RESUMEN
OBJECTIVE: To investigate the relationship between sleep duration and carotid intima-media thickness (CIMT) in adolescents. We hypothesized that short sleep duration was associated with an increased CIMT. STUDY DESIGN: This was a cross-sectional study. Healthy participants aged 10-18 years were recruited from a school-based cohort established to examine the prevalence of obstructive sleep apnea in Hong Kong. All participants completed a prospective 7-day sleep diary, underwent anthropometric measurements, overnight polysomnography, and CIMT assessment. Overweight participants or those with an obstructive apnea hypopnea index of ≥5 were excluded from analysis. Regression analysis was used to assess the association between CIMT and sleep duration and other possible correlates. RESULTS: One hundred forty-two participants completed the assessments. Male participants tended to have shorter sleep duration than females (P = .012). There were no differences in age, body mass index, Tanner developmental stage, or parental history of hypertension between groups of different sleep durations. There was a weak but significant association between short sleep duration and CIMT (r = -0.273; P < .001). CONCLUSION: Sleep duration was found to have a weakly negative association with CIMT. Further research is needed to determine whether adult adverse cardiovascular events may originate in childhood owing to short sleep duration.
Asunto(s)
Grosor Intima-Media Carotídeo , Privación de Sueño/complicaciones , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Polisomnografía/métodos , Estudios Prospectivos , Análisis de Regresión , Autoinforme , Distribución por SexoRESUMEN
OBJECTIVES: To examine the average sleep duration in Chinese preschoolers and to investigate the association between sleep duration and school readiness. STUDY DESIGN: This is a cross-sectional study that included 553 Chinese children (mean age = 5.46 years) from 20 preschools in 2 districts of Hong Kong. Average daily sleep duration in the last week was reported by parents and school readiness as measured by the teacher-rated Chinese Early Development Instrument (CEDI). RESULTS: Most Chinese preschoolers had 9-10 hours of sleep per day. Only 11% of preschoolers had the recommended 11-12 hours of sleep per day. This group was associated with more "very ready" CEDI domains. Sleep deprivation (≤7 hours per day) was associated with a lower CEDI total score, lower scores in the emotional maturity and language/cognitive domain, and prosocial behaviors subdomain but a greater score in the hyperactivity/inattention subdomain. Children with a lower family socioeconomic index, lower maternal education level, infrequent parent-child interactions, and who used electronic devices for more than 3 hours per day had shortened sleep durations. CONCLUSIONS: Optimal sleep duration was associated with better school readiness in preschool children, whereas sleep deprivation was associated with lower school readiness, more hyperactivity and inattention, and less prosocial behavior.
Asunto(s)
Discapacidades para el Aprendizaje/epidemiología , Privación de Sueño/epidemiología , Sueño/fisiología , Pueblo Asiatico/etnología , Niño , Desarrollo Infantil , Preescolar , Estudios Transversales , Femenino , Hong Kong/epidemiología , Humanos , Masculino , Relaciones Padres-Hijo , Instituciones Académicas , Encuestas y CuestionariosAsunto(s)
Leucemia/etiología , Neoplasias Inducidas por Radiación/etiología , Radiación Ionizante , Niño , Historia del Siglo XX , Humanos , Pediatría/historia , Monitoreo de Radiación , Protección Radiológica , Literatura de Revisión como Asunto , Tomografía Computarizada por Rayos X/efectos adversosRESUMEN
BACKGROUND: Establishment of a consistent bedtime routine (the activities that occur right before lights out) is often recommended as part of healthy sleep habits. However, no studies have investigated the dose-dependent association of a bedtime routine with sleep outcomes, especially in young children for whom they are particularly recommended. Thus, the aim of this study was to examine the associations of a consistent bedtime routine with sleep outcomes in young children (ages 0 through 5 y) in a large global sample and assess whether there is a dose-dependent relationship between the frequency of a bedtime routine both concurrently and retrospectively with sleep outcomes. PARTICIPANTS: Mothers of 10,085 children (Australia-New Zealand, Canada, China, Hong Kong, India, Japan, Korea, Malaysia, Philippines, Singapore, Thailand, United Kingdom, United States) completed the Brief Infant/Child Sleep Questionnaire. RESULTS: A consistent bedtime routine was associated with better sleep outcomes, including earlier bedtimes, shorter sleep onset latency, reduced night wakings, and increased sleep duration. Decreased parent-perceived sleep problems and daytime behavior problems were also related to institution of a regular bedtime routine. Furthermore, there was a dose-dependent relationship, with better outcomes associated with increased "doses" of having a bedtime routine, both currently and retrospectively, and was found within both predominantly Asian and predominantly Caucasian cultural regions. CONCLUSIONS: These results indicate that having a regular nightly bedtime routine is associated with improved sleep in young children, and suggests that the more consistently a bedtime routine is instituted and the younger started the better.
