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The Influence of Sleep Quality, Sleep Duration and Sleepiness on School Performance in Children and Adolescents: A Meta-Analytic Review
Abstract
Insufficient sleep, poor sleep quality and sleepiness are common problems in children and adolescents being related to learning, memory and school performance. The associations between sleep quality (k=16 studies, N=13,631), sleep duration (k=17 studies, N=15,199), sleepiness (k=17, N=19,530) and school performance were examined in three separate meta-analyses including influential factors (e.g., gender, age, parameter assessment) as moderators. All three sleep variables were significantly but modestly related to school performance. Sleepiness showed the strongest relation to school performance (r=-0.133), followed by sleep quality (r=0.096) and sleep duration (r=0.069). Effect sizes were larger for studies including younger participants which can be explained by dramatic prefrontal cortex changes during (early) adolescence. Concerning the relationship between sleep duration and school performance age effects were even larger in studies that included more boys than in studies that included more girls, demonstrating the importance of differential pubertal development of boys and girls. Longitudinal and experimental studies are recommended in order to gain more insight into the different relationships and to develop programs that can improve school performance by changing individuals' sleep patterns.
... Hence, fostering healthy sleep behaviors may be a potentially effective preventive health model for physical as well as mental health [112]. Unhealthy sleep has negative impacts not only on mental and physical health but also on students' academic performance [3,[113][114][115]. Hence, one could assume that the negative effects of disturbed and inadequate sleep should raise the awareness of education politicians and ministries. ...
... In their 'Perfect Storm Model', it is explained how the combination of circadian phase delay in adolescents combined with a rise in bedtime autonomy, screen time, and social interactions on the one hand and early school start times, on the other hand, shorten sleep time. As described earlier, insufficient sleep can cause physical [108,109] and mental health problems [110,111] as well as academic problems [3,114]. Furthermore, the phenomenon of 'social jetlag' adds to this problem. ...
... Recommendations for teaching with Sustainable Development Goals (SDGs) about sleep and light pollution in an Education for Sustainable Development (ESD) setting. Development Goals Links to Teaching about Sleep and Light Pollution SDG 3: 'Ensure healthy lives and promote well-being for all at all ages' • sleep is essential for human health and well-being [89,90] • sleep disorders are well-known to be a health risk and a public health issue [93] • ALAN is a threat to human sleep, e.g., through suppression of the hormone melatonin and circadian disruption [33,34] • sleep deprivation and insufficient sleep quality lead to dementia, obesity, cardiovascular disease, depression, diabetes, inflammation, and cancer [4-6] SDG 4: 'Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all' • a large number of young people across the world are affected by inadequate sleep and chronic sleep loss [19,107] • adolescents' decreases in sleep time and increases in delayed bedtimes suggest an emerging sleep restriction as a worldwide and intercultural problem [104-106] •fostering healthy sleep behaviors may be a potentially effective preventive health model for physical as well as mental health[112] • unhealthy sleep has negative impacts on students' academic performance[3,[113][114][115] • belief in sleep myths is related to unhealthy sleep behavior[118] • there is a lack of awareness among children, adolescents, and adults of the extent of sleep loss[91] • one of the most effective approaches to preventing sleep problems is the education of new parents on how to encourage healthy sleep for their children[111] • sleep education for sleep health literacy in schools is necessary to ensure the health of children, adolescents, and adults globally SDG 5: 'Achieve gender equality and empower all women and girls' ...
Sleep disorders are risk factors for diseases such as dementia or diabetes, and cause enormous costs. Despite the crucial impacts of sleep on human health, there is little to no research on sleep and health in the field of science education. Although health education is an overarching goal of science education in school, the topic of sleep is rarely addressed. In the related field of medical education, empirical studies shed light on the impact of school projects concerning sleep health but are yet unrecognized by science education research. Systematic reviews demonstrate the effectiveness of school-based sleep education programs for increasing sleep knowledge but show contradicting findings regarding the impact on sleep behaviors. Lacking knowledge about healthy sleep is related to unhealthy sleep behavior. In this perspective article, we prepare the topic of sleep for the field of science education by presenting the state of research concerning sleep education. Using the connection between light pollution and sleep disruption, we present a concept of sleep health literacy in science education, argue for the implementation of sleep health literacy in science education curricula, and describe how the topics of sleep and light can serve as a link between health education and Education for Sustainable Development.
... For example, Shad and colleagues found that exhaustion, a component of academic burnout, was significantly associated with poor sleep quality and daytime dysfunction due to insomnia (45). Consistently, sleep deprivation and sleepiness may increase the likelihood of poor academic performance and burnout (48,49). Arbabisarjou et al. reported that sleep quality was a predictor of academic burnout in medical students (50), which was also found by Brubaker and Beverly during the COVID-19 pandemic (51). ...
... Self-determination theory suggests that effective self-regulation and psychological well-being depend on the satisfaction of three basic psychological needs: Esteem, competence, and relatedness (56). Fear of missing out results from a lack of relatedness needs (48), and individuals with high FoMO tend to seek connection with others through specific channels or platforms to achieve basic psychological need satisfaction (57,58). With the rise of mobile smart network devices and the shift of FoMO from traditional offline contexts to online contexts, FoMO may lead individuals to rely on smartphones as the primary means of portable online social interaction for psychological need satisfaction (59,60), leading to the risk of misuse (61). ...
Introduction
Learning burnout has a significant negative impact on students’ academic performance and professional development, which has been exacerbated by the growing trend of problematic smartphone use, such as smartphone addiction, among young people. Recently, the literature on excessive social media use has revealed a critical role of fear of missing out. Objective The purpose of this study was to examine how fear of missing out affects smartphone addiction and its subsequent effect on learning burnout in college students.
