Prevalence of sleep problems and habits in a sample of Saudi primary school children

Immediate effects of Ramadan on objective time asleep in male youth football players from the Middle East: an interrupted time-series study

OBJECTIVE

To examine the abrupt effects of Ramadan onset on actigraphy-based time asleep in male youth Muslim football players.

METHODS

We adopted a quasi-experimental, interrupted time-series research design and tracked objective time asleep over a minimum of 12 consecutive nights in the two weeks prior to and immediately after Ramadan onset, respectively. Twenty-two, male academy student-athletes (chronological age range: 12.6 to 16.2 years) participated in the study (464 individual observations). Segmented generalized mixed-effects modelling estimated the effects of Ramadan onset on time asleep during the first period of night sleep only.

RESULTS

Ramadan onset led to an immediate mean reduction of 89 min (95% confidence interval [CI], 54 to 123 min) in time asleep during the first period of night sleep compared to pre-Ramadan sleep patterns. Model-adjusted estimated marginal means for time asleep were ~ 5.7 h (95%CI, 5.1 to 6.2 h) before and ~ 4.2 h (95%CI, 3.6 to 4.7 h) after Ramadan onset. Night sleep interruptions resulting in two or more fragmented periods accounted for 8% (95%CI, 2 to 21%) to 19% (95%, 11 to 29%) of sleep observations before and after Ramadan onset, respectively.

CONCLUSIONS

The onset of Ramadan determined an abrupt reduction in time asleep of ~ 1 h 30 min in the first period of a night cycle and contributed to additional problems of heterogeneous sleep fragmentation that can impact optimal school learning and youth athlete performance development processes.

Obstructive Sleep Apnea Among Obese Children in Tabuk City, Saudi Arabia

Introduction Obstructive sleep apnea (OSA) is prevalent among children, impacting their well-being. Obesity and related morbidity may lead to serious health disorders. In obese children, OSA may be a risk factor for systemic diseases that negatively affect their quality of life. This study explored the correlation between obesity and OSA among children aged five to 14 years in Tabuk, Saudi Arabia. Methods This cross-sectional study employed an online questionnaire for the parents of 517 children, assessing sociodemographic variables, medical history, and OSA symptoms. The data analysis used Statistical Product and Service Solutions (SPSS; IBM SPSS Statistics for Windows, Armonk, NY) software, employing descriptive and inferential statistics. Results The children were predominantly male (281, 54.4%) and from Tabuk (405, 78.3%), with 158 (30.6%) classified as obese. Symptoms such as snoring (191, 36.9%), daytime fatigue (195, 37.7%), and impact on daily activities (79, 15.3%) were prevalent. OSA scores significantly correlated with BMI categories (p < 0.001), family history of OSA (p < 0.001), and medical conditions including diabetes, hypertension, and high cholesterol (p < 0.05). Correlations showed weak positive associations of age (ρ = 0.159) and height (ρ = 0.229) with OSA score, whereas a strong correlation existed between weight (ρ = 0.531) and OSA score (p < 0.001). Conclusion Obesity demonstrated a strong association with OSA severity among children in Tabuk. Higher BMI categories, a family history of OSA, and certain medical conditions correlated significantly with increased OSA scores. Although age and height displayed weaker associations, weight emerged as a major contributing factor to OSA severity. These findings emphasize the importance of addressing obesity in managing pediatric OSA, advocating for early interventions to mitigate its impact on children's health and well-being.

Determination of the risk of obstructive sleep apnea syndrome in individuals aged 18 years and above

OBJECTIVE

This study aimed to increase awareness by determining the risk of obstructive sleep apnea syndrome in individuals aged 18 years and above.

METHODS

The study is a descriptive and cross-sectional study. A total of 633 individuals aged 18 years and above participated in the study. The data were collected online from individuals in the form of describing the demographic characteristics of individuals and with the Berlin survey. The IBM SPSS statistics 26.0 program was used in the analysis of the data.

RESULTS

In this study, 38.9% of individuals were found to be at high risk for obstructive sleep apnea syndrome. A significant relationship was found between the risk of obstructive sleep apnea syndrome and gender, age, body mass index, education level, chronic obstructive pulmonary disease, diabetes, hypertension, presence of cardiovascular diseases, and smoking (p<0.05).

