Sleep and its relation to health-related quality of life in 3–10-year-old children

Sundell, Anna Lena; Angelhoff, Charlotte

doi:10.1186/s12889-021-11038-7

Cited by 19 publications

(14 citation statements)

References 46 publications

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“…Second, according to the time displacement hypothesis, screen viewing may displace the time that could otherwise have been used for intellectually demanding activities or health-enhancing physical activities [33][34][35]. Lack of such activities might consequently lead to impaired HRQOL and more behavioral problems in children [36][37][38][39]. Third, the social withdrawal hypothesis has suggested that excessive screen time could hinder children's social interaction with their peers and parents, which may subsequently jeopardize children's psychosocial well-being and prosocial behaviors [40,41].…”

Section: Discussionmentioning

confidence: 99%

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

et al. 2022

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Background Both excessive screen time and early screen exposure have been linked to children’s health outcomes, but few studies considered these two exposures simultaneously. The aim of this study was to explore the independent and interactive associations of excessive screen time and early screen exposure with health-related quality of life (HRQOL) and behavioral problems among Chinese children attending preschools. Methods A cross-sectional study of 4985 children aged between 3 and 6 years was conducted in Chengdu, China. Each parent has finished an online questionnaire regarding their children’s screen use, HRQOL, and behavioral problems. Children with screen time over 1 h/day were considered as having excessive screen time. Early screen exposure was defined if the children had started using screen-based media before the age of 2 years. HRQOL was assessed by the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0), while behavioral problems were confirmed with the 48-item Conners’ Parent Rating Scale (CPRS-48). Results Of the 4985 children (2593 boys and 2392 girls) included, the mean age was 4.6 (SD: 1.0) years. After adjustment for confounders and early screen exposure, excessive screen time was significantly associated with worse HRQOL scores in all dimensions and summary scales, as well as each type of behavioral problems (all p values < 0.05). We also found that compared to children with later initiation of screen exposure, those with screen use before the age of 2 years had significantly lower emotional functioning score (β: − 2.13, 95%CI: − 3.17, − 1.09) and psychosocial health summary score (β: − 0.82, 95%CI: − 1.54, − 0.10) of HRQOL, as well as higher risks of conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, and hyperactivity index, which were independent of excessive screen use. Furthermore, there were significant interactive effects of excessive screen time and early screen exposure on emotional functioning domain of HRQOL scores and conduct problems. Conclusion Excessive screen time and early screen exposure are two independent and interactive factors to children’s HRQOL and behavioral problems. Our findings support current guidelines to limit screen exposure in children. Appropriate screen use may represent an important intervention target to improve children’s HRQOL and reduce their behavioral problems.

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Section: Discussionmentioning

confidence: 99%

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

et al. 2022

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“…13 Evidence is emerging that HRQOL is also adversely affected in community samples of children with milder sleep health issues, such as parent-reported sleep problems 14,15 or sleep initiation or maintenance difficulties. 16 However, little research has determined whether HRQOL is a factor in sleep in otherwise healthy children. A 2016 systematic review 6 reported an inverse association between sleep duration and HRQOL in 3 studies but rated such evidence as very low quality.…”

