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Jackson R, Gu C, Haszard J, Meredith-Jones K, Galland B, Camp J, Brown D, Taylor R. The Effect of Prebedtime Behaviors on Sleep Duration and Quality in Children: Protocol for a Randomized Crossover Trial. JMIR Res Protoc 2024; 13:e63692. [PMID: 39163119 PMCID: PMC11372319 DOI: 10.2196/63692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND It is recommended that children should avoid eating dinner, being physically active, or using screens in the hour before bed to ensure good sleep health. However, the evidence base behind these guidelines is weak and limited to cross-sectional studies using questionnaires. OBJECTIVE The aim of this randomized crossover trial was to use objective measures to experimentally determine whether recommendations to improve sleep by banning electronic media, physical activity, or food intake in the hour before bed, impact sleep quantity and quality in the youth. METHODS After a baseline week to assess usual behavior, 72 children (10-14.9 years old) will be randomized to four conditions, which are (1) avoid all 3 behaviors, (2) use screens for at least 30 minutes, (3) be physically active for at least 30 minutes, and (4) eat a large meal, during the hour before bed on days 5 to 7 of weeks 2 to 5. Families can choose which days of the week they undertake the intervention, but they must be the same days for each intervention week. Guidance on how to undertake each intervention will be provided. Interventions will only be undertaken during the school term to avoid known changes in sleep during school holidays. Intervention adherence and shuteye latency (time from getting into bed until attempting sleep) will be measured by wearable and stationary PatrolEyes video cameras (StuntCams). Sleep (total sleep time, sleep onset, and wake after sleep onset) will be measured using actigraphy (baseline, days 5 to 7 of each intervention week). Mixed effects regression models with a random effect for participants will be used to estimate mean differences (95% CI) for conditions 2 to 4 compared with condition 1. RESULTS Recruitment started in March 2024, and is anticipated to finish in April 2025. Following data analysis, we expect that results will be available later in 2026. CONCLUSIONS Using objective measures, we will be able to establish if causal relationships exist between prebedtime behaviors and sleep in children. Such information is critical to ensure appropriate and achievable sleep guidelines. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12624000206527; https://tinyurl.com/3kcjmfnj. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/63692.
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Affiliation(s)
- Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Chao Gu
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | | | - Barbara Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Justine Camp
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Deirdre Brown
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Muller D, Signal TL, Shanthakumar M, Fleming T, Clark TC, Crengle S, Donkin L, Paine SJ. Inequities in adolescent sleep health in Aotearoa New Zealand: Cross-sectional survey findings. Sleep Health 2024; 10:385-392. [PMID: 38910037 DOI: 10.1016/j.sleh.2024.05.007] [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: 11/29/2023] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVES To investigate ethnic inequities in, and social determinants of, adolescent sleep health in Aotearoa New Zealand. METHODS Analysis of self-report data from a cross-sectional survey of secondary school students (12- to 18-year-olds). Analyses included weighted prevalence estimates of good and poor sleep health stratified by ethnicity, and multivariable logistic regression models concurrently adjusted for ethnicity, school year, gender, rurality, neighborhood deprivation, school decile, housing deprivation, sleeping elsewhere due to lack of adequate housing, unsafe environment, and racism. RESULTS Inequities in social determinants of health were evident for Māori (Indigenous peoples of Aotearoa New Zealand; n = 1528) and minoritized (Pacific n = 1204; Asian n = 1927; Middle Eastern, Latin American, and African [MELAA] n = 210; and 'Other' ethnicity n = 225) adolescents. A greater proportion of Māori, Pacific, Asian, MELAA, and 'Other' adolescents had short sleep, compared to European (n = 3070). Māori, Pacific, Asian, and MELAA adolescents were more likely to report late bedtimes (after midnight), and Māori, Pacific, and 'Other' adolescents were more likely to report early waketimes (5 AM-6 AM or earlier), on school days. Rurality, neighborhood deprivation, school-level deprivation, housing deprivation, sleeping elsewhere due to inadequate housing, unsafe environments, and racism partially, but not fully, explained associations between ethnicity and short sleep, late bedtimes, and early waketimes. CONCLUSIONS Ethnic inequities exist in adolescent sleep health in Aotearoa New Zealand. Socio-political actions are needed to address racism and colonialism as root causes of ethnic inequities in adolescent sleep, to ensure all young people are afforded the basic human right of good sleep health and associated mental and physical well-being.
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Affiliation(s)
- Diane Muller
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University, Wellington, New Zealand.
| | - T Leigh Signal
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University, Wellington, New Zealand
| | - Mathangi Shanthakumar
- Environmental Health Intelligence New Zealand (EHINZ), Research Centre for Hauora and Health, College of Health, Massey University, Wellington, New Zealand
| | - Terry Fleming
- School of Health, Faculty of Health, Te Herenga Waka/Victoria University of Wellington, Wellington, New Zealand
| | - Terryann C Clark
- School of Nursing, Faculty of Medical Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Liesje Donkin
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
| | - Sarah-Jane Paine
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Time WS, Fakapulia IF, Samalia L, Wibowo E. The Relationship Between Academic Stress, Sleep Quality, and Psychological Wellbeing in Pasifika and New Zealand European Students at the University of Otago. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02043-8. [PMID: 38856838 DOI: 10.1007/s40615-024-02043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Pasifika students in New Zealand are overrepresented in poor academic outcomes, and their academic challenges may potentially influence their wellbeing. We aim to: 1) compare the academic stress, sleep quality, and psychological wellbeing of Pasifika and New Zealand European (NZE) anatomy students at the University of Otago, and 2) determine if academic stress mediates the association between their psychological wellbeing and sleep quality. METHODS We launched a brief online survey to Pasifika and NZE students in our department. The survey included basic demographics, Perception of Academic Stress Scale, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, a short loneliness scale, a reduced morningness-eveningness scale, and the Epworth Sleepiness Scale. RESULTS Perceived academic stress were comparable between NZE and Pasifika students, but Pasifika students reported poorer sleep quality than NZE students (t(113) = 14.41, P < .001). In addition, Pasifika students reported more loneliness (t(119) = 8.933, P < .001), less anxiety symptoms (t(120) = 2.469, P = .015), and less of a morning person (t(121) = 2.618, P = .010) than NZE students, but they had comparable depressive symptoms and daytime sleepiness. After controlling for age, ethnicity and gender, we found that academic stress fully mediated the relationship between anxiety or depressive symptoms and poor sleep quality. Furthermore, academic stress partially mediated the relationship between loneliness and poor sleep quality in our cohort. CONCLUSION Our findings highlight the importance for academic institutions to support students' wellbeing, including ethnic minority students such as Pasifika students in New Zealand.