CONCLUSION

The results of this study showed that male gender, increasing age, obesity, presence of chronic disease, and smoking increase the risk of obstructive sleep apnea syndrome. Defining the risk of obstructive sleep apnea syndrome, especially in risky groups, will be effective in planning health care, increasing the effectiveness of treatment, and improving the quality of life. It is recommended to include this diagnosis in health care protocols and to expand its use in order to plan and repeat trainings that will emphasize its importance.

Sleep-Disordered Breathing among Saudi Primary School Children: Incidence and Risk Factors

This study aimed to identify the incidence and risk factors of sleep-disordered breathing (SDB) using an Arabic version of the pediatric sleep questionnaire (PSQ). A total of 2000 PSQs were circulated to children aged 6-12 years who were randomly selected from 20 schools in Al-Kharj city, Saudi Arabia. The questionnaires were filled out by the parents of participating children. The participants were further divided into two groups (younger group: 6-9 years and older group: 10-12 years). Out of 2000 questionnaires, 1866 were completed and analyzed (93.3% response rate), of which 44.2% were from the younger group and 55.8% were from the older group. Among all the participants, a total of 1027 participants were female (55%) and 839 were male (45%) with a mean age of 9.67 ± 1.78 years. It showed that 13% of children were suffering from a high risk of SDB. Chi-square test and logistic regression analyses within this study cohort showed a significant association between SDB symptoms (habitual snoring; witnessed apnea; mouth breathing; being overweight; and bedwetting) and risk of developing SDB. In conclusion: habitual snoring; witnessed apnea; mouth breathing; being overweight; and bedwetting strongly contribute the to development of SDB.

Prevalence of sleep problems and habits among children in Saudi Arabia: A cross-sectional study

OBJECTIVES

To investigate children's sleep problems, habits, and lifestyle changes.

METHODS

A cross-sectional study was carried out in Riyadh, Saudi Arabia, over a period of 2 months, from August through September 2022, with parents of children aged 2-14 years after reviewing the literature and formulating a validated Google questionnaire containing 30 questions related to sleep habits, problems, and disorders.

RESULTS

In total, 585 questionnaires were included in the analysis. The sample comprised 345 (59%) males and 240 (41%) females. The mean age of patients was 7 (range: 2-14) years. Bed-time resistance was the most prevalent sleep problem (70.3%), followed by sleep-onset delay (58.1%), difficulty waking up in the morning on weekdays (41.3%), weekends (38%), and interrupted sleep (31%). An alarmingly high prevalence of hyperactivity (41.8%) and aggressive behaviour (42.2%) was noted. Co-sleeping with parents was reported in 41% of children. Night terror was reported in 20.6% and 26.5% in nightmares. Statistically significant associations were noted between screen time, snoring, and witnessed apnoea with sleep problems.

CONCLUSION

Sleep problems are common among children in Saudi Arabia. The study sheds some light on sleep habits and practices in this age group in Saudi Arabia, such as the high prevalence of bed-time resistance and sleep-onset delay, hyperactivity, and sleep-affecting culprits such as screen time, snoring, and witnessed apnoea.

Prevalence and Correlates of Sleep Disorders Among Pediatric Inpatients in a Tertiary Pediatric Hospital

Background It is possible to define sleep disorders as any disturbance in sleep timing, quality, or quantity that results in daytime distress and impairment in functioning that, in turn, affects the baseline functional status of an individual. Our study aimed to describe how sleep disorders might affect pediatric inpatients at King Abdulaziz University Hospital (KAUH) as well as estimate their prevalence (2021-2022). We assessed the sleep habits using questionnaires and analyzed and combined these data to create rankings to compare the different issues affecting sleep habits in pediatric patients. Methodology Two scoring systems were used in this study, namely (a) the Children's Sleep Habits Questionnaire (CSHQ) and (b) the Pediatric Sleep Questionnaire. Analyses of the data were conducted using SPSS version 23 (IBM Corp., Armonk, NY, USA) and GraphPad Prism version 8 (GraphPad Software, Inc., San Diego, CA, USA). Results The prevalence of sleep disorders and their correlations were evaluated among 98 pediatric inpatients at KAUH, Saudi Arabia, between 2021 and 2022. The average duration of hospital stay was 11.97 ± 11.0 days (N = 78), and the average number of previous admissions was 2.85 ± 3.7 (N = 93). Conclusions According to the sleep behavior domain of the CSHQ, most children woke up sweating, screaming, and inconsolable during the night. Furthermore, bedtime resistance and sleep anxiety were the most prevalent sleep disturbances observed in the study population.

