Editorial

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Open AccessEditorial

Factors Affecting the Quality of Sleep in Children

by Jun Kohyama

Children 2021, 8(6), 499; https://0-doi-org.brum.beds.ac.uk/10.3390/children8060499 - 12 Jun 2021

Cited by 4 | Viewed by 2057

Abstract

Sleep quality is difficult to define objectively [...] Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

Research

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16 pages, 564 KiB

Open AccessArticle

Effects of Treatment of Sleep Disordered Breathing on Sleep Macro- and Micro-Architecture in Children with Down Syndrome

by Viecky M. P. Betavani, Margot J. Davey, Gillian M. Nixon, Lisa M. Walter and Rosemary S. C. Horne

Children 2022, 9(7), 984; https://0-doi-org.brum.beds.ac.uk/10.3390/children9070984 - 30 Jun 2022

Cited by 6 | Viewed by 1519

Abstract

Background: Children with Down syndrome (DS) are at increased risk of obstructive sleep disordered breathing (SDB), which is associated with intermittent hypoxia and sleep disruption affecting daytime functioning. We aimed to examine the effects of treatment of SDB on sleep quality and daytime [...] Read more.

Background: Children with Down syndrome (DS) are at increased risk of obstructive sleep disordered breathing (SDB), which is associated with intermittent hypoxia and sleep disruption affecting daytime functioning. We aimed to examine the effects of treatment of SDB on sleep quality and daytime functioning in children with DS. Methods: Children with DS and SDB (n = 24) completed a baseline and follow-up overnight polysomnographic (PSG) study 22 ± 7 months (mean ± SD) later. Sleep micro-architecture was assessed using EEG spectral analysis, and parents completed a number of questionnaires assessing sleep, behavior, daytime functioning, and quality of life (QOL). Results: A total of nine children (38%) were treated. At baseline, the treated group had more severe SDB compared to the untreated group. SDB severity was significantly improved from 40.3 ± 46.9 events/h to 17.9 ± 26.9 events/h (p < 0.01) at follow up in children who were treated. There were no significant differences in sleep macro-architecture parameters from baseline to follow up in either the treated or untreated group. Sleep micro-architecture was not different between studies in the treated group, however this tended to improve in the untreated group, particularly in REM sleep. Daytime functioning and behavior were not different between the studies in either group, however, QOL improved after treatment. Conclusions: Our study identified that treatment of SDB improves severity of the disease as defined by PSG, and this was associated with parental reports of improved QOL, despite treatment having no demonstrable impacts on sleep quality, behavior, or daytime functioning. Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

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15 pages, 1124 KiB

Open AccessArticle

Change of Internet Use and Bedtime among Junior High School Students after Long-Term School Closure Due to the Coronavirus Disease 2019 Pandemic

by Hideki Nakayama, Takanobu Matsuzaki, Satoko Mihara, Takashi Kitayuguchi and Susumu Higuchi

Children 2021, 8(6), 480; https://0-doi-org.brum.beds.ac.uk/10.3390/children8060480 - 07 Jun 2021

Cited by 12 | Viewed by 3562

Abstract

Most schools in Japan were closed in spring 2020 due to the novel coronavirus disease 2019 (COVID-19) pandemic. We investigated lifestyle and internet use among junior high school students across eight schools after long-term school closure and compared the data with those we [...] Read more.

Most schools in Japan were closed in spring 2020 due to the novel coronavirus disease 2019 (COVID-19) pandemic. We investigated lifestyle and internet use among junior high school students across eight schools after long-term school closure and compared the data with those we obtained from previous surveys. In the summers of 2018, 2019, and 2020, we conducted questionnaire surveys on seventh-grade students from the same schools. In total, 2270 participants were analyzed. All questionnaires included items regarding background, bedtime, and internet use. The participants of the 2020 survey had significantly less sleepiness during classes and longer internet use times compared with those of the previous surveys. In the 2020 survey, the rate of problematic internet use (Young’s Diagnostic Questionnaire score, ≥5) was not significantly different from the results of previous surveys. The COVID-19 pandemic might have strongly influenced the sleepiness experienced by students in classes and increased the time spent using the internet since the summer of 2020. Our results indicate the need for attempts to encourage students to improve their sleep habits and moderate their media use. Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