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Affiliation(s)
| | | | - Latika Samalia
- Department of Anatomy, University of Otago, Dunedin, 9016, New Zealand
| | - Erik Wibowo
- Department of Anatomy, University of Otago, Dunedin, 9016, New Zealand.
- School of Medical Sciences, University of Sydney, Sydney, 2006, Australia.
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Jakobsson M. "I'm not sure if it works": School nurses' experiences of sleep-promoting work in Sweden. Sleep Health 2024; 10:272-278. [PMID: 38245476 DOI: 10.1016/j.sleh.2023.12.009] [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] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVES Lack of sleep is a common problem in children and adolescents of school age (students), and it is a health aspect that affects the ability to assimilate into the school's education and thereby falls within the school nurses promoting work. This study aimed to describe school nurses' experiences of sleep-promoting work. METHOD Data were collected by n = 61 school nurses' written narratives of their sleep-promotion work. Data were analyzed using qualitative content analysis. RESULTS The results describe school nurses' experiences of sleep-promoting work in three main categories: (1) Informing and providing knowledge is the primary task. School nurses do it systematically, through dialogs with an individual student, with several students simultaneously, or with parents. (2) Benefits take place when the needs of the student guide the work. Through curiosity about the personal story, the keys to sleep-promoting work can be found, appropriate strategies can be given, and the student can be guided further if needed. (3) Barriers challenge the outcome of the work. The school nurses experience these barriers in the form of unmotivated students, unsupportive parents, and lack of prerequisites, which make the school nurses unsure of their performance. CONCLUSIONS School nurses experience a significant benefit in their sleep-promoting work when the needs of the student guide the sleep-promoting information, strategies, and follow-ups. To avoid feeling insecure in sleep-promoting work, school nurses need updates on the state of knowledge and evidence-based tools. Further research on sleep-promoting work at school is necessary.
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Affiliation(s)
- Malin Jakobsson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden; CHILD-Research Group, Jönköping University, Jönköping, Sweden.
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Ashby C, Driller MW, Suppiah H, O'Donnell S. Sink or Swim? Sleep Patterns in Highly Trained Adolescent Swimmers during the In-Season Phase of Training. Sleep Sci 2024; 17:e176-e184. [PMID: 38846587 PMCID: PMC11152630 DOI: 10.1055/s-0043-1777778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Objectives The aim of this study was to investigate the sleeping patterns of highly-trained adolescent swimmers. Further objectives were to compare subjective and objective measures of sleep and to evaluate the relationship between electronic device use and sleep in this cohort. Methods Fifteen national-level swimmers (age: 16.4 ± 1.0 years) wore wrist actigraphs while completing sleep diaries over a two-week training period. Types of nights were classified as early morning training (≤7am - EARLY), day training (>7am - DAY), and no training (REST). Information on electronic device use before bed and other sleep behaviors was collected via questionnaires. Results Total sleep time (TST) was significantly ( p < 0.05) shorter on nights preceding EARLY (5:53 ± 1:06 hour:min) compared with nights preceding DAY (7:40 ± 1:12 hour:min) and REST (7:59 ± 1:19 hour:min). Participants overestimated subjective TST by ∼54 minutes when compared with objectively measured TST ( p < 0.05). Discussion Adolescent athletes obtained a greater amount of sleep prior to later training the next day or before rest days, when compared with early morning swim training the next day. Adolescents also overestimated their sleep duration by ∼1 hour per night. There were no significant relationships between electronic device use at night and measured sleep indices.
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Affiliation(s)
- Claudia Ashby
- School of Health, University of Waikato, Hamilton, Waikato, New Zealand
| | - Matthew W. Driller
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services, and Sport, Melbourne, La Trobe University, Victoria, Australia
| | - Haresh Suppiah
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services, and Sport, Melbourne, La Trobe University, Victoria, Australia
| | - Shannon O'Donnell
- School of Health, University of Waikato, Hamilton, Waikato, New Zealand
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Reichenberger DA, Master L, Mathew GM, Snyder CK, Buxton OM, Hale L, Chang AM. Interactive Screen-Based Activities Predict Worse Actigraphic Sleep Health That Night Among Adolescents. J Adolesc Health 2024; 74:774-781. [PMID: 38099901 PMCID: PMC10960697 DOI: 10.1016/j.jadohealth.2023.10.027] [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: 02/24/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 03/24/2024]
Abstract
PURPOSE To determine the micro-longitudinal effects of duration and timing of screen-based activities on sleep within and between adolescents. METHODS Daily survey and actigraphy data from the age 15 wave of the Future of Families and Child Wellbeing Study were analyzed using multilevel modeling. Four hundred seventy five adolescents provided three or more days of valid daily survey and nighttime sleep data. RESULTS Within-person results showed that on days when adolescents played video games more than their daytime average ± SE (1.3 ± 1.2 hours), sleep onset (6 ± 2 minutes, p < .01) and midpoint (4 ± 2 minutes, p < .02) were delayed for each additional hour of gaming. Between-person results showed that for each hour adolescents used screens to communicate with friends across the day, sleep onset was later (11 ± 3 minutes, p < .01), sleep midpoint was later (8 ± 3 minutes, p < .01), and sleep duration was shorter (-5 ± 2 minutes, p < .03). Adolescents who used screens to communicate with friends or play video games in the hour before bed had later sleep onset (30 ± 14 minutes, p < .03) and midpoint (25 ± 13 minutes, p < .05). DISCUSSION Among adolescents, passive screen usage such as browsing the Internet or watching videos may not affect sleep timing or duration, but limiting interactive screen-based activities could protect adolescent sleep health and well-being.