A cross-cultural comparison of sleep patterns between typically developing children and children with ASD living in Saudi Arabia and the United Kingdom

BACKGROUND

Sleep is crucial for child development, especially for children with ASD. While it is known that children with ASD experience more severe sleep problems and that these problems tend to persist compared to their typically developing counterparts, these findings tend to come from only Western countries. A cross-cultural study is important to understand if the prevailing understanding of sleep in children with ASD can be extended to different cultural backgrounds.

AIM

A cross-cultural study is conducted, involving typically developing children and children with ASD aged 5-12 across two countries: Saudi Arabia and the United Kingdom.

METHODS AND PROCEDURES

Using a combination of questionnaires measuring ASD severity (CARS-2), sleep quality (CSHQ), sociodemographic and lifestyle variables and sleep diaries, 244 children were sampled using a mixture of snowball and convenience sampling methods.

OUTCOMES AND RESULTS

Children with ASD experience more sleep problems compared to typically developing children in Saudi Arabia, and these problems similarly persist across time. Specifically, it was found that children with ASD in Saudi Arabia experience greater sleep onset latency and a greater number of night awakenings. Additionally, across the ASD groups, it was found that children from Saudi Arabia generally experienced poorer sleep than children in the United Kingdom in terms of shorter sleep duration, although children in the United Kingdom tended to report more instances of sleep anxiety and parasomnias.

CONCLUSIONS AND IMPLICATIONS

Several reasons such as parental education about sleep hygiene, cultural influences and social hours were put forward as potential explanations for cross-cultural differences. Findings served to emphasise the importance of culturally-appropriate interventions and public education regarding child sleep.

Joint consensus statement of the Saudi Public Health Authority on the recommended amount of physical activity, sedentary behavior, and sleep duration for healthy Saudis: Background, methodology, and discussion

The Saudi Public Health Authority recently prepared a Consensus Statement regarding how much time a person should spend engaged in physical activity, sedentary behavior, and sleep to promote optimal health across all age groups. This paper describes the background literature, methodology, and modified RAND Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach that guided the development process. A Leadership Group and Consensus Panels were formed, and credible existing guidelines were identified. The Panel identified clear criteria to choose the best practice guidelines for the set objectives after evaluation, based on GRADE table evidence, findings table summaries, and draft recommendations. Updating of the selected practice guidelines was performed, and the Consensus Panels separately reviewed the evidence for each behavior and decided to adopt or adapt the selected practice guideline recommendations or create de novo recommendations. Data related to cultural factors that may affect the studied behaviors, such as prayer times, midday napping or "Qailulah," and the holy month of Ramadan, were also reviewed. Two rounds of voting were conducted to reach a consensus for each behavior.

Epidemiology of Sleep Disturbances Among Primary School Students in Kerman, Iran, in 2019

Primary sleep disturbances are common in both children and adults and can lead to cognitive problems and educational and psychological disorders. In this study, we evaluated the epidemiology of sleep disturbances among children in Kerman, Iran, in 2019. This cross-sectional study was done in 2019 with 561 children in elementary schools of Kerman, Iran. Data were collected by a Pittsburgh Sleep Quality Index (PSQI) questionnaire that was filled out by parents and analyzed statistically. A total of 561children with a mean age of 9.54 ± 1.55 years were enrolled. The ratio of boys to girls was 1.01 and consistent across age groups. The prevalence of sleep disturbances in this population study was 26.7% (150 patients); 51.3% of them were girls. Sleep disturbances were associated with mothers' lower education level and parents' higher job positions (P < .05). This study showed the relatively high prevalence of sleep disturbances among children in this region. It can be reduced by a program such as sleep training or by promoting the level of parents' education. We recommend some educational programs and preschool screening to evaluate sleep disturbances and educating the parents to increase their responsiveness.

