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American Journal of Public Health Research. 2013, 1(4), 93-100
DOI: 10.12691/AJPHR-1-4-3
Original Research

Sleep Patterns, Sleep Problems and Associations with Reported Sleep Quality in Chinese School-Aged Children

Zeyu Zhang1, Ting Chen1, Xingming Jin2, Chonghuai Yan3, Xiaoming Shen3 and Shenghui Li1,

1School of Public Health, Shanghai Jiaotong University, Shanghai, People’s Republic of China

2Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China

3MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

Pub. Date: May 06, 2013

Cite this paper

Zeyu Zhang, Ting Chen, Xingming Jin, Chonghuai Yan, Xiaoming Shen and Shenghui Li. Sleep Patterns, Sleep Problems and Associations with Reported Sleep Quality in Chinese School-Aged Children. American Journal of Public Health Research. 2013; 1(4):93-100. doi: 10.12691/AJPHR-1-4-3

Abstract

Sleep plays a key role not only in children’s physical growth, behavior, and emotional development, but also in cognitive functioning. The present study was designed to survey the sleep characteristics and to examine the associations between sleep characteristics and child-reported sleep quality in urban school-aged children of China. A random sample of 19,299 children aged 5.08 to 11.99 years old, 49.7% boys and 50.3% girls with a mean age of 9.00 years old, participated in a cross-sectional survey which was conducted in 8 cities of China. A parent-administered questionnaire and the Chinese version of the Children’s Sleep Habits Questionnaire were completed to quantify family and personal information and to characterize sleep behaviors. The mean sleep duration was 9.17h (SD=0.80) on weekdays and 9.80h (SD=1.06) at weekends. Sleep problems were commonly existed with a relatively high prevalence ranging from 14.5% for sleep-disordered breathing to 75.3% for daytime sleepiness. There were significant gender and age differences existed in sleep problems. Various kinds of sleep problems and unhealthy sleep patterns were associated with poor sleep quality in Chinese school-aged children. The mean sleep duration was less than the recommended 10 hours per day for school-aged children. Sleep problems were commonly existed, which was beyond our expectation. Sleep problems and unhealthy sleep patterns were harmful to children’s sleep quality. A longitudinal study is needed to investigate the trends of sleep behaviors and the relative factors including personal lifestyle, family and social environment so as to intervene and improve children’s sleep quality.

Keywords

children, sleep patterns, sleep problems, sleep quality

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Amschler, D.H., McKenzie, J.F., “Elementary Students’ Sleep Habits and Teacher Observations of Sleep-Related Problems”, J Sch Health, 75(2). 50-56. Feb.2005.
 
[2]  DeVincent, C.J., Gadow, K.D., Delosh, D., Geller, L., “Sleep disturbance and its relation to DSM-IV psychiatric symptoms in preschool-age children with pervasive developmental disorder and community controls,” J Child Neurol, 22(2). 161-9. Feb.2007.
 
[3]  Curcio, G., Ferrara, M., De Gennaro, L., “Sleep loss, learning capacity and academic performance,” Sleep Med Rev, 10(5). 323-337. Oct.2006.
 
[4]  Stores, G., “Children’s sleep disorders: modern approaches, developmental effects, and children at special risk,” Dev Med Child Neurol, 41(8). 568-73. Aug.1999.
 
[5]  Beebe, D.W., “Cognitive, Behavioral, and Functional Consequences of Inadequate Sleep in Children and Adolescents,” Pediatr Clin North Am. 58(3). 649-665. Jun.2011.
 
[6]  Hoedlmoser, K., Kloesch, G., Wiater, A., Schabus, M., “Self-reported sleep patterns, sleep problems, and behavioral problems among school children aged 8-11 years,”Somnologie (Berl), 14(1). 23-31. Mar.2010.
 
[7]  Smaldone, A., Honig, J.C., Byrne, M.W., “Sleepless in America: inadequate sleep and relationships to health and well-being of our nation's children,” Pediatrics. 119. S29-37. Feb.2007.
 
[8]  Blunden, S.L., Chervin, R.D., “Sleep problems are associated with poor outcomes in remedial teaching programmes: A preliminary study,” J Paediatr Child Health. 44(5). 237-42. May.2008.
 
[9]  Dewald, J.F., Meijer, A.M., Oort, F.J., Kerkhof, G.A., Bögels, S.M., “The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review,” Sleep Med Rev. 14(3). 179-189. Jun.2010.
 
[10]  Carvalho Bos, S., Gomes, A., Clemente, V., Marques, M., Pereira, A.T., Maia, B., Soares, M.J., Cabral, A.S., Macedo, A., Gozal, D., Azevedo, M.H., “Sleep and behavioral/emotional problems in children: A population-based study,” Sleep Med. 10(1). 66-74. Jan.2009.
 