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Affiliation(s)
- David A Reichenberger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania.
| | - Lindsay Master
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
| | - Gina Marie Mathew
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Cynthia K Snyder
- Department of Nursing, Pennsylvania College of Health Sciences, Lancaster, Pennsylvania
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
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Echevarria P, Del-Ponte B, Tovo-Rodrigues L, Matijasevich A, Halal CS, Santos IS. Screen use and sleep duration and quality at 15 years old: Cohort study. Sleep Med X 2023; 5:100073. [PMID: 37305851 PMCID: PMC10251069 DOI: 10.1016/j.sleepx.2023.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Objective/background The evidence on the association between screen use and sleep of adolescents is mainly based on studies about time watching television, with a few examining time using computers, videogames, and mobile devices. Our aim was to investigate the association between screen time for entertainment (watching TV, using computer, or playing games on tablets, smartphones, or videogame consoles) and sleep duration and self-reported sleep quality, among adolescents aged 15 years. Methods With data from the 2004 Pelotas Birth Cohort, sleep duration was assessed with questions extracted from the Munich Chronotype Questionnaire and quality was self-reported. Adjusted β coefficients and prevalence ratios (PR) with (95% confidence intervals) were obtained, respectively, by linear and Poisson regressions. Results 1,949 adolescents had information about screen time and sleep quality, and 1,851 about screen time and sleep duration. The median screen time was 4.5hs/24hs. The mean sleep duration was 7.6hs/24hs and the prevalence of bad sleep was 17.3% (15.7-19.0%). There was an inverse relationship between screen time and sleep duration. When compared with those with less than 2hs/24hs of screen time, adolescents with 6-8.8hs/24hs and ≥9hs experienced, respectively, 23.4 and 32.4 min reduction in sleep duration (β = -0.39; -0.62;-0.16 and β = -0.54; -0.77;-0.30). Adolescents with ≥9hs of screen time were 60% more likely to report bad sleep than those with less than 2hs/24hs (PR: 1.60; 1.10-2.32). Conclusions The median time spent using screens was longer than recommended. Screen use for ≥6hs/24hs was associated with a shorter sleep duration, and ≥9hs/24hs with poor sleep quality.
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Affiliation(s)
- Priscila Echevarria
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Bianca Del-Ponte
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Camila S. Halal
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Iná S. Santos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
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He J, Fu Y, Cui S, Barnhart WR, Zhang X, Han J, Wang Y, Ganson KT, Nagata JM. Screen use while eating is associated with lower intuitive eating and higher disordered eating in Chinese adult men and women. Int J Eat Disord 2023; 56:1961-1972. [PMID: 37489116 DOI: 10.1002/eat.24026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE We aimed to explore the potential associations between screen use while eating and intuitive eating and disordered (thinness-oriented and muscularity-oriented) eating behaviors. METHODS Analyses included 600 Chinese adults (50% women; Mage = 30.67, SD = 8.08) recruited online. The use of four major screen devices was captured, including cell phones, tablets, computers, and TVs. Three types of eating behaviors were examined, namely intuitive eating, thinness-oriented disordered eating, and muscularity-oriented disordered eating. Pearson correlation and hierarchical regression analyses were conducted separately for men and women to examine the sex-specific associations between screen use while eating and intuitive eating, thinness-oriented disordered eating, and muscularity-oriented disordered eating. RESULTS In both men and women, more screen use while eating was significantly associated with lower intuitive eating, higher thinness-oriented disordered eating, and higher muscularity-oriented disordered eating, above and beyond total screen time and social media use. DISCUSSION We found preliminary evidence for the significant links between screen use while eating and intuitive eating and disordered eating. Given the global increases in screen use, continued research is warranted to further explore the role of screen use while eating in the development and maintenance of intuitive eating and disordered eating. PUBLIC SIGNIFICANCE Much remains unknown regarding screen use while eating and eating behaviors. We found that in both Chinese men and women, more screen use while eating was significantly and uniquely associated with lower intuitive eating, higher thinness-oriented disordered eating, and higher muscularity-oriented disordered eating. Findings highlight the importance of incorporating screen use while eating in future research on intuitive eating and disordered eating.
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Affiliation(s)
- Jinbo He
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yuru Fu
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Shuqi Cui
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Xinyi Zhang
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Jiayi Han
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yitong Wang
- School of Economics and Management, Yan'an University, Yan'an, Shaanxi, China
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Jason M Nagata
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA
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Jones BL, Wikle JS. Activities and social contact as antecedents to sleep onset time in U.S. adolescents. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:1048-1060. [PMID: 37127934 DOI: 10.1111/jora.12857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 03/09/2023] [Accepted: 04/15/2023] [Indexed: 05/03/2023]
Abstract
This study evaluated adolescents' evening patterns in activities, social contact, and location to better understand antecedents to adolescents' sleep onset time (SOT). The SOT is important for sleep duration and related health outcomes. Using a nationally representative sample of 15- to 18-year-old adolescents from the American Time Use Survey (N = 10,341; 47% female; 57% white), structural equation modeling demonstrated that late SOTs mediated links between evening activities, social contact, locations, and shorter sleep durations. Passive leisure, time in public locations, and time with friends late in the evenings were associated with later SOTs, whereas homework and active leisure did not. Parents and practitioners can use this information to carefully evaluate evening activities, social contact, and location to support healthy SOTs for adolescents across time.