Sleep-disordered breathing among Saudi children seeking orthodontic treatment

Aims

The aim of this research is to assess the prevalence of sleep disordered breathing (SDB) and evaluate the risks and symptoms in children seeking orthodontic treatment in a Saudi dental center.

Settings and Design

It is a cross-sectional survey-based study.

Methods and Material

Pediatric sleep questionnaire (PSQ) was used to survey 285 children and adolescents aged 5 to 18 years old who are undergoing orthodontic screening in a Saudi Dental Center.

Statistical Analysis Used

PSQ scores were tested with multiple variables including gender, parents' education, academic performance using Mann-Whitney-U test. Correlation of study sample scores with age were calculated using the Spearman rank correlation coefficient (rho).

Results

In this study 136 (47.7%) of the participants were deemed to be high risk for developing SDB and 149 (52.3%) were low risk, males were significantly at higher risk compared to females (P ≤ 0.05). Participants with previous adenoidectomy surgery were more likely to be identified as high-risk for SDB (P-value = 0.000) as well as participants with a family history of snoring (P-value = 0.000).

Conclusions

Sleep disordered breathing was prevalent among Saudi children seeking orthodontic therapy, it is important to screen children and adolescents in dental pediatric and orthodontic clinics for SDB risk as this is a prevalent disorder among this population, early detection of SDB will improve patients' quality of life and prevent future complications associated to this disorder.

Prevalence and Determinants of Bad Sleep Perception among Italian Children and Adolescents

Although sleep problems at young ages are well investigated, the prevalence of bad sleepers and the determinants of sleep quality perception remain unexplored in these populations. For this purpose, we addressed these issues in a sample of children (n = 307), preadolescents (n = 717), and adolescents (n = 406) who completed the School Sleep Habits Survey, addressing sleep quality perception, sleep habits, sleep features, daytime behavior and sleep disturbances, circadian preference, and dreaming. The sample was split in “good sleepers” and “bad sleepers”, based on the answer to the question item assessing overall subjective sleep quality. Being a bad sleeper was reported by 11.7% of the sample, with significant between-groups differences (children: 8.3%; preadolescents: 11.3%; adolescents: 15.3%; p = 0.01). At all ages, relative to good sleepers, bad sleepers showed higher eveningness, sleepiness, and depression, longer sleep latency, more frequent insufficient sleep, nocturnal awakenings, sleep–wake behavioral problems, and unpleasant dreams (all p’s ≤ 0.01). Sleep quality perception was predicted: in children, by depressed mood, eveningness, and unpleasant dreams (all p’s ≤ 0.01); in preadolescents, by sleep latency, awakening frequency, depressed mood, sufficiency of sleep, and unpleasant dreams (all p’s < 0.01); in adolescents, by awakening frequency, depressed mood, and sufficiency of sleep (all p’s < 0.001). In children, bad subjective sleep quality appears to be mainly determined by daytime psychological features, for example, depressed mood, whereas at later ages, sleep characteristics, such as frequent awakenings, add to the former determinants. This could depend on (a) the appearance, with increasing age, of objective sleep modifications and (b) a greater attention paid by adolescents to their sleep characteristics.

Sleep disturbances and associated factors among 2-6-year-old male children with autism in Bhubaneswar, India

BACKGROUND

Sleep disturbances are considered one of the significant comorbidities of autism; they negatively impact the quality of life of children with autism as well as their parents or caregivers. This study aimed to determine the prevalence of sleep disturbances in Indian male children diagnosed with autism and examine the association of lifestyle behaviors and socio-demographic characteristics with sleep problems.

METHODS

The present cross-sectional study was conducted in Bhubaneswar city in the year 2018, involving mothers of 100 male children with autism aged 2-6 years. We used a children's sleep habits questionnaire (CSHQ) to evaluate the sleep problems in children with autism and a semi-structured schedule for gathering information regarding lifestyle behaviors and socio-demographic characteristics.