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13 pages, 356 KiB

Open AccessArticle

Sleep Quality and Duration in European Adolescents (The AdolesHealth Study): A Cross-Sectional, Quantitative Study

by Pablo Galan-Lopez, Raúl Domínguez, Thordis Gísladóttir, Antonio J. Sánchez-Oliver, Maret Pihu, Francis Ries and Markos Klonizakis

Children 2021, 8(3), 188; https://0-doi-org.brum.beds.ac.uk/10.3390/children8030188 - 03 Mar 2021

Cited by 8 | Viewed by 5393

Abstract

Sleep is a vital element of adolescents’ overall health; it influences their body and mind and thus affects their quality of life. Adequate sleep quality and duration are essential for maintaining optimal metabolic health and lowering the risk of developing several medical conditions, [...] Read more.

Sleep is a vital element of adolescents’ overall health; it influences their body and mind and thus affects their quality of life. Adequate sleep quality and duration are essential for maintaining optimal metabolic health and lowering the risk of developing several medical conditions, such as cardiovascular disease. The current study aimed to assess the perceived sleep quality and duration of 1717 European adolescents from three different European countries (Spain, Iceland and Estonia) aged 13- to 16-years (900 boys, 817 girls) using the Pittsburgh Sleep Quality Index (PSQI). A multivariate analysis of variance (MANOVA) was performed to examine differences between groups and two-factor analysis of variance (ANOVA) was used to analyze city and age differences. The probability of having poor sleep quality and duration was calculated by Odd-Ratio (OR). Our study found poor sleep quality in 44% of the boys and 53% of the girls, whereas 68% and 69%, respectively did not get the recommended hours of sleep (i.e., 8–10 h). No difference was found between adolescents from Estonia, Iceland and Spain regarding sleep duration. In contrast, Spanish and Estonian adolescents reported higher probabilities of having poor sleep quality. Finally, girls had a significantly higher probability of poor sleep quality than boys. Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

11 pages, 1683 KiB

Open AccessArticle

A Longitudinal Study of Subjective Daytime Sleepiness Changes in Elementary School Children Following a Temporary School Closure Due to COVID-19

by Yoko Komada, Yoshiki Ishibashi, Shunta Hagiwara, Mariko Kobori and Akiyoshi Shimura

Children 2021, 8(3), 183; https://0-doi-org.brum.beds.ac.uk/10.3390/children8030183 - 01 Mar 2021

Cited by 7 | Viewed by 2703

Abstract

Excessive daytime sleepiness is increasingly being recognized as a major global health concern. However, there have been few studies related to sleepiness and its associated factors in elementary school children. In Japan, all schools were closed from February to May 2020 to prevent [...] Read more.

Excessive daytime sleepiness is increasingly being recognized as a major global health concern. However, there have been few studies related to sleepiness and its associated factors in elementary school children. In Japan, all schools were closed from February to May 2020 to prevent coronavirus disease 2019 (COVID-19) outbreaks. The aim of this study was to identify changes in the subjective sleepiness of pupils during the 1.5-year period and to elucidate factors associated with changes in sleepiness. Questionnaire surveys about pupils’ sleep habits and the Japanese version of the Pediatric Daytime Sleepiness Scale (PDSS-J) were conducted longitudinally at one elementary school in June 2019, January 2020, and June 2020. The average ∆PDSS score was 0.94 ± 5.51 (mean ± standard deviation) from June 2019 to January 2020 and −1.65 ± 5.71 (t[498] = 6.13, p < 0.01) from January 2020 to June 2020. Univariate and multivariate logistic regression analyses revealed that decreasing social jetlag was associated with decreasing PDSS scores (OR = 0.77, 95% CI: 0.62–0.96, p = 0.02) during the school closure. A less restrictive school schedule secondary to a COVID-19-related school closure decreased sleepiness in children and was associated with decreasing social jetlag. Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

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14 pages, 285 KiB

Open AccessArticle

Sleep and the General Behavior of Infants and Parents during the Closure of Schools as a Result of the COVID-19 Pandemic: Comparison with 2019 Data

by Yasuaki Shinomiya, Arika Yoshizaki, Emi Murata, Takashi X. Fujisawa, Masako Taniike and Ikuko Mohri

Children 2021, 8(2), 168; https://0-doi-org.brum.beds.ac.uk/10.3390/children8020168 - 22 Feb 2021

Cited by 18 | Viewed by 3672

Abstract

This study compared cross-sectional data from online surveys describing the sleep behavior of infants and caregivers in March 2020 (the school closure period during the early stages of the COVID-19 pandemic; n = 295, 23.8 ± 3.8 months old) and March 2019 (before [...] Read more.