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Affiliation(s)
- Blake L Jones
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Jocelyn S Wikle
- School of Family Life, Brigham Young University, Provo, Utah, USA
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Jakobsdottir G, Stefansdottir RS, Gestsdottir S, Stefansson V, Johannsson E, Rognvaldsdottir V, Gisladottir TL. Changes in health-related lifestyle choices of university students before and during the COVID-19 pandemic: Associations between food choices, physical activity and health. PLoS One 2023; 18:e0286345. [PMID: 37352179 PMCID: PMC10289399 DOI: 10.1371/journal.pone.0286345] [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: 12/20/2022] [Accepted: 05/13/2023] [Indexed: 06/25/2023] Open
Abstract
The COVID-19 pandemic has had a profound effect on our lives and society, influencing both individuals' lifestyles and habits. Recent research shows that anxiety and loneliness have continued to rise, along with changes in food and lifestyle choices. The aim of the study was to investigate whether the pandemic influenced food choices and consumption of energy drinks, alcohol, fruits, and vegetables among first-year university students. Additionally, assessing the relationship between mental and physical health, physical activity, and food choices. A total of 128 male and 128 female first-year students at the University of Iceland were invited to answer an electronic questionnaire in January and early February 2021. A total of 118 students (54% men) participated in the study and valid answers were 115 (46% participation rate). Almost half of the students (44%) experienced that their food choices had worsened, while 14% reported an improvement, compared to before the pandemic. Consumption of caffeinated beverages increased for 26% of students, while 19% experienced a decrease. Just over half of the students reported not drinking alcohol (13%) or reduced consumption (41%). Participants who reported that their mental health had deteriorated or remained the same tended to spend less time on physical activity and experienced worsened food choices (p<0.05). Similarly, those who spent less or the same time on physical activity estimated that their food choices had deteriorated (p<0.05). The COVID-19 pandemic has had a significant impact on the lifestyles of university students and this study has revealed how lifestyle choices and mental health seem to be highly affected by one another. Additionally, the potentially harmful effects of excessive intake of energy drinks need to be enhanced. Interestingly, about 40% of the respondents in the current study drank less alcohol during the pandemic than prior to the pandemic, indicating a strong relationship between alcohol drinking and social gatherings. This study reveals the importance of educating young people on healthy lifestyle choices and the importance of mental health needs to be emphasised.
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Affiliation(s)
- Greta Jakobsdottir
- Center of Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
| | - Runa Sif Stefansdottir
- Center of Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
| | - Sunna Gestsdottir
- Center of Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
| | - Vignir Stefansson
- Center of Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
| | - Erlingur Johannsson
- Center of Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Vaka Rognvaldsdottir
- Center of Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
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The relationship between sleep duration and health among Pacific adolescents within New Zealand: Findings from the Pacific Islands families study. Aust N Z J Public Health 2023; 47:100021. [PMID: 36917880 DOI: 10.1016/j.anzjph.2023.100021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/31/2022] [Accepted: 12/28/2022] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVE Sleep insufficiency is bi-directionally associated with adverse behavioural, physical and mental health outcomes in paediatric populations. However, little is known about the degree of sleep insufficiency and its effect on Pacific adolescents' wellbeing. METHODS A cross-sectional study of 14-year old Pacific adolescents nested within a longitudinal birth cohort was conducted. Self-reported sleep duration was related to sentinel physical, mental, and risk taking behaviour measures in crude and adjusted logistic regression models. Complete case and multiple imputed analyses were conducted. RESULTS 916 Pacific adolescents were eligible, with a mean age of 14.2 years. Valid sleep data were available from 828 (90.4%) participants, with only 220 (26.6%) meeting the recommended amount of sleep. Insufficient sleep duration was associated with significantly higher rates of depressive symptoms and risk taking behaviours. In multiple imputed analyses, increased body mass index was also significantly related. CONCLUSIONS Sleep insufficiency is ubiquitous among Pacific adolescents and associated with negative impacts on their health and wellbeing. IMPLICATIONS FOR PUBLIC HEALTH Insufficient sleep duration is amenable to change. Bespoke, culturally responsive public health strategies that draw attention to the importance of positive sleep practices are needed. Particularly, among adolescents who are at risk of experiencing the greatest burden of insufficient sleep.
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Yu J, Liu Y, Liao L, Yan J, Wang H. Cluster Analysis of Sleep Time and Adolescent Health Risk Behaviors. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231153272. [PMID: 36748745 PMCID: PMC9909054 DOI: 10.1177/00469580231153272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Adolescents are prone to multiple health risk behaviors. These might lead to insufficient sleep, which is inconducive to adolescent growth. Therefore, this study explored the impact of a cluster of adolescent health risk behaviors on sleep time, providing a reference for designing relevant intervention measures. From November to December 2019, a stratified cluster sampling method was used to sample middle and high schools in 4 functional districts of Chongqing, China. A total of 8546 participants were selected for a questionnaire survey. Two-step clustering helped identify the health risk behavior clusters. Multivariate logistic regression models helped examine the association between the different clusters and sleep time. The rate of insufficient sleep was 65.8%. Three types of clusters were identified, namely (1) high-risk (poor) cluster (17.3%), (2) low physical activity (medium) cluster (55.1%), and (3) low-risk (good) cluster (27.6%). The high-risk and low physical activity clusters showed that the adjusted OR values of 1.471 (1.266-1.710) and 1.174 (1.052-1.310) were significantly associated with insufficient sleep (P < .001). Adolescent health risk behaviors were clustered, and different clusters had different sleep time. Schools authorities and healthcare practitioners should formulate effective intervention measures according to the characteristics of different clusters to promote healthy growth among adolescents.