RESULTS

The overall prevalence of parent-reported sleep problems was 93%; the most prevalent CSHQ subscales were: bedtime resistance (95%), sleep anxiety (85%), and sleep duration (81%). The mean ISAA score of the study sample was 133.89 ± 19.59, where 12%, 71%, and 17% of the children had mild, moderate, and severe autism, respectively. Multiple linear regression analysis revealed that variables such as autism severity, screen time, caffeine intake, physical activity, maternal age, child's age, and birth weight were significantly associated with the CSHQ subscales.

CONCLUSION

The prevalence of parent-reported sleep problems is very high among the male children with autism in Bhubaneswar, India, and there is an urgent need for interventional measures for appropriate management of this problem among these children.

Prevalence of sleep-disordered breathing and associations with orofacial symptoms among Saudi primary school children

Background

This study aimed to determine the prevalence of sleep-disordered breathing among primary school children in Riyadh, Saudi Arabia, and to evaluate associations between sleep-disordered breathing and respiratory conditions/orofacial symptoms.

Methods

In this cross-sectional study, 1600 questionnaires were distributed to Saudi boys and girls aged 6–12 years from 16 primary schools in Riyadh. The questionnaire covered relevant demographic and personal characteristics, presence of respiratory conditions and orofacial symptoms, and the Pediatric Sleep Questionnaire. The latter was used to assess the prevalence of symptoms of sleep-disordered breathing and was completed by the participating children’s parents.

Results

In total, 1350 completed questionnaires were returned (85% response rate). The children’ mean age was 9.2 ± 1.8 years; 733 (54.3%) were boys and 617 (45.7%) girls. Overall, 21% of children were at high risk of sleep-disordered breathing. The prevalence of snoring was 14.4% and that of sleep apnea 3.4%. Boys were at higher risk of sleep-disordered breathing than girls (P = 0.040). Children with respiratory conditions or orofacial symptoms were at higher risk of sleep-disordered breathing (P < 0.0001) than children without these conditions/symptoms.

Conclusions

Around 21% of Saudi children are at risk of sleep-disordered breathing. There is a strong association between sleep-disordered breathing symptoms and the presence of respiratory conditions or orofacial symptoms.

Nigerian sleep study found that children slept less and had more problems than children in other countries

AIM

We studied sleep patterns, sleep problems and associated socio-demographic factors among children aged one year to 12 years in Lagos, Nigeria.

METHODS

This prospective hospital-based study involved 432 children (55% males) who came for routine paediatric care at the Lagos State University Teaching Hospital. Information on socio-demographics, sleeping patterns and specific sleep disorders was obtained.

RESULTS

The mean age of the subjects was 5.4 ± 3.3 years. Night sleep duration decreased significantly with age from 9.6 ± 1.3 hours at one to four years to 8.7 ± 1.0 hours at nine years to 12 years (p < 0.001). There was no significant gender difference in bedtimes (p = 0.057), rise times (p = 0.095) and night sleep duration (p = 0.191). Most (70%) napped during the day, and 26% of these did so on a regular basis. The most common sleep problems were enuresis (42%), afraid of sleeping alone (38%), snoring (28%) and sleep talking (24%). There was no significant association between sleep duration (p > 0.05), sleep problems (p > 0.05) and socio-demographic characteristics. Comparisons with other studies showed that the children had shorter sleep duration than peers in other countries and regions and a higher prevalence of sleep disorders.

CONCLUSION

Children in Nigeria had shorter sleep duration and more sleep problems than children in other international studies.

