Establishing normal values for pediatric nighttime sleep measured by actigraphy: a systematic review and meta-analysis

Galland, Barbara; Short, Michelle A.; Terrill, Philip I.; Rigney, Gabrielle; Haszard, Jillian J.; Coussens, Scott; Foster-Owens, Mistral D.; Biggs, Sarah Nichole

doi:10.1093/sleep/zsy017

Cited by 169 publications

(126 citation statements)

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“…The sleep behaviours of this sample are similar to recently provided guidelines for establishing actigraphy norms in children (see Galland et al ., ). Our average sleep duration of 8.12 hr for the twins is slightly under pooled means of 6‐ to 8‐year‐olds (8.98 hr) and 9‐ to 11‐year‐olds (8.85), but does fall within the range of reported durations, which are 8.10 to 9.86 hr for the younger group and 7.87 to 9.52 hr for the older group.…”

Section: Discussionmentioning

confidence: 97%

“…Our average sleep duration of 8.12 hr for the twins is slightly under pooled means of 6‐ to 8‐year‐olds (8.98 hr) and 9‐ to 11‐year‐olds (8.85), but does fall within the range of reported durations, which are 8.10 to 9.86 hr for the younger group and 7.87 to 9.52 hr for the older group. There is less information on actigraphy‐based sleep efficiency and latency; therefore, our results can only be compared to means across all ages (Galland et al ., ). Children in the current study had a 90.37% sleep efficiency, which is close to the mean of other studies including 3‐ to 14‐year‐olds (i.e., 88.3%, range 79.2–97%).…”

Section: Discussionmentioning

confidence: 97%

“…Children in the current study had a 90.37% sleep efficiency, which is close to the mean of other studies including 3‐ to 14‐year‐olds (i.e., 88.3%, range 79.2–97%). Sleep latency (25.26 min) also fell close to the mean of prior reported studies including 3‐ to 18‐year‐olds of 19.40 min (range 3.8 to 45; Galland et al ., ). While children in the current study are not meeting duration guidelines of 9–11 hr/night, they are sleeping efficiently.…”

Section: Discussionmentioning

confidence: 97%

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Early parental positive personality and stress: Longitudinal associations with children's sleep

Miadich

Doane

Davis

et al. 2019

British J Health Psychol

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Objectives The current study examined the influence of early parental stress and positive parent personality during infancy on sleep in middle childhood. Further, the role of positive parent personality as a buffer of the association between parental stress and sleep was considered. Methods Participants included 381 twins and their primary caregivers who were recruited from birth records in the United States. Primary caregivers completed survey assessments via phone when twins were 12 and 30 months of age to assess multiple dimensions of parental stress and positive parent personality. Approximately 6 years later (M = 5.78, SD = 0.42), twins participated in an intensive assessment that included wearing actigraph watches to provide an objective measurement of sleep, while primary caregivers completed daily diaries regarding twins' sleep. Results Positive parent personality was associated prospectively with longer actigraphy sleep duration and higher parent‐reported sleep quality/daytime functioning. Parental stress was associated prospectively with greater variability in sleep duration. Positive parent personality moderated the parental stress – sleep‐timing relation, such that greater parental stress was associated with a later midpoint of the sleep period only for children with parents low on positive personality (e.g., low optimism). All other findings were non‐significant. Conclusions Findings suggest that both positive attributes and stress may influence sleep in middle childhood and that low parent positive personality may exacerbate associations between parental stress and later timing of sleep periods in children. Early interventions to promote healthy sleeping may consider focusing on decreasing parental stress and increasing parental empathy and optimism as early as infancy. What is already known on this subject? Early‐life experiences, especially adversity, have been related to health outcomes among adults and children, such that negative experiences are associated with poor health outcomes. Poor sleep (e.g., short duration, poor quality) among children is associated with negative outcomes including poorer cognitive performance and higher adiposity. What does this study add? This study used a prospective design to understand relations between early parent‐related factors and child sleep. Early parental stress and positive parent personality were associated with objective sleep quality. Positive parent personality during infancy may have promotive/protective influences on sleep later in childhood.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

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Early parental positive personality and stress: Longitudinal associations with children's sleep

Miadich

Doane

Davis

et al. 2019

British J Health Psychol

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“…Thus, sleep may worsen across the high school years, and preexisting poor sleep may become more pervasive after high school. Initial support for this notion comes from cross-sectional studies indicating that older age and grade are associated with shorter sleep within school-aged adolescents [10,11], longitudinal studies with children and adolescents not older than 18 years suggesting worsening sleep trends prior to young adulthood [12][13][14][15][16], and studies showing that college students experience a variety of widespread sleep issues including insufficient and inconsistent sleep amounts and poor sleep quality [17,18].…”

Section: Introductionmentioning

confidence: 99%

“…Given these issues and the paucity of research, we do not adequately understand how sleep changes as adolescents move beyond high school years. It is particularly important to provide objective, actigraphy-derived sleep data [12] to avoid limitations of self-reported sleep including participants' biases and ambiguous sleep questions that may be interpreted differently across participants.…”