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Affiliation(s)
- Junjie Yu
- School of Public Health, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Yang Liu
- School of Public Health, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Liping Liao
- School of Public Health, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Jie Yan
- School of Public Health, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Hong Wang
- School of Public Health, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China,Hong Wang, School of Public Health, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
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13
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Elder D, Miller J, Douglas B, Stanley J, McDowall P, Campbell A. Children talking about their sleep: a cross-sectional survey of differences by ethnicity and socioeconomic status in Aotearoa New Zealand primary schools. J Clin Sleep Med 2023; 19:119-133. [PMID: 36591794 PMCID: PMC9806790 DOI: 10.5664/jcsm.10264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 01/07/2023]
Abstract
STUDY OBJECTIVES This study examined differences by ethnicity and socioeconomic status in attitudes to sleep and bedtime routine, as self-reported by children aged 7-9 years. METHODS Four groups of parent-child dyads were recruited: Māori participants from low- (n = 18) and high- (n = 17) decile schools and New Zealand European participants from low- (n = 18) and high- (n = 17) decile schools. Children completed a questionnaire about their sleep, a self-report of anxiety symptoms, and a semistructured interview. RESULTS Most (77%) children reported liking to go to sleep (Māori, 88% vs New Zealand European, 65%; P = .053) and 28% reported trouble sleeping. Māori children were less likely to report fear of the dark and fighting about going to bed. Liking going to sleep was associated with less fear of the dark and of sleeping alone. Children from low-decile schools more often reported waking with pain and feeling sleepy (P = .022) and taking naps (P = .018) during the day. They also had more symptoms of anxiety. New Zealand European children more frequently reported using "screen time" (P = .02) or "reading a book" (P = .05). Children attending high-decile schools were more likely to read at bedtime (P = .01), whereas children attending low-decile schools were more likely to have "play time" (P = .02). Children were able to articulate what was a good night and bad night sleep. CONCLUSIONS These findings suggest that more adverse differences in sleep habits and attitudes in children are most likely to be related to socioeconomic status than to ethnicity. CITATION Elder D, Miller J, Douglas B, Stanley J, McDowall P, Campbell A. Children talking about their sleep: a cross-sectional survey of differences by ethnicity and socioeconomic status in Aotearoa New Zealand primary schools. J Clin Sleep Med. 2023;19(1):119-133.
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Affiliation(s)
- Dawn Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - James Miller
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Bronte Douglas
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Dean’s Department, University of Otago, Wellington, New Zealand
| | - Philippa McDowall
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Angela Campbell
- Department of Medicine, University of Otago, Wellington, New Zealand
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14
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Digital media use and sleep in late adolescence and young adulthood: A systematic review. Sleep Med Rev 2022; 68:101742. [PMID: 36638702 DOI: 10.1016/j.smrv.2022.101742] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023]
Abstract
Despite much attention on digital media use and young peoples' sleep, the literature on digital media and its impact on sleep in older adolescents and young adults remains to be synthesized. We conducted a systematic review of studies including young people aged 16-25 years. We searched Medline, Web of Science, and CINAHL for observational studies, identifying 60 studies. These studies were assessed for methodological quality. Only studies rated as moderate or high-quality studies were included (n = 42). A narrative synthesis summarized the impact of digital media use on eight sleep outcomes: Bedtime; Sleep onset latency or problems falling asleep; Sleep duration; Early awakening; Sleep disturbance; Daytime tiredness and function; Sleep deficits; Sleep quality. In summary, digital media use was associated to shorter sleep duration and poorer sleep quality. These associations were found for general screen use and use of mobile phone, computer, internet, and social media, but not for television, game console, and tablet use. Most studies investigating bedtime or nighttime use found associations to poor sleep outcomes. Later bedtime and daytime tiredness were associated with mobile phone use at night. Additional research is warranted to draw solid conclusions about the causal direction and to understand the underlying mechanisms.
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15
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Pillion M, Gradisar M, Bartel K, Whittall H, Kahn M. What's "app"-ning to adolescent sleep? Links between device, app use, and sleep outcomes. Sleep Med 2022; 100:174-182. [PMID: 36084495 DOI: 10.1016/j.sleep.2022.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 01/12/2023]
Abstract
This study investigated the associations between adolescent evening use of technology devices and apps, night time sleep, and daytime sleepiness. Participants were 711 adolescents aged 12-18 years old (46% Female, Mage = 15.1, SD = 1.2). Time spent using technology devices and apps in the hour before bed, and in bed before sleep onset, was self-reported. Participants additionally completed a questionnaire about their sleep on school nights and next day sleepiness. In the hour before bed, 30 min of phone use was associated with a 9-min delay in bedtimes. Thirty minutes spent using laptops, gaming consoles, and watching YouTube was associated with later lights out times of 9 min, ∼16 min and ∼11 min respectively, while watching TV was associated with a 9 min earlier lights out times. Using gaming consoles and watching YouTube were associated with greater odds of receiving insufficient sleep (≤7 h TST). In bed before sleep onset, 30 min spent using laptops, phones, iPad/tablets, and watching YouTube were linked with later lights out times of ∼7 min for phones and laptops, 9 min for iPad/tablets, and ∼13 min for YouTube. Watching Netflix was associated with greater daytime sleepiness. YouTube at this time point was associated with increased odds of sleeping ≤7 h on school nights. Adolescents are engaging with a wide range of technology devices and apps in the evenings. However, certain devices and apps (e.g., phones, laptops, gaming and YouTube) might lead to more negative sleep outcomes for adolescents on school nights compared to others.
