Road, Beijing, 100191, China
| | - Jun Liu
- Preventive Medicine Experimental Teaching Centre, Zunyi Medical University, No.6 Xuefu West Road, Zunyi, 564699, Guizhou Province, China
| | - Yan-Hua Liu
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Sui Zhu
- Department of Medical Statistics, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China
| | - Fang-Fang Zeng
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China.
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17
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Hiltunen P, Leppänen MH, Ray C, Määttä S, Vepsäläinen H, Koivusilta L, Sajaniemi N, Erkkola M, Roos E. Relationship between screen time and sleep among Finnish preschool children: results from the DAGIS study. Sleep Med 2020; 77:75-81. [PMID: 33338700 DOI: 10.1016/j.sleep.2020.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES To examine the associations between screen time, the time spent on different screen devices, and sleep in a sample of Finnish preschool children. METHODS The current study analyzed cross-sectional data from the DAGIS study carried out in Finland in 2015-2016 on 736 children aged 3-6 years. Parents reported in a 7-day diary the durations the child used screen devices daily, with separate details about watching TV or DVDs, using tablets or smartphones, and using computers. In addition, parents reported children's bedtimes and wake-up times, which were further used in calculating sleep duration. Parents answered questions regarding their child's sleep consistency. Statistical analyses included adjusted general linear modeling. RESULTS An hourly increase in total screen time was associated with 11 min later bedtime (p < 0.001) and 10 min shorter sleep duration (p < 0.001). More TV/DVD watching was associated with later bedtimes (p = 0.016) and a shorter sleep duration (p = 0.001). More smartphone/tablet use was associated with later bedtimes (p = 0.005), later wake-up times (p = 0.038), and weaker sleep consistency (p = 0.024). More computer use was associated with later bedtimes (p = 0.046). Results did not differ between genders. CONCLUSIONS Increased screen time was associated with later bedtimes and shorter sleep duration among preschool children. Adverse associations with sleep outcomes were found for each screen device. Attention should be paid to promoting balanced use of screens and regular sleep habits in young children.
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Affiliation(s)
- Pauliina Hiltunen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland.
| | - Marja H Leppänen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Public Health, Faculty of Medicine, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Suvi Määttä
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Faculty of Social Sciences, University of Helsinki, Unioninkatu 37, P.O. Box 54, 00014 University of Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Leena Koivusilta
- Department of Social Research, University of Turku, FI-20014, Turku, Finland
| | - Nina Sajaniemi
- Faculty of Educational Sciences, University of Helsinki, Siltavuorenpenger 1-5, 10, P.O. Box 9, 00014 University of Helsinki, Finland; Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, P.O. Box 111, FI-8010, Joensuu, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland; Department of Public Health, Faculty of Medicine, P.O. Box 63, 00014 University of Helsinki, Finland.
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18
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Perpétuo C, Fernandes M, Veríssimo M. Comparison Between Actigraphy Records and Parental Reports of Child's Sleep. Front Pediatr 2020; 8:567390. [PMID: 33072676 PMCID: PMC7541828 DOI: 10.3389/fped.2020.567390] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
Given the impact of sleep in several domains of a child's development, the comparison between actigraphy and parental questionnaires is of great importance in preschool-aged children, an understudied group. While parental reports tend to overestimate sleep duration, actigraphy boosts the frequency of night-waking's. Our primary goal was to compare actigraphy data and parental reports (Children's Sleep Habits Questionnaire, CSHQ), regarding bedtime, wake-up time, sleep duration, and wake after sleep onset (WASO), using the Bland-Altman technique. Forty-six children, age 3-6 years, and their parents participated. Results suggest that, despite existing associations between sleep schedule variables measured by both methods (from r = 0.57 regarding bedtime at weekends to r = 0.86 regarding wake-up time during the week, ps), differences between them were significant and agreements were weak, with parents overestimating bedtimes and wake-up times in relation to actigraphy. Differences between actigraphy and CSHQ were ± 52 min for weekly bedtime, ± 38 min for weekly wake-up time, ±159 min for total sleep time, and ± 62 min for WASO, indicating unsatisfactory agreement between methods. Correlations between actigraphy data and CSHQ dimensions are also explored. Our study contributes to the knowledge of the characteristics of each instrument, along with their tendency to overestimate and underestimate certain sleep parameters. We conclude that a complementary use of both instruments would better inform clinical practice and research on a child's sleep.
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Affiliation(s)
- Catarina Perpétuo
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - Marília Fernandes
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
| | - Manuela Veríssimo
- William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal
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