This study compared cross-sectional data from online surveys describing the sleep behavior of infants and caregivers in March 2020 (the school closure period during the early stages of the COVID-19 pandemic; n = 295, 23.8 ± 3.8 months old) and March 2019 (before the pandemic; n = 2017, 24.2 ± 3.8 months old). In comparing those two points in time, no significant differences were found in wake-up times (2019: 7:19 ± 0:46 am vs. 2020: 7:18 ± 0:47 am, p = 0.289), bedtimes (21:01 ± 0:48 pm vs. 21:04 ± 0:53 pm, p = 0.144), or nocturnal sleep times (593.7 ± 43.9 min vs. 588.1 ± 50.3 min, p = 0.613). Regarding the caregivers, in 2020, wake-up times (2019: 6:46 ± 0:50 am vs. 2020: 6:39 ± 0:50 am, p = 0.017) and bedtimes (22:53 ± 1:17 pm vs. 22:42 ± 1:04 pm, p = 0.016) became significantly earlier compared to 2019. Among infants staying at home, total sleep time and percentage of outdoor play decreased significantly, and media use increased significantly in 2020. Lower levels of exercise and more frequent media viewing may have caused prolonged sleep latency in these children. The percentage of caregivers responding with “negative childcare feelings” was significantly higher in the group with less than three nursery school attendance days. Caregivers and infants staying at home are a high-risk group during the pandemic. Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

13 pages, 252 KiB

Open AccessArticle

Social and Family Factors as Determinants of Sleep Habits in Japanese Elementary School Children: A Cross-Sectional Study from the Super Shokuiku School Project

by Satomi Sawa, Michikazu Sekine and Masaaki Yamada

Children 2021, 8(2), 110; https://0-doi-org.brum.beds.ac.uk/10.3390/children8020110 - 05 Feb 2021

Cited by 3 | Viewed by 3832

Abstract

This study explored the associations of lifestyle, familial, and social factors with sleep habits in 1882 elementary school children, aged 6–13 years, from the Super Shokuiku School Project in January 2016. A survey assessed sex, grade, sleep habits, lifestyle, social background, and parental [...] Read more.

This study explored the associations of lifestyle, familial, and social factors with sleep habits in 1882 elementary school children, aged 6–13 years, from the Super Shokuiku School Project in January 2016. A survey assessed sex, grade, sleep habits, lifestyle, social background, and parental lifestyle. Bedtime “≥22:00,” wake-up time “≥07:00,” sleep duration “<8 h,” and “daytime sleepiness” were defined as poor sleep habits; correlates were analyzed using logistic regression. Skipping breakfast was consistently significantly associated with poor sleep, especially among children with late wake-up times (adjusted odds ratio 5.45; 95% confidence interval 3.20–9.30). Excessive screen time was associated with late bed and wake-up times. Physical inactivity was significantly associated with daytime sleepiness. Children of mothers with poor lifestyle habits were likely to go to bed late and feel sleepy the next day. Social and family factors were associated with children’s sleep habits. Several behaviors, including skipping breakfast, excessive screen time, and physical inactivity, were associated with poor sleep habits, manifesting as a night-oriented lifestyle. Although a longitudinal study is needed to determine causality, in addition to sleep education for children, sleep education for parents and society at large may be necessary to improve children’s sleep habits. Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

11 pages, 437 KiB

Open AccessArticle

Association between Self-Reported Sleep Duration and Dietary Nutrients in Korean Adolescents: A Population-Based Study

by Jee Hyun Lee, Sang-Jin Chung and Won Hee Seo

Children 2020, 7(11), 221; https://0-doi-org.brum.beds.ac.uk/10.3390/children7110221 - 08 Nov 2020

Cited by 7 | Viewed by 2294

Abstract

(1) Background: Adolescence is a transient period from childhood to adulthood, which is characterized by rapid physical growth and psychological changes, including sleep. Because the relationship between insufficient sleep and obesity has been observed in children and adults, the potential links between sleep, [...] Read more.