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Affiliation(s)
- Meg Pillion
- Flinders University, College of Education, Psychology, and Social Work, Adelaide, Australia.
| | | | - Kate Bartel
- Flinders University, College of Education, Psychology, and Social Work, Adelaide, Australia
| | - Hannah Whittall
- Flinders University, College of Education, Psychology, and Social Work, Adelaide, Australia
| | - Michal Kahn
- Flinders University, College of Education, Psychology, and Social Work, Adelaide, Australia
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16
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Jakobsson M, Sundin K, Högberg K, Josefsson K. "I Want to Sleep, but I Can't": Adolescents' Lived Experience of Sleeping Difficulties. J Sch Nurs 2022; 38:449-458. [PMID: 33063632 PMCID: PMC9465542 DOI: 10.1177/1059840520966011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sleeping difficulties are increasingly prevalent among adolescents and have negative consequences for their health, well-being, and education. The aim of this study was to illuminate the meanings of adolescents' lived experiences of sleeping difficulties. The data were obtained from narrative interviews with 16 adolescents aged 14-15 in a Swedish city and were analyzed using the phenomenological hermeneutic method. The findings revealed four themes: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates that being an adolescent with sleeping difficulties means it is challenging to go through the night and to cope the next day. It also means a feeling of being trapped by circumstances. As the adolescents' lived experiences become apparent, the possibility for parents, school nurses, and other professional caregivers to support adolescents' sleep increases.
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Affiliation(s)
- Malin Jakobsson
- Faculty of Caring Science, Work Life and Social Welfare,
University of Borås, Sweden
| | | | - Karin Högberg
- Faculty of Caring Science, Work Life and Social Welfare,
University of Borås, Sweden
| | - Karin Josefsson
- Faculty of Caring Science, Work Life and Social Welfare,
University of Borås, Sweden
- Department of Health Science, Karlstad University,
Sweden
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17
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Xu X, Zheng F, Cai Y, Lin J, Zeng Z, Wei S, Wu S. Sleep health and its related influencing factors in primary and middle school students in Fuzhou: A large multi-center cross-sectional study. Front Public Health 2022; 10:924741. [PMID: 35991023 PMCID: PMC9386349 DOI: 10.3389/fpubh.2022.924741] [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: 04/20/2022] [Accepted: 07/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background This current study set out to investigate the status of sleep health in 7–20-year-old students in Fuzhou and explore the related influencing factors of sleep health. Methods A total of 38,467 children and adolescents in Fuzhou were included in the study through a random stratified cluster sampling. Data were collected from May to June 2019, in 18 primary schools and 18 middle schools from nine districts, Fuzhou. Children's parents and adolescents of sampled classes were invited to fill out a series of questionnaires about the performance of the last 6 months (sociodemographic characteristics, sleep-related lifestyle behaviors, and electronic-products usage). Multiple linear regression was carried out to analyze data. Results Of the total 40,888 questionnaires we released, 38,467 were valid and effective with the response rate was 94.08%. The age of the surveyed participants was 11.85 ± 3.1, including 20,013 boys and 18,454 girls. The multiple linear regression analysis identified factors associated with sleep health (p < 0.05): Boy (coef = 0.073, 95% CI: 0.030–0.115), age (coef = 1.797, 95% CI: 0.224–0.243), key school (coef = 2.069, 95% CI: 0.105–0.193), urban (coef = 0.096, 95% CI: 0.054–0.139), excessive daytime sleepiness (coef = 0.535, 95% CI: 0.432–0.639), unhealthy sleep habits (coef = 0.363, 95% CI: 0.307–0.419), eating before sleep (coef = 0.578, 95% CI: 0.527–0.630), using electronic products in bedroom (coef = 0.074, 95% CI: 0.028–0.121), screen time per day during school (coef = 0.260, 95% CI: 0.235–0.284), frequency of using electronics 30 min before bedtime (coef = 0.150, 95% CI: 0.134–0.166), strained relationship with parents (coef = 0.361, 95% CI: 0.270–0.452), strained relationship with peers (coef = 0.267, 95% CI: 0.171–0.363), excessive homework or learning (coef = 0.189, 95% CI: 0.141–0.237), time for doing homework (coef = 0.266, 95% CI: 0.245–0.287), and mood swings frequently (coef = 1.174, 95% CI: 1.127–1.221) negatively impact sleep health. Sleep alone (coef = −0.204, 95% CI: −0.262–0.147) were the risk factors for sleep health. Furthermore, frequent mood swings was considered the most influential factor on overall variables. Conclusions Sleep health is associated with factors covered sociodemographic characteristics, family sleep habits, and routine activities before bedtime. Multiple measures should be taken to improve sleep quality in a targeted manner.