Asunto(s)
Conducta Infantil/fisiología , Sueño/fisiología , Pueblo Asiatico/estadística & datos numéricos , Preescolar , Femenino , Humanos , Lactante , Conducta del Lactante/fisiología , Recién Nacido , Internacionalidad , Masculino , Madres/psicología , Medicina del Sueño/métodos , Encuestas y Cuestionarios , Factores de Tiempo , Estados Unidos , Vigilia/fisiología , Población Blanca/estadística & datos numéricosRESUMEN
OBJECTIVE: To examine the association between passive smoking and snoring in preschool children using parent-reported questionnaires and urine cotinine levels. STUDY DESIGN: This was a population-based cross-sectional survey of 2954 children aged 2-6 years in Hong Kong. Parent-reported questionnaires provided information on snoring and household smoking. One-third of children randomly chosen from the cohort provided urine samples for cotinine analysis. Increased urine cotinine was defined as urinary cotinine concentration ≥ 30 ng/mg creatinine. Using multivariate logistic regression analysis, we analyzed the association between snoring and passive smoking, controlling for potential confounders including age, sex, body mass index z-score, atopic diseases, recent upper respiratory tract infection, parental allergy, parental education, family income, and bedroom-sharing. RESULTS: A total of 2187 completed questionnaires were included in the final analysis, and 724 children provided urine samples for cotinine measurement. After adjustment for confounding factors, questionnaire-based household smoking (>10 cigarettes/d: OR = 2.22, 95% CI = 1.02-4.81) and increased urine cotinine (OR = 4.37, 95% CI = 1.13-16.95) were significant risk factors for habitual snoring (snoring ≥ 3 nights per week). For occasional snoring (snoring 1-2 nights per week), reported household smoking (1-10 cigarettes/d: OR = 1.41, 95% CI = 1.14-1.76; >10 cigarettes/d: OR = 1.56, 95% CI = 1.05-2.31), and increased urine cotinine (OR = 1.82, 95% CI = 1.03-3.20) were also identified as significant risk factors. A dose-effect relationship was found for snoring frequency and adjusted natural logarithms of urinary cotinine concentrations (P < .001). CONCLUSIONS: Environmental tobacco smoke exposure is an independent risk factor for snoring in preschool children. Parents' smoking cessation should be encouraged in management of childhood snoring.
Asunto(s)
Cotinina/orina , Exposición a Riesgos Ambientales/efectos adversos , Ronquido/inducido químicamente , Contaminación por Humo de Tabaco/efectos adversos , Antropometría/métodos , Índice de Masa Corporal , Niño , Preescolar , Estudios Transversales , Femenino , Hong Kong , Humanos , Modelos Logísticos , Masculino , Análisis Multivariante , Padres , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To examine the prevalence and correlates of nocturnal enuresis (NE) in primary school children, and to compare the prevalence of NE in children with and those without obstructive sleep apnea (OSA). STUDY DESIGN: Parents of children aged 6-11 years completed a questionnaire eliciting information on sleep-related symptoms, demography, and family and past medical history. Children screened due to high risk for OSA, along with a randomly chosen low-risk group, underwent overnight polysomnography (PSG). RESULTS: A total of 6147 children (3032 girls) were studied. The overall prevalence of NE (≥1 wet night/month) was 4.6% (6.7% of boys and 2.5% of girls). Boys had a significantly greater prevalence across all age groups. In 597 children (215 girls) who underwent PSG, the prevalence of NE was not greater in children with OSA, but was increased with increasing severity of OSA in girls only. Boys with NE had longer deep sleep duration. Sex and sleep-related symptoms were associated with NE. CONCLUSIONS: This community-based study demonstrated a sex-associated prevalence of NE in relation to increasing OSA severity.