Sleep Medicine in Saudi Arabia

ABSTRACT

The practice of sleep medicine in Saudi Arabia began in the mid to late 1990s. Since its establishment, this specialty has grown, and the number of specialists has increased. Based on the available data, sleep disorders are prevalent among the Saudi population, and the demand for sleep medicine services is expected to increase significantly. Currently, two training programs are providing structured training and certification in sleep medicine in this country. Recently, clear guidelines for accrediting sleep medicine specialists and technologists were approved. Nevertheless, numerous obstacles hamper the progress of this specialty, including the lack of trained technicians, specialists, and funding. Increasing the awareness of sleep disorders and their serious consequences among health care workers, health care authorities, and insurance companies is another challenge. Future plans should address the medical educational system at all levels to demonstrate the importance of early detection and the treatment of sleep disorders. This review discusses the current position of and barriers to sleep medicine practice and education in Saudi Arabia.

Bed-sharing and related factors in early adolescents

OBJECTIVE

To investigate the prevalence of bed-sharing and examine correlates of bed-sharing habits in early adolescents.

METHODS

Participants were 1452 early adolescents from 10 primary schools in Shanghai, China. Children's health status and past history, family environment and parents' attitude towards bed-sharing, and children's sleep arrangements were surveyed. Sleep was assessed by the Children's Sleep Habit Questionnaire. Tanner stage was determined by the endocrinologist.

RESULTS

The median of age was 10.83 years (range: 9.42-12.92; 95% confidence interval [CI]: 10.79-10.83) and boys accounted for 51.17%. The prevalence of bed-sharing was 16.8%. Positive parental attitude toward bed-sharing (OR: 9.87; 95% CI: 6.57-14.83), asthma (OR: 2.15; 95% CI: 1.16-3.98), smaller residential space (OR: 1.90; 95% CI: 1.17-3.09), extended family (OR: 1.59; 95% CI: 1.16-2.18), and being physically less mature (OR: 2.39; 95% CI: 1.16-4.91) increased the likelihood of bed-sharing. Bed-sharers were more likely to have bedtime resistance (OR: 12.20; 95% CI: 8.59-17.33), sleep anxiety (OR: 3.76; 95% CI: 2.74-5.15), and poor sleep quality (OR: 3.21; 95% CI: 2.28-4.81) compared to non-bed-sharers. Furthermore, bed-sharing was associated with daytime sleepiness (OR: 1.53; 95% CI: 1.10-2.13) but not with sleep duration.

CONCLUSIONS

Bed-sharing is highly prevalent among Chinese early adolescents and is significantly related to sleep quality. Parental positive attitude toward bed-sharing was the most determining factor.

Factors affecting general sleep pattern and quality of sleep in pregnant women

Objective:

To investigate factors affecting general sleep pattern and sleep quality in pregnant women.

Materialds and Methods:

We assessed all pregnant women applied to Department of Obstetrics and Gynecology in Training and Research Hospital, School of Medicine, Kahramanmaraş Sütçü İmam University between 01 January 2014 and 01 March 2014. The participants were informed prior to the study and 100 pregnant women who gave their informed consent were included in the study. Questionnaires consisting sociodemographic characteristics, pregnancy history and the Epworth sleepiness scale were applied to the patients. Factors affecting general sleep pattern and sleep quality in pregnant women were compared.

Results:

The mean age of 100 pregnant women was 27.9 years (min=16, max=42). The mean gestational age of participants was found to be 24.8 weeks (min=5, max=40). In obstetric history, 9% of women previously had a stillbirth and also 25% of women previously had curettage performed. There were tobacco use in 6% of participants and 6% of patients previously had been to the hospital due to a sleep disorder. The mean excessive daytime sleepiness scale score of pregnant women were found to be 4.56. There were no significant difference among the patients regarding regular exercise (p=0.137), tobacco use (p=0.784), accompanying disease (p=0.437) and excessive daytime sleepiness scale score.

Conclusion:

In our study, patients who had a complaint of sleep disorder before and who were previously admitted to a health center for this problem, were also found to suffer from the same problem during pregnancy. Treatment of sleep disorders in preconception period for women planning pregnancy is important in terms of mother and the baby’s health. Pregnant women should be informed about factors reducing sleep quality during pregnancy.

Prevalence of short sleep duration and its association with obesity among adolescents 15- to 19-year olds: A cross-sectional study from three major cities in Saudi Arabia

BACKGROUND

Adequate sleep has been considered important for the adolescent's health and well being. On the other hand, self-imposed sleep curtailment is now recognized as a potentially important and novel risk factor for obesity. The present study aimed to assess the prevalence of short sleep duration and its association with obesity among Saudi adolescents.