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Affiliation(s)
- Xingyan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Fuhao Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Office of Academic Research, Fujian Provincial Hospital, Fuzhou, China
| | - Yingying Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jie Lin
- The Second Attached Hospital of Fujian Medical University, Quanzhou, China
| | - Zhaonan Zeng
- Center for Experimental Research in Clinical Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - Shichao Wei
- Sleep Medicine Center, Fujian Provincial Hospital, Fuzhou, China
- *Correspondence: Shichao Wei
| | - Siying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Siying Wu
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18
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McKelvie-Sebileau P, Gerritsen S, Swinburn B, D’Souza E, Tipene-Leach D. Nourishing Hawke’s Bay: He wairua tō te kai – food security, health behaviours and wellbeing in children in regional New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2064519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Pippa McKelvie-Sebileau
- School of Population Health, University of Auckland, Auckland, New Zealand
- Research and Innovation Centre, Eastern Institute of Technology, Napier, New Zealand
| | - Sarah Gerritsen
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Erica D’Souza
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - David Tipene-Leach
- Research and Innovation Centre, Eastern Institute of Technology, Napier, New Zealand
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19
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George M, Richards R, Watson B, Lucas A, Fitzgerald R, Taylor R, Galland B. Pacific families navigating responsiveness and children's sleep in Aotearoa New Zealand. Sleep Med X 2021; 3:100039. [PMID: 34881360 PMCID: PMC8590065 DOI: 10.1016/j.sleepx.2021.100039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 08/16/2021] [Accepted: 10/12/2021] [Indexed: 12/31/2022] Open
Abstract
The stakes for understanding sleep practices are rising as health inequalities related to sleep become more apparent. Pacific peoples in Aotearoa New Zealand face disproportionate challenges around poverty and health and sleep is one growing area of importance in addressing health inequalities. Through a qualitative study of 17 Pacific families in Aotearoa New Zealand, we provide a rare and valuable glimpse into the familial, cultural, social and economic context of sleep for Pacific families and children in New Zealand. These Pacific families uphold a core value of responsiveness to family, community, culture and faith. These values feed wellbeing in a variety of ways, especially when health is considered through Pacific, holistic frameworks. These families apply the same responsiveness to economic pressures, often taking on shiftwork. We show how responsiveness to family and culture, as well as limited economic means, permeates sleep practices within these Pacific households. These broader shaping factors must be acknowledged, considered, respected and integrated into any healthy sleep initiatives and interventions, in order to ensure benefit - and not harm - is achieved. A rare, valuable and intimate glimpse into the familial, cultural, social and economic context of sleep for Pacific families in New Zealand. Many health initiatives and interventions do not account for cultural variation and do not reach the populations that need them most. A qualitative study, integrating the Fonofale Model of health, informing culturally relevant sleep interventions for Pacific families. Pacific families value family, community, faith and culture; they are also disproportionately affected by economic hardship. Both impact sleep.
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Affiliation(s)
- Molly George
- University of Otago, PO Box 56, Dunedin, New Zealand
| | | | | | - Albany Lucas
- University of Otago, PO Box 56, Dunedin, New Zealand
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20
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Morrison S, Galland BC, Haszard JJ, Jackson R, McIntosh DR, Beebe DW, Elder DE, Ward AL, Meredith-Jones K, Taylor RW. Eating in the absence of hunger in children with mild sleep loss: a randomized crossover trial with learning effects. Am J Clin Nutr 2021; 114:1428-1437. [PMID: 34192297 DOI: 10.1093/ajcn/nqab203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND While insufficient sleep duration has emerged as a strong, independent risk factor for obesity, the mechanisms remain unclear. One possibility is greater "eating in the absence of hunger" (EAH) or energy intake beyond the point of satiety, when tired. OBJECTIVE The aim was to determine whether mild sleep loss increases EAH in children. METHODS A crossover study was undertaken in 105 healthy children (8-12 y) with normal sleep (∼8-11 h/night). After randomization, children went to bed 1 h earlier (sleep extension) or 1 h later (sleep restriction) than their usual bedtime, over 2 intervention weeks separated by a 1-wk washout. At the end of each intervention week, children underwent an EAH feeding experiment involving a preloading meal until satiation, followed by an ad libitum buffet (of highly palatable snacks) to measure EAH, with each food item weighed before and after consumption. RESULTS Ninety-three children completed the EAH experiment. There was no evidence of a difference in energy intake from EAH between sleep restriction and extension conditions when analyzed as a crossover design. However, a learning effect was found, with children eating significantly less (-239 kJ; 95% CI: -437, -41 kJ; P = 0.018) during the preload phase and significantly more (181 kJ; 95% CI: 38, 322 kJ; P = 0.013) in the ad libitum phase in the second week. No significant differences were seen using an underpowered parallel analysis for energy intake during the ad libitum phase when sleep deprived (106 kJ; 95% CI: -217, 431 kJ; P = 0.514). CONCLUSIONS Our findings suggest that measuring a difference in eating behavior in relation to sleep proved unsuitable using the EAH experiment in a crossover design in children, due to a learning effect. This trial was registered at the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true) as ACTRN12618001671257 .
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Affiliation(s)
- Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Dean W Beebe
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dawn E Elder
- Department of Pediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Aimee L Ward
- Department of Medicine, University of Otago, Dunedin, New Zealand.,Department of Geography, Kent State University, Kent, OH, USA
| | | | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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21
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Rose S, Boucher SE, Galland BC, Wiltshire EJ, Stanley J, Smith C, de Bock MI, Rayns JA, MacKenzie KE, Wheeler BJ. Impact of high-risk glycemic control on habitual sleep patterns and sleep quality among youth (13-20 years) with type 1 diabetes mellitus compared to controls without diabetes. Pediatr Diabetes 2021; 22:823-831. [PMID: 33880853 DOI: 10.1111/pedi.13215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/28/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In type 1 diabetes mellitus (T1D), glycemic control and sleep have a bidirectional relationship, with unhealthy glycemic control impacting sleep, and inadequate sleep impacting diabetes management. Youth are at risk for poor quality sleep; however, little is known about sleep among youth with high-risk glycemic control. OBJECTIVE To assess differences in habitual sleep timing, duration, and quality among youth with T1D and controls. SUBJECTS Two-hundred-thirty youth (13-20 years): 64 with T1D (mean age 16.6 ± 2.1 years, 48% female, diabetes duration 7.5 ± 3.8 years, HbA1c 96 ± 18.0 mmol/mol [10.9 ± 1.7%]), and 166 controls (mean age 15.3 ± 1.5, 58% female). METHODS Comparison of data from two concurrent studies (from the same community) using subjective and objective methods to assess sleep in youth: Pittsburgh Sleep Quality Index evaluating sleep timing and quality; 7-day actigraphy measuring habitual sleep patterns. Regression analyses were used to compare groups. RESULTS When adjusted for various confounding factors, youth with T1D reported later bedtimes (+36 min; p < 0.05) and shorter sleep duration (-53 min; p < 0.05) than controls, and were more likely to rate subjective sleep duration (OR 3.57; 95% CI 1.41-9.01), efficiency (OR 4.03; 95% CI 1.43-11.40), and quality (OR 2.59; 95% CI 1.16-5.76) as "poor" (p < 0.05). However, objectively measured sleep patterns were similar between the two groups. CONCLUSIONS Youth with high-risk T1D experience sleep difficulties, with later bedtimes contributing to sleep deficit. Despite a lack of objective differences, they perceive their sleep quality to be worse than peers without diabetes.