Section: Introductionmentioning

confidence: 99%

Effect of Sleep Changes on Health-Related Quality of Life in Healthy Children

et al. 2023

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ImportanceLittle is known regarding the effect of poor sleep on health-related quality of life (HRQOL) in healthy children.ObjectiveTo determine the effect of induced mild sleep deprivation on HRQOL in children without major sleep issues.Design, Setting, and ParticipantsThis prespecified secondary analysis focused on HRQOL, a secondary outcome of the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized crossover trial of children who underwent alternating weeks of sleep restriction and sleep extension and a 1-week washout in between. The DREAM trial intervention was administered at participants’ homes between October 2018 and March 2020. Participants were 100 children aged 8 to 12 years who lived in Dunedin, New Zealand; had no underlying medical conditions; and had parent- or guardian-reported normal sleep (8-11 hours/night). Data were analyzed between July 4 and September 1, 2022.InterventionsBedtimes were manipulated to be 1 hour later (sleep restriction) and 1 hour earlier (sleep extension) than usual for 1 week each. Wake times were unchanged.Main Outcomes and MeasuresAll outcome measures were assessed during both intervention weeks. Sleep timing and duration were assessed using 7-night actigraphy. Children and parents rated the child’s sleep disturbances (night) and impairment (day) using the 8-item Pediatric Sleep Disturbance and 8-item Sleep-Related Impairment scales of the Patient-Reported Outcomes Measurement Information System questionnaire. Child-reported HRQOL was assessed using the 27-item KIDSCREEN questionnaire with 5 subscale scores and a total score. Both questionnaires assessed the past 7 days at the end of each intervention week. Data were presented as mean differences and 95% CIs between the sleep restriction and extension weeks and were analyzed using intention to treat and an a priori difference in sleep of at least 30 minutes per night.ResultsThe final sample comprised 100 children (52 girls [52%]; mean [SD] age, 10.3 [1.4] years). During the sleep restriction week, children went to sleep 64 (95% CI, 58-70) minutes later, and sleep offset (wake time) was 18 (95% CI, 13-24) minutes later, meaning that children received 39 (95% CI, 32-46) minutes less of total sleep per night compared with the sleep extension week in which the total sleep time was 71 (95% CI, 64-78) minutes less in the per-protocol sample analysis. Both parents and children reported significantly less sleep disturbance at night but greater sleep impairment during the day with sleep restriction. Significant standardized reductions in physical well-being (standardized mean difference [SMD], −0.28; 95% CI, −0.49 to −0.08), coping in a school environment (SMD, −0.26; 95% CI, −0.42 to −0.09), and total HRQOL score (SMD, −0.21; 95% CI, −0.34 to −0.08) were reported by children during sleep restriction, with an additional reduction in social and peer support (SMD, −0.24; 95% CI, −0.47 to −0.01) in the per-protocol sample analysis.Conclusions and RelevanceResults of this secondary analysis of the DREAM trial indicated that even 39 minutes less of sleep per night for 1 week significantly reduced several facets of HRQOL in children. This finding shows that ensuring children receive sufficient good-quality sleep is an important child health issue.Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12618001671257

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“…Secondly, poor sleep quality will reduce daytime alertness, which, in turn, may decrease the attention effect and lead to impaired academic performance [ 35 ]. In addition, students at the last ranking will encounter greater learning pressure, which may affect the quality of sleep [ 1 , 2 , 3 , 4 ]. Screen time was positively correlated with the sleep quality score of primary school students, this may be due to the screen light stimulating the brain and inhibiting melatonin production, resulting in an increase in sleep latency [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Sleep is closely related to the healthy growth of adolescents and has extensive public health significance. The American Academy of Sleep Medicine proposes that school-age children need to ensure 9–12 h of sleep to maintain their physical and mental health [ 1 ] Good sleep quality is conducive to the healthy growth, study, and life of adolescents. However, many studies have reported that children have many sleep-related problems.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Learning Burnout on Sleep Quality in Primary School Students: The Mediating Role of Mental Health

et al. 2022

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Due to the growth of research on sleep, mental health, and learning burnout on healthy growth and its related public health significance of adolescents, this study aimed to provide a deeper understanding of the effect of mental health and learning burnout on sleep among primary school students. The sleep quality (subjective sleep quality, sleep time, sleep latency, sleep duration, sleep efficiency, sleep disturbance, and daytime dysfunction), mental health, and learning burnout (exhaustion, learning cynicism, and reduced efficacy) of 900 students of grades 3–6 in primary schools were assessed in 2020. The PSQI scores of participants were 4.19 ± 2.545, of which a number of 322 (39.03%) students had sleep disturbance (PSQI scores ≧ 5). Binary logistic regression analysis showed that screen time (OR = 1.518, 95% CI: 1.164–1.980), ranking status (OR = 0.659, 95% CI: 0.480–0.907), learning burnout (OR = 1.088, 95% CI: 1.067–1.108), and mental health (OR = 4.672, 95% CI: 1.954–11.173) were the influencing factors for sleep quality of grade 3–6 students. According to the mediation effect analyses, mental health played a mediating effect (58.73% of the total effect) on the relationship between learning burnout and sleep quality. In conclusion, primary school students in Hunan of China have prominent sleep problems, and the daytime dysfunction caused by sleep problems is the most serious. Learning burnout positively predicted poorer sleep quality, and mental health played a mediating effect on the relationship between learning burnout and sleep quality.

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Sleep and its relation to health-related quality of life in 3–10-year-old children

Cited by 19 publications

References 46 publications

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

Effect of Sleep Changes on Health-Related Quality of Life in Healthy Children

The Effect of Learning Burnout on Sleep Quality in Primary School Students: The Mediating Role of Mental Health

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