Asunto(s)
Enuresis Nocturna/epidemiología , Apnea Obstructiva del Sueño/complicaciones , Niño , Progresión de la Enfermedad , Enuresis , Femenino , Estudios de Seguimiento , Hong Kong/epidemiología , Humanos , Masculino , Enuresis Nocturna/etiología , Enuresis Nocturna/fisiopatología , Polisomnografía , Prevalencia , Factores de Riesgo , Sueño/fisiología , Apnea Obstructiva del Sueño/epidemiología , Apnea Obstructiva del Sueño/fisiopatología , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
OBJECTIVES: To determine sleep/wake patterns of primary school children and their correlates. STUDY DESIGN: A total of 4470 sets of mother-father-child community-based trios were recruited in this study. We constructed 3 integrated models with structural equation modeling to predict sleep/wake patterns of children (bedtime, wakeup time, and time in bed [TIB]). RESULTS: Our best-fitting models explained 40% to 71% variances of various sleep/wake patterns of the children, which were influenced by a web of interactive factors including school start time, parental sleep/wake patterns, sociodemographics, and daytime activities. The strongest predictor of various sleep/wake patterns was school start time. Higher socioeconomic status would shorten TIB of both children and parents, but through different pathways (by advancing wakeup time and delaying bedtime in children but by delaying bedtime in parents). Media use and homework shortened TIB of children, while leisure extracurricular activities and later school start time lengthened it. The age and sex effects on sleep/wake patterns, at least in part, were mediated by daytime activities. Daytime activities of children also influenced their parental sleep/wake patterns, especially their maternal one. A consistent pattern of stronger mother-child than father-child associations were found in various sleep/wake patterns. CONCLUSIONS: There was a complex and interactive relationship among school schedule, parental sleep/wake patterns, socioeconomic status, and daytime activities in determining the sleep/wake patterns of children. These findings have important clinical implications for the management of childhood sleep/wake habits and problems.
Asunto(s)
Actividades Cotidianas , Trastornos de Somnolencia Excesiva/epidemiología , Relaciones Padres-Hijo , Trastornos del Sueño del Ritmo Circadiano/epidemiología , Sueño/fisiología , Vigilia/fisiología , Adulto , Niño , Trastornos de Somnolencia Excesiva/diagnóstico , Trastornos de Somnolencia Excesiva/fisiopatología , Femenino , Estudios de Seguimiento , Hong Kong/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Polisomnografía , Estudios Retrospectivos , Trastornos del Sueño del Ritmo Circadiano/diagnóstico , Trastornos del Sueño del Ritmo Circadiano/fisiopatología , Clase SocialRESUMEN
OBJECTIVES: To compare ambulatory blood pressure (ABP) in nonoverweight, prepubertal children with and without primary snoring (PS), and to investigate whether PS is a part of the dose-response relationship between sleep-disordered breathing (SDB) and BP in children. STUDY DESIGN: This was a cross-sectional community-based study involving 190 children age 6 to 13 years. Each participant underwent an overnight sleep study and ABP monitoring after completing a validated sleep symptoms questionnaire. Individual systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial BP were calculated for wake and sleep periods. Subjects were hypertensive if mean SBP or DBP was > 95th percentile (relative to sex and height) of reference. RESULTS: A total of 56 nonsnoring controls, 46 children with PS, 62 children with an apnea-hypopnea index (AHI) of 1 to 3, and 26 children with an AHI > 3 were identified. The daytime and nighttime BP increased across the severity spectrum of SDB. The dose-response trends for the proportion of subjects with nighttime systolic and diastolic hypertension also were significant. Nighttime DBP was significantly higher in the children with PS compared with controls after adjusting for age, sex, and body mass index. CONCLUSIONS: PS was demonstrated to be an aspect of the dose-response relationship between SDB and BP in children and should not be considered completely benign.