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The Prevalence of Insufficient Sleep and Bedtime Delay Among Kindergarten Children Aged 3 to 6 Years in a Rural Area of Shanghai: A Cross-Sectional Study.

ABSTRACT: Introduction: Sleep deprivation in children is a global public health problem that affects the physical and mental development of children. Bedtime delay induced by longer screen time and heavy study load is a common cause of sleep deprivation in children. However, the prevalence of insufficient sleep and bedtime delay and related influencing factors among kindergarten children is limited in Shanghai, China. Methods: In 2018, we selected 8,586 children aged 3 to 6 years and their parents in Songjiang District, Shanghai. Data was collected among parents by face-to-face questionnaire interview with signed informed consent. We defined insufficient sleep as those who slept for < 10 h in children aged 3-5 years or 9 h in children aged 6 years within 24 h, and we define bedtime delay as children with bedtime after 21:00. SAS 9.1.3 software was used to calculate the prevalence of bedtime delay and insufficient sleep, and logistic regression was used to explore potential influencing factors. Results: The prevalence of insufficient sleep and bedtime delay among children aged 3 to 6 years was 11.67 and 56.85%, respectively. The prevalence of insufficient sleep among boys was slightly higher than among girls [odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.04-1.35]. With the increase of the age of children, the prevalence of insufficient sleep increased gradually (P < 0.05). The prevalence of insufficient sleep was higher among the only child in the family (OR = 1.18, 95% CI: 1.02-1.36) and those with longer hours of TV watching (OR = 109, 95% CI: 1.02-1.16). Meanwhile, the prevalence of bedtime delay was also higher among the only child in the family (OR = 1.17, 95% CI: 1.06-1.79), among those with parents accompanying for sleep (OR = 1.21, 95% CI: 1.10-1.34), and those with longer TV watching time (OR = 1.13, 95% CI: 1.07-1.18). Conclusions: Insufficient sleep and bedtime delay were prevalent in Chinese children aged 3 to 6 years, especially in boys and older children. TV watching as well as parents accompanying for sleep were associated with insufficient sleep and bedtime delay. We recommend that parents should limit the screen time of children, advocate earlier bedtime and later morning wake-up among children, as well as make their children sleep in separate beds or rooms in younger age.

SUBMITTER: Chen X

PROVIDER: S-EPMC8655690 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveTo investigate the associations of sleep duration, wake-up time, bedtime, and childhood abdominal obesity, and to test whether there is a weekday/weekend difference and the potential modifying role of sex.MethodsThis cross-sectional study was based on the Students' Constitution and Health Survey and included 9559 students (4840 boys and 4719 girls) aged 7-18 years (7227 aged 7-12 years, 2332 aged 13-18 years). They were divided into two groups (control group and group with abdominal obesity). The physical measurements included children and youth body height, body weight, and waist circumference (WC). A parent-report questionnaire was used to collect the information about parent characteristics as well as lifestyle and sleep patterns (sleep duration, bedtime, and wake-up time of weekdays and weekends) of children and youth.ResultsThe prevalence of abdominal obesity was 30.57% and the percentages of sleep duration <9 hours/day, wake-up time before 07:00 am on weekdays and weekends, bedtime after 10:00 pm on weekends were significantly higher in the group with abdominal obesity. After adjusting for confounders, sleep duration <9 hours/day on weekends was inversely related to abdominal obesity in the overall subjects, regardless of their sex and age, while bedtime after 10:00 pm on weekends was inversely related to abdominal obesity only in the overall subjects, boys, and children aged 7-12 years. Logistic regression models in all subjects showed that shorter hours of weekends sleep duration were associated with greater risks of abdominal obesity, even after adjusting for all confounders, including wake-up time and bedtime. The adjusted odds ratios and 95% confidence intervals of abdominal obesity (with ≥10 hours/day as the reference group) for children with 9-10 hours/day, 8-9 hours/day, and <8 hours/day of weekend sleep duration were 1.23 (1.04-1.46), 1.59 (1.32-1.91) and 1.83 (1.42-2.36), respectively. Specifically, after stratification by sex and age, this phenomenon was only observed in boys and children aged 7-12 years.ConclusionsSleep duration and bedtime on weekends were independently associated with the risk of childhood abdominal obesity, particularly in boys and children aged 7-12 years.

Project description:There is evidence that insufficient sleep and more stressors are individually associated with poor metabolic health outcomes. Examining sleep and stressors jointly may account for greater variability in health outcomes; however, we know little about the combined effect of both insufficient sleep and more stressors on metabolic health. This study examined whether experiencing more stressors in response to insufficient sleep ("stressor reactivity to insufficient sleep") was associated with body mass index in middle-aged workers. One-hundred and twenty-seven participants (Mage = 45.24 ± 6.22 years) reported nightly sleep characteristics and daily stressors on 8 consecutive days. We collected height and weight measurements to calculate body mass index (kg m-2 ). On average, workers reported more stressors following nights with shorter-than-usual sleep duration or poorer-than-usual sleep quality (negative slope means higher stressor reactivity to insufficient sleep). When examining stressor reactivity to insufficient sleep with insufficient sleep represented by shorter-than-usual sleep duration, compared with those with average stressor reactivity to insufficient sleep (within ±½ SD; reference), workers with high stressor reactivity to insufficient sleep (≤-½ SD) had higher body mass index (B = 3.24, p < .05). The body mass index of these workers fell in the obese range. There was no difference in body mass index between workers with low stressor reactivity to insufficient sleep (≥+½ SD) and the reference group. When examining stressor reactivity to insufficient sleep with insufficient sleep represented by poorer-than-usual sleep quality, stressor reactivity to insufficient sleep was not significantly associated with body mass index. Results suggest that middle-aged workers with higher stressor reactivity to insufficient sleep duration may be at greater risk for obesity. Results may inform future studies on interventions for improving sleep and reducing stress in middle-aged workers.

Dataset Information

The Prevalence of Insufficient Sleep and Bedtime Delay Among Kindergarten Children Aged 3 to 6 Years in a Rural Area of Shanghai: A Cross-Sectional Study.

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