Section: Introductionmentioning

confidence: 99%

Developmental trends in sleep during adolescents' transition to young adulthood

et al. 2019

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DEVELOPMENTAL TRENDS IN SLEEP 1 Objective: Poor sleep poses negative health consequences for youth, yet few longitudinal actigraphy studies have examined basic developmental trends in sleep across adolescents' transition to young adulthood. In this longitudinal actigraphy study, stability of individual differences and trajectories of sleep during and after high school were examined. The degree to which sleep trajectories differed by college attendance status was also studied. Methods: A total of 343 youth with Asian, Latino, and European American backgrounds completed eight days of wrist actigraphy at two-year intervals in Wave 1(n = 295, Mage = 16.39), Wave 2 (n = 211 including 34 new participants to refresh the sample, Mage = 18.31), and Wave 3 (n = 144, Mage = 20.29). Sleep duration, efficiency, and latency were estimated for weekdays and weekends. Intra-individual variability in duration across nights was also obtained. Results: Sleep parameters were correlated modestly between Wave 1 and Wave 2, but not correlated between Wave 1 and Wave 3, indicating modest shorter-term and little longer-term stability of individual differences. Multilevel growth models demonstrated declines in weekday sleep duration and efficiency across high school and post-high school years. Intra-individual variability in duration increased over the years. Latency trajectories changed more for noncollege attendees compared with college attendees. Conclusions: Overall the findings suggest developmental trends of worsening sleep during adolescents' transition to young adulthood. Interventions to improve sleep may need to target specific issues faced by youth at that particular period in their lives.

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Effects of a Sleep Health Education Program for Children and Parents on Child Sleep Duration and Difficulties

et al. 2022

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IMPORTANCE Preschool-aged children often lack sufficient sleep and experience sleep difficulties. A consistent bedtime routine, falling asleep alone, and other sleep practices reduce difficulties and increase sleep duration. OBJECTIVE To evaluate the effects of a preschool-based sleep health literacy program on children's sleep duration and difficulties and on parent sleep knowledge, attitudes, self-efficacy, and beliefs 9 and 12 months after the program. DESIGN, SETTING, AND PARTICIPANTS This stepped-wedge cluster randomized clinical trial was implemented across the 2018-2019 school year. Head Start preschool personnel delivered interventions and collected outcomes data at baseline and 4 follow-ups. Seven Head Start agencies across New York State were randomized to implement interventions in either fall 2018 or winter and spring 2019. Outcomes were ascertained at 9-and 12-month follow-up. From March 19 through September 28, 2018, Head Start staff recruited (a) English-or Spanish-speaking parents (b) of children 3 years of age on or about September 2018 (c) who planned to remain at the site through the school year. Altogether, 519 parent-child (aged 3 years) dyads completed baseline and (any) followup data. INTERVENTIONS A 2-week classroom curriculum for children, a 1-hour parent workshop, and 1-on-1 parent discussions at home or school. MAIN OUTCOMES AND MEASURESOutcomes were the pre-vs postintervention differences measured at baseline and 9-month follow-up for parent-reported child school-night sleep duration per sleep logs, mild or moderate sleep difficulties per a validated questionnaire, and the total and domain scores for parent sleep knowledge, attitudes, self-efficacy, and beliefs. A modified intentionto-treat analysis excluding participants with only baseline data was used. RESULTSThe mean (SD) age at enrollment of 519 children was 2.7 (0.1) years, 264 (50.9%) were girls, 196 (37.8%) lived in Spanish-speaking households, and 5 (0.9%) identified as Alaskan Native or American Indian, 17 (3.2%) as Asian American or Pacific Islander, 57 (10.8%) as Black, 199 (37.8%) as White, and 63 (12.0%) as other. Mean sleep durations increased nonsignificantly from baseline by 5.6 minutes (95% CI, −2.3 to 13.6 minutes; P = .17) at 9-month follow-up and by 6.8 minutes (95% CI, 0.2-13.7 minutes; P = .06) at 12-month follow-up. There was a slight improvement in parental knowledge (1.13 unit increase from baseline; 95% CI, 0.13-2.12 units), but no significant outcomes for parent sleep attitudes (0.16 unit increase from baseline; 95% CI, −0.46 to 0.77 units), self-efficacy (−0.13 unit decrease from baseline; 95% CI, −1.02 to 0.76 units) and beliefs (−0.20 unit decrease from baseline; 95% CI, −0.56 to 0.16 units). Intervention effects for child sleep difficulties were not (continued) Key Points Question Does a sleep health education program for children and parents in Head Start improve childhood sleep and related outcomes? Findings This stepped-wedge cluster randomized clinical trial of 519 parentchild (aged 3 years at enroll...

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Establishing normal values for pediatric nighttime sleep measured by actigraphy: a systematic review and meta-analysis

Abstract: These normative values have potential application to assist the interpretation of actigraphy measures from nighttime recordings across the pediatric age range, and aid future research.

Cited by 169 publications

References 127 publications

Early parental positive personality and stress: Longitudinal associations with children's sleep

Early parental positive personality and stress: Longitudinal associations with children's sleep

Developmental trends in sleep during adolescents' transition to young adulthood

Effects of a Sleep Health Education Program for Children and Parents on Child Sleep Duration and Difficulties

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