[11]  Paavonen, E.J., Räikkönen, K., Lahti, J., Komsi, N., Heinonen, K., Pesonen, A.K., Järvenpää, A.L., Strandberg, T., Kajantie, E., Porkka-Heiskanen, T., “Short sleep duration and behavioral symptoms of attention-deficit/hyperactivity disorder in healthy 7- to 8-year-old children,” Pediatrics. 123(5). e857-864. May.2009.
 
[12]  Paavonen, E.J., Porkka-Heiskanen, T., Lahikainen, A.R., “Sleep quality, duration and behavioral symptoms among 5-6-year-old children,” Eur Child Adolesc Psychiatry. 18(12). 747-754. Dec.2009.
 
[13]  Willoughby, M.T., Angold, A., Egger, H.L., “Parent-reported attention-deficit/ hyper- activity disorder symptomatology and sleep problems in a preschool-age pediatric clinic sample,” J Am Acad Child Adolesc Psychiatry. 47(9). 1086-94. Sep.2008.
 
[14]  Owens, J.A., Fernando, S., Mc Guinn, M., “Sleep disturbance and injury risk in young children,” Behav Sleep Med. 3(1). 18-31. 2005.
 
[15]  Fricke-Oerkermann, L., Plück, J., Schredl, M., Heinz, K., Mitschke, A., Wiater, A., Lehmkuhl, G., “Prevalence and course of sleep problems in childhood,” Sleep, 30(10). 1371-1377. Oct.2007.
 
[16]  Spruyt, K, O'Brien, L.M., Cluydts, R.., Verleye, G.B., Ferri, R., “Odds, prevalence and predictors of sleep problems in school-age normal children,” J Sleep Res, 14(2). 163-76. Jun.2005.
 
[17]  Dahl, R.E., Lewin, D.S., “Pathways to adolescent health: sleep regulation and behavior,” J Adolesc Health, 31(6). 175-84. Dec.2002.
 
[18]  Meltzer, L.J., Johnson, C., Crosette, J., Ramos, M., Mindell, J.A., “Prevalence of Diagnosed Sleep Disorders in Pediatric Primary Care Practices. Pediatrics,” 125(6). e1410-e1418. Jun.2010.
 
[19]  Carskadon, M.A., Wolfson, A.R., Acebo, C., Tzischinsky, O., Seifer, R., “Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days,” Sleep, 21(8). 871-81. Dec.1998.
 
[20]  Yang, C.K., Kim, J.K., Patel, S.R., Lee, J.H., “Age-related changes in sleep/wake patterns among Korean teenagers,” Pediatrics, 115(1). 250-6. Jun.2005.
 
[21]  Cunnane, SC., “Children origins of lifestyle-related risk factors for coronary heart disease in adulthood,” Nutr Health, 23(2). 98-105.1993.
 
[22]  Adam, E.K., Snell, E.K., Pendry, P., “Sleep timing and quantity in ecological and family context: a nationally representative time-diary study,” J Fam Psychol, 21(1). 4-19. Mar.2007.
 
[23]  Olds, T., Blunden, S, Petkov, J.,.Forchino, F., “The relationships between sex, age, geography and time in bed in adolescents: A meta-analysis of data from 23 countries,” Sleep Med Rev, 14(6). 371-8. Dec.2010.
 
[24]  Liu, X., Liu, L., Owens, J.A., Kaplan, D.L, “Sleep patterns and sleep problems among schoolchildren in the United States and China,” Pediatrics, 115(1). 241-9. Jan.2005.
 
[25]  Liu, X., Sun, Z., Uchiyama, M., Shibui, K., Kim,. K, Okawa, M., “Prevalence and Correlates of Sleep Problems in Chinese Schoolchildren,” Sleep, 23(8). 1053-62. Dec.2000.
 
[26]  Liu, X.C, Liu, L.Q., Wang, R.Z., “Bed sharing, sleep habits, and sleep problems among Chinese school-aged children,” Sleep, 26(7). 89-94. Nov.2003.
 
[27]  Li, S., Zhu, S, Jin, X., et al. Risk factors associated with short sleep duration among Chinese school-aged children. Sleep Med 2010; 11:907-16.
 
[28]  Li, S., Jin, X., Wu, S., Jiang, F., Yan, C., Shen, X., “The impact of media use on sleep patterns and sleep disorders among school-aged children in China,” Sleep, 30(3). 361-7. Mar.2007.
 
[29]  Owens, J.A., Spirito, A., McGuinn, M., “The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children,” Sleep, 23(8).1043-51. Dec.2000.
 
[30]  Li, S.H., Jin, X.M., Shen, X.M., Wu, S.H., Jiang, F., Yan, C.H., Yu, X.D., Qiu, Y.L., “Development and psychometric properties of the Chinese version of Children's Sleep Habits Questionnaire,” Zhonghua Er Ke Za Zhi, 45(3). 176-80. Mar. 2007.
 
[31]  Cole, T.J., Bellizzi, M.C., Flegal, K.M., Dietz, W.H.. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000 May 6; 320(7244):1240-3.
 