METHODS

This is a school-based cross-sectional study with self-reported sleep questionnaires. It was conducted during the years 2009/2010 in three cities in Saudi Arabia; Al-Khobar, Jeddah, and Riyadh. Participants were 2868 secondary-school males (1379) and females (1389) aged 15 to 19 years, randomly selected using a multistage stratified sampling technique. Measurements included weight, height, waist circumference, BMI, and sleeping duration. Logistic regression analysis while adjusted for age, gender, and location was used to examine the associations between sleep duration and obesity measures.

RESULTS

The mean (SD) of sleep duration was 7.2 (1.6) hours/day with no significant differences between males and females. About 31% of the participants obtain less than 7 hours of sleep per day, while approximately 50% of the sample gets less than 8 hours of daily sleep. Two-way ANCOVA results while controlling for the effect of age revealed a significant gender by school-type interaction (P<0.001). In addition, adequate sleep duration increased the odds of having normal weight (adjusted odds ratios = 1.28, 95% CI = 1.08-1.50, P = 0.003).

CONCLUSION

The present study observed a high prevalence of short sleep duration among Saudi adolescents 15- to 19-year olds and that short sleep duration was significantly associated with increased risk of overweight and obesity. Future interventions should investigate whether adopting a healthy lifestyle by adolescents with short sleep duration would improve their sleeping habits or not.

Qur'anic insights into sleep

Sleep has preoccupied and fascinated many civilizations since the dawn of mankind. Here, we critically review the various elements pertaining to sleep in the context of early Islamic religion and culture. The many principles of sleep hygiene, wellbeing and health associated with adequate sleep, and the understanding of sleep as a dynamic state are all apparent from such explorative process of Islamic tradition.

Good and Bad Sleep in Childhood: A Questionnaire Survey amongst School Children in Southern Italy

Despite its clinical importance, the issue of subjective sleep quality in children remains unexplored. Here we investigate, in school-aged children, the prevalence of bad sleep perception and its relationships with sleep habits and daytime functioning, to provide hints on its possible determinants. Subjective sleep perception, sleep habits, and daytime functioning were studied through a questionnaire survey in a sample of 482 children (6–12 yrs.). Being “bad sleeper” was reported by 6.9% of the sample. Compared to the “good sleepers”, these subjects displayed shorter sleep duration on schooldays, longer sleep latencies, and a more pronounced evening preference, beyond more frequent insufficient sleep. Though no differences emerged in sleepiness, bad sleepers showed higher impairments in daytime functioning, indicated by more frequent depressed mood and impulsivity. These distinctive features might be very important to precociously detect those children who are possibly more vulnerable to sleep disturbances and whose sleep-wake rhythms evolution should be paid particular attention thereafter.

“The good people sleep much better at night than the bad people.

Of course, the bad people enjoy the waking hours much more”

Woody Allen

Sleep of children living in institutional care facilities

PURPOSE

To describe sleep patterns and problems among institutionalized children.

METHODS

In this cross-sectional study, the caregivers of 118 children, aged 4-12 years from six institutional care facilities completed the Children's Sleep Habits Questionnaire (CSHQ).

RESULTS

The mean (±SD) of night bedtime was 21:05 ± 2:52, mean morning wake-up time was 06:58 ± 0:31, mean total sleep duration was 10 ± 1.1 h, and mean night-sleep duration was 9.5 ± 0.9 h. The percentage of children who took a daytime nap was 34.7% (n = 41) and the mean duration of nap was 0.5 ± 0.7 h. The most frequently reported sleep problems were bedtime resistance, daytime sleepiness and night awakening. Children with bedtime at or after 9 PM, night-sleep duration less than 10 h and daytime napping had more disturbed sleep.

CONCLUSIONS

Sleep problems are common among this sample of institutionalized children.