(1) Background: Adolescence is a transient period from childhood to adulthood, which is characterized by rapid physical growth and psychological changes, including sleep. Because the relationship between insufficient sleep and obesity has been observed in children and adults, the potential links between sleep, dietary intake, and nutrition have received increased attention. We aimed to examine the association of sleep duration with dietary nutrients intake in South Korean adolescents; (2) Methods: This population-based, cross-sectional study analyzed the data obtained from the Korea National Health and Nutrition Examination Survey between 2013 and 2015. Data related to 1422 adolescents aged 12–18 years (741 males and 681 females) were included in the analysis. Sleep duration was assessed using a self-reported questionnaire. Nutrient intake, including daily total energy intake, was assessed with a 24-h dietary recall questionnaire; (3) Results: Most males (84.4%) and females (86.4%) reported < 9 h of sleep per night. Short sleep duration was inversely associated with body mass index and obesity in both sexes. We found that higher intake of fiber and lower intake of sodium were associated with longer sleep duration (P < 0.05). When comparing the intake above and below the estimated average requirements (EAR), the difference in sleep duration was significant in the group that consumed vitamins B₁ and C below EAR; (4) Conclusions: The findings of this study indicate that sleep duration can be associated with intake of some nutrients, which may also be associated with obesity in adolescents. Therefore, it is possible to prevent obesity and its complications by controlling the sleep duration and intake of nutrients of adolescents. Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

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Review

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13 pages, 278 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Which Is More Important for Health: Sleep Quantity or Sleep Quality?

by Jun Kohyama

Children 2021, 8(7), 542; https://0-doi-org.brum.beds.ac.uk/10.3390/children8070542 - 24 Jun 2021

Cited by 25 | Viewed by 13019

Abstract

Sleep is one of the basic physiological processes for human survival. Both sleep quantity and sleep quality are fundamental components of sleep. This review looks at both sleep quantity and sleep quality, considering how to manage the complex but probably unavoidable physiological phenomenon [...] Read more.

Sleep is one of the basic physiological processes for human survival. Both sleep quantity and sleep quality are fundamental components of sleep. This review looks at both sleep quantity and sleep quality, considering how to manage the complex but probably unavoidable physiological phenomenon of sleep. The need for sleep has marked variations between individuals, in addition to the effects of variable conditions. Studies on sleep quality started later than those on sleep quantity, beginning in 1989 when Ford and Kamerow revealed that insomnia increases the risk of psychiatric disorders. According to the nationwide research team on the quality of sleep (19FA0901), sleep quality is superior to sleep quantity as an index for assessing sleep, and that restfulness obtained through sleep is a useful index for assessing sleep quality. We should pay more attention to obtaining sleep of good quality (restfulness, no sleepiness, no need for more sleep, sufficient objective sleep depth, etc.), although there have not been enough studies on the associations between sleep quality and health or disorders in children and adolescents. Further studies using the deviation from an individual’s optimal sleep quantity may show us another aspect of the effects of sleep quantity on various life issues. Full article

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8 pages, 357 KiB

Open AccessReview

Factors Affecting the Quality of Sleep in Children

by Ahmad Fadzil

Children 2021, 8(2), 122; https://0-doi-org.brum.beds.ac.uk/10.3390/children8020122 - 09 Feb 2021

Cited by 21 | Viewed by 10752

Abstract

Sleep quality is one of the domains of sleep. Having adequate quality sleep is defined as one’s “feeling fresh” after waking-up. Inadequate sleep quality results in sleep insufficiency producing a variety of symptoms and signs. The central nervous system is affected the most [...] Read more.

Sleep quality is one of the domains of sleep. Having adequate quality sleep is defined as one’s “feeling fresh” after waking-up. Inadequate sleep quality results in sleep insufficiency producing a variety of symptoms and signs. The central nervous system is affected the most in children, although other system too may be involved. Several factors affect sleep quality in children including genetics, sleep habits, medical problems, parents/caregiver factors, screen time and the child’s environment. These factors are inter-related and dynamic. The outcome of sleep insufficiency is many involving neurocognitive and neurobehavior, mood and emotional issues and specific conditions, like pulmonary hypertension, cor pulmonale and obesity. Management should start with proper history taking to identify the multifaceted nature of the condition. Treatment is planned cognizant of the age of the patient and the associated etiological factors, and should involve both the children and their parents. Full article

(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)

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