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Affiliation(s)
- Shelley Rose
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Department of Pediatrics and Child Health, University of Otago Wellington, Wellington, New Zealand
| | - Sara E Boucher
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Esko J Wiltshire
- Department of Pediatrics and Child Health, University of Otago Wellington, Wellington, New Zealand.,Pediatric Department, Capital and Coast District Health Board, Wellington, New Zealand
| | - James Stanley
- Biostatistical Group, Dean's Department, University of Otago Wellington, Wellington, New Zealand
| | - Claire Smith
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Martin I de Bock
- Department of Paediatrics, University of Otago, Christchurch, New Zealand.,Pediatric Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Jenny A Rayns
- Endocrinology Department, Southern District Health Board, Dunedin, New Zealand
| | - Karen E MacKenzie
- Department of Paediatrics, University of Otago, Christchurch, New Zealand.,Pediatric Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Benjamin J Wheeler
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Pediatric Department, Southern District Health Board, Dunedin, New Zealand
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22
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Estevan I. Psychometric properties of the Morningness/Eveningness scale for children among Uruguayan adolescents: the role of school start times. BIOL RHYTHM RES 2020. [DOI: 10.1080/09291016.2020.1846284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Ignacio Estevan
- Programa de Neuropsicología y Neurobiología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
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23
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Frayon S, Wattelez G, Paufique E, Nedjar-Guerre A, Serra-Mallol C, Galy O. Overweight in the pluri-ethnic adolescent population of New Caledonia: Dietary patterns, sleep duration and screen time. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2020; 2:100025. [PMID: 34327376 PMCID: PMC8315340 DOI: 10.1016/j.lanwpc.2020.100025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/19/2020] [Accepted: 09/02/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND A high prevalence of overweight and obesity has been found in adolescents of New Caledonia and other Pacific Island Countries and Territories. Although Westernization may contribute to the weight gain in populations of Oceanian, Non-European, Non-Asian ancestry (ONENA), little is known about the sociodemographic and lifestyle factors associated with overweight in the Melanesian and Polynesian adolescents of New Caledonia. METHODS In this cross-sectional study, a pluri-ethnic sample of New Caledonian adolescents (N = 954; age M = 13.2 years) completed a survey to estimate sleep duration, screen time, and dietary pattern using a food frequency questionnaire. Demographic data (gender, ethnicity, socioeconomic status: SES, area of residence) were collected, and anthropometric measures were used to compute weight status. FINDINGS We found a higher risk for being overweight in Melanesian (OR = 1.67) and Polynesian (OR = 5.40) adolescents compared with European adolescents, even after controlling for age, SES, area of residence, dietary pattern, sleep duration and screen time. We also found that low SES (OR = 3.43) and sleep duration (OR = 0.65 per hour) were independently associated with overweight status in the European but not in ONENA adolescents. INTERPRETATION In this study, the main contribution to being overweight was ethnic background, i.e. being Melanesian or Polynesian. The hypothesis of a genetic influence thus seems attractive and merits further analyses. FUNDING This project was funded by the University of New Caledonia and the Fondation Nestlé France.
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Affiliation(s)
- Stéphane Frayon
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
| | - Guillaume Wattelez
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
| | - Emilie Paufique
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
| | - Akila Nedjar-Guerre
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
| | - Christophe Serra-Mallol
- Centre on Work Organizations and Policies (CERTOP), UMR 5044 CNRS, University of Toulouse Jean Jaurès, 5 allées Antonio Machado, 31058 Toulouse cedex 9, France
| | - Olivier Galy
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
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Association between Sleep Timing and Weight Status among 14- to 19-Year-Old Adolescents in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165703. [PMID: 32784581 PMCID: PMC7460288 DOI: 10.3390/ijerph17165703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022]
Abstract
This study examined the cross-sectional and longitudinal association of sleep timing with weight status in 14- to 19-year-old adolescents in Wuhan, China. A prospective school-based study was conducted in Wuhan, China between 28 May and 29 September 2019. Data on sociodemographic information, academic performance, diet, mental health status, physical activity, sleep characteristics, body weight, and height were collected. A linear regression model and binary logistic regression model were performed. A total of 1194 adolescents were included in the analysis. Adolescents who woke up before 05:45 had higher body mass index (BMI) Z-score (odds ratio (OR) with 95% confidence interval (CI) = 1.28 (1.05, 1.57), p = 0.02) and higher odds of overweight/obesity (odds ratio (OR) with 95% confidence interval (CI) = 1.74 (1.10, 2.76), p = 0.02) at baseline after fully adjustment for covariates, compared with those who woke up after 05:45. Longitudinal data showed a nonsignificant association between waking up time and change in BMI Z-score (p = 0.18). No association of bedtime with weight status was observed in this sample after full adjustment (p > 0.1). Earlier waking up time might contribute to overweight and obesity in adolescents; however, more data are needed to test and elucidate this relationship.
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Short Sleep Duration is Associated with Central Arterial Stiffness in Children Independent of Other Lifestyle Behaviors. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42978-020-00062-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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