[32]  Matricciani, L., Olds, T., Petkov, J., “In search of lost sleep: secular trends in the sleep time of school-aged children and adolescents,” Sleep Med Rev, 16(3). 203-11. Jun.2012.
 
[33]  Leger, D., Beck, F., Richard, J.B., Godeau, E., “Total sleep time severely drops during adolescence,” PLoS One .7(10). e45204. Oct.2012.
 
[34]  Spilsbury, J.C., Storfer-Isser, A., Drotar, D., Rosen, C.L., Kirchner, L.H., Benham, H., Redline, S., “Sleep behavior in an urban US sample of school-aged children,” Arch Pediatr Adolesc Med, 158(10). 988-94. Oct.2004.
 
[35]  Holley, S., Hill, C.M., Stevenson, J., “An hour less sleep is a risk factor for childhood conduct problems,” Child Care Health Dev, 37(4). 563-70. Jul.2011.
 
[36]  Gruber, R., Cassoff, J., Frenette, S., Wiebe, S., Carrier, J., “Impact of Sleep Extension and Restriction on Children's Emotional Lability and Impulsivity,” Pediatrics. 130(5). e1155-61. Nov.2012.
 
[37]  Banks, S., Dinges, D.F., “Behavioral and physiological consequences of sleep restriction,” J Clin Sleep Med. 3(5). 519-28. Aug.2007.
 
[38]  Jiang, F., VanDyke, R,D., Zhang, J., Li, F., Gozal, D., Shen, X., “Effect of chronic sleep restriction on sleepiness and working memory in adolescents and young adults,” J Clin Exp Neuropsychol, 33(8). 892-900. Aug.2011.
 
[39]  Goel, N., Rao, H., Durmer, J,S., Dinges, D.F., “Neurocognitive consequences of sleep deprivation,” Semin Neurol. 29(4). 320-39. Sep.2009.
 
[40]  Wang, G., Xu, G., Liu, Z., Lu, N., Ma, R., Zhang, E., “Sleep patterns and sleep disturbances among Chinese school-aged children: Prevalence and associated factors,” Sleep Med. 14(1). 45-52. Jan.2013.
 
[41]  Gaina, A., Sekine, M., Hamanishi, S., Chen, X., Wang, H., Yamagami, T., Kagamimori, S., “Daytime sleepiness and associated factors in Japanese school children,” J Pediatr, 151(5). 518-22. Nov. 2007.
 
[42]  Ng, E.P., Ng, D.K., Chan, C.H., “Sleep duration, wake/sleep symptoms, and academic performance in Hong Kong Secondary School Children,” Sleep Breath. 13(4). 357-67. Nov.2009.
 
[43]  Bahammam, A.S., Alaseem, A.M., Alzakri, A.A, Almeneessier, A.S., Sharif, M.M., “The relationship between sleep and wake habits and academic performance in medical students: a cross-sectional study,” BMC Med Educ, 12. 61. Aug.2012.
 
[44]  Borchers, C, Randler, C., “Sleep-Wake Cycle of Adolescents in Côte d'Ivoire: Influence of Age, Gender, Religion and Occupation,” Chronobiol Int. 29(10). 1366-75. Dec.2012.
 
[45]  Russo, P.M., Bruni, O., Lucidi, F., Ferri, R., Violani, C., “Sleep habits and circadian preference in Italian children and adolescents,” J Sleep Res, 16(2). 163-9. Jun.2007.
 
[46]  Bee, H., “The development child,” 5th ed. New York: Harper & Row Publishers, 1989.
 
[47]  Dwyer, S.B., Nicholson, J.M., Battistutta, D, “Parent and teacher identification of children at risk of developing internalizing or externalizing mental health problems: a comparison of screening methods,” Prev Sci, 7(4). 343-57. Dec.2006.
 
[48]  Pressman, M.R., “Disorders of arousal from sleep and violent behavior: the role of physical contact and proximity,” Sleep, 30(8). 1039-47. Aug.2007.
 
[49]  Veldi, M., Aluoja, A., Vasar, V., “Sleep quality and more common sleep-related problems in medical students,” Sleep Med. 6(3). 269-75. May.2005.
 
[50]  Sun, W.Q., Chen, W.J., Jiang, Y.R., Li, F., Li, S.H., Yan, C.H., Jin, X.M., Shen, X.M., Jiang, F., “The association of sleep hygiene and sleep quality among school-age children,” Zhonghua Yu Fang Yi Xue Za Zhi. 46(8). 713-7. Aug.2012.
 
[51]  Suen, L.K., Tam, W.W., Hon, K.L., “Association of sleep hygiene-related factors and sleep quality among university students in Hong Kong,” Hong Kong Med J, 16(3). 180-5. Jun.2010,
 
[52]  Li, S., Jin, X., Yan, C., Wu, S., Jiang, F., Shen, X., “Bed- and room-sharing in Chinese school-aged children: prevalence and association with sleep behaviors,” Sleep Med, 9(5).555-63. Jul.2008.