Sleep medicine in Saudi Arabia: Current problems and future challenges

Sleep medicine is a relatively new specialty in the medical community. The practice of sleep medicine in Saudi Arabia (KSA) began in the mid to late nineties. Since its inception, the specialty has grown, and the number of specialists has increased. Nevertheless, sleep medicine is still underdeveloped in the KSA, particularly in the areas of clinical service, education, training and research. Based on available data, it appears that sleep disorders are prevalent among Saudis, and the demand for sleep medicine service is expected to rise significantly in the near future. A number of obstacles have been defined that hinder the progress of the specialty, including a lack of trained technicians, specialists and funding. Awareness about sleep disorders and their serious consequences is low among health care workers, health care authorities, insurance companies and the general public. A major challenge for the future is penetrating the educational system at all levels to demonstrate the high prevalence and serious consequences of sleep disorders. To attain adequate numbers of staff and facilities, the education and training of health care professionals at the level of sleep medicine specialists and sleep technologists is another important challenge that faces the specialty. This review discusses the current position of sleep medicine as a specialty in the KSA and the expected challenges of the future. In addition, it will guide clinicians interested in setting up new sleep medicine services in the KSA or other developing countries through the potential obstacles that may face them in this endeavor.

Factors associated with bed and room sharing in Chinese school-aged children

BACKGROUND AND OBJECTIVES

Co-sleeping (bed or room sharing) has potential implications for children's development. Previous studies showed that co-sleeping was more prevalent in non-Western countries than in Western countries, which demonstrated that co-sleeping was marked with ethnic and socio-cultural background characteristics. The purpose of this study was to survey the prevalence of bed and room sharing and to examine related factors among school-aged children in an Asian country - China.

METHODS

A cross-sectional questionnaire survey was conducted in 10 districts of Shanghai, China from November to December 2005. A total of 4108 elementary school children, 49.2% boys and 50.8% girls with a mean age of 8.79 years, participated. Parent-administered questionnaires were used to collect information about children's sleeping arrangements and socio-demographic characteristics.

RESULTS

The prevalence of routine bed sharing, room sharing and sleeping alone in Chinese school-aged children was 21.0%, 19.1% and 47.7%, respectively. Bed and room sharing didn't show significant gender difference but gradually decreased with increasing age. Multivariate logistic regression identified those factors associated with bed and room sharing: younger age, large family, children without their own bedroom and parents' approval of a co-sleeping arrangement.

CONCLUSION

Co-sleeping arrangement was a common practice in Chinese school-aged children. Associated factors were characterized by intrinsic socio-cultural values and socio-economic status in China.

Bed- and room-sharing in Chinese school-aged children: prevalence and association with sleep behaviors

OBJECTIVE

To survey the prevalence of bed- and room-sharing and assess associations with sleep/wake patterns, duration of sleep, and sleep problems among urban school-aged children in China.

METHODS

Students representing eight Chinese cities were studied during November and December, 2005. A total of 19,299 elementary-school children (49.7% boys and 50.3% girls with a mean age of 9.00 years) participated in the survey. A parent-administered questionnaire and the Chinese version of the Children's Sleep Habits Questionnaire were completed to quantify children's sleep arrangements and to characterize sleep behaviors.

RESULTS

Co-sleeping was a common practice, with a prevalence of 37.6% (routine bed-sharing: 23.0%; room-sharing: 14.6%) in Chinese school-aged children. Bed- and room-sharing did not show significant gender difference but gradually decreased with increasing age. Compared to room-sharing and sleeping alone, bed-sharing was correlated with later bedtimes, later awakening times, and a shorter duration of sleep. However, the small difference was unlikely to have clinical significance. Bed- and room-sharing tended to be associated with the increased probability of six types of sleep problems: bedtime resistance, sleep anxiety, night waking, parasomnia, sleep-disordered breathing, and daytime sleepiness. Compared to bed-sharing, room-sharing had a lower odds ratio. Among six sleep problems, bedtime resistance and sleep anxiety had the strongest association with bed-sharing.

CONCLUSIONS

Sleep problems were common in Chinese school-aged children. Co-sleeping was highly prevalent and may be potentially associated with negative effects on sleep hygiene and sleep quality, although the context of the co-sleeping must be taken into consideration.