Methods
In Study 1, 352 medical students were recruited to complete a cross-sectional survey. In Study 2, 2,948 college students were recruited to complete a cross-sectional survey. Further in Study 3, 30 medical students were recruited into a mindfulness-based intervention program.
Results
Study 1 preliminarily confirmed that fear of missing out was positively correlated with learning burnout. Study 2 then revealed a moderated mediation model showing that fear of missing out may increase smartphone addiction, which in turn affects their sleep quality and finally leads to learning burnout. This chain mediation model was moderated by the participants’ level of mindfulness. To confirm the promoting role of mindfulness, Study 3 further confirmed that mindfulness training indeed can improve smartphone addiction and reduce learning burnout in medical students.
Discussion
Theoretical and practical contributions were discussed, highlighting the effects of fear of missing out on smartphone addiction and a moderating role of mindfulness training.
... La regresión lineal múltiple con estimación ponderada, sugiere que el RAA es moderado por la actividad del sueño con mayor efecto en estudiantes más jóvenes, cuya correlación inversa significativa (Tabla 1). Asimismo, la actigrafía resulta ser una técnica muy importante para medir actividad fisiológica como el sueño/vigilia 41 de cuyos parámetros (como la Desviación Estándar de la actividad del sueño) resultan sensibles para encontrar efectos significativos en variables de tipo social y educativo, como es el rendimiento académico, que transversa variables psicológicas y emocionales, entre otras, como plantean algunas investigaciones [8][9][10][11][12] . ...
... También se confirman los hallazgos que relacionan el sueño y el RA demostrando que la duración del sueño se asocia fuertemente con el funcionamiento cognitivo [8][9][10][11][42][43][44][45] así como la eficiencia de sueño y las puntuaciones académicas 12 ; además, se confirman las evidencias anteriores a este estudio del efecto que la edad tiene sobre el RAA 17 , mientras que no se encontraron efectos significativos con las demás variables estudiadas. ...
Introducción: se sabe poco de la relación de parámetros fisiológicos del sueño con la personalidad y el rendimiento académico en estudiantes universitarios. Objetivo: Explorar la relación entre sueño, cronotipo, ansiedad, personalidad, calidad de vida y rendimiento académico en adolescentes universitarios. Método: el estudio fue de corte cuantitativo, observacional transversal. Se exploró el rendimiento académico acumulado (RAA), los parámetros fisiológicos del sueño, índice de calidad de sueño, cronotipo, personalidad, ansiedad y calidad de vida en estudiantes universitarios. Se realizó comparación y regresión lineal múltiple. Resultados: en una muestra de 27 estudiantes universitarios, se encontraron: correlaciones significativas positivas entre RAA y sexo y duración del sueño; varianza para edad, del sueño, ansiedad, atención a normas y sensibilidad; efecto significativo en edad y desviación estándar del sueño, sobre la varianza del RAA (p=0,001) con 39,1% a 50,8% de causalidad (R2a=0,39; R2=0,51). Conclusiones: el RAA en jóvenes es moderado por la duración del sueño y de la actividad de sueño es sensible para identificar cambios significativos en el RAA. El índice de calidad de sueño, cronotipo, personalidad, ansiedad y calidad de vida no son susceptibles de identificar efectos significativos en el RAA en estudiantes.
... A revisão sistemática da literatura fornece ampla evidência para demonstrar que o sono inadequado tem consequências significativas nos aspetos-chave da saúde e funcionamento dos adolescentes, incluindo saúde somática e psicossocial, desempenho académico e comportamentos de risco (Dewald, Meijer, Oort, Kerkhof, & Bogels, 2010;Cunhal, Cunhal, & Paiva, 2010;Paiva, 2008;Rebelo-Pinto et al, 2016;, Quist et al., 2016Shochat, Cohen-Zion & Tzischinsky, 2014). ...
... A cafeína promove a vigília por antagonismo dos recetores de adenosina no cérebro, sendo usualmente utilizada como contramedida de fadiga ou até mesmo em fármacos analgésicos e supressores do apetite (Clark & Landolt, 2017 Apesar da relevante evolução dos conhecimentos sobre o sono nas últimas décadas (Paiva, 2008) existem lacunas no que se refere a investigações com populações adolescentes, cujos dados possam legitimar intervenções educativas e terapêuticas adequadas e cientificamente fundamentadas . A realização de investigação na área do sono é fundamental para aumentar o conhecimento sobre a correlação do sono com as diferentes variáveis e consequentemente desenvolver programas de promoção efetivos para as populações-alvo, em particular em crianças e adolescentes (DGS, 2015;Chaput, 2014;Dewald et al., 2010, McNeil, Doucet, & Chaput, 2013. ...
O sono dos adolescentes tem características próprias e é influenciado pelos hábitos da sociedade moderna, que frequentemente perturbam um ritmo saudável de sono e vigília. A presente investigação avaliou a qualidade de sono de alunos do ensino secundário do concelho de Bragança e a sua relação com o consumo de substâncias psicoativas, estudando-se uma amostra de 345 alunos. Os dados foram recolhidos em maio de 2017, através de um questionário que incluía o Índice de Qualidade do sono de Pittsburgh (IQSP) e questões sobre o consumo de substâncias psicoativas. Constatou-se que a maioria dos adolescentes em estudo consome bebidas alcoólicas (73.6%), café (66.4%) e outras bebidas com cafeína ou derivados (87.8%) e que 10.4% são fumadores. Concluiu[1]se que o risco de má qualidade do sono é superior nos adolescentes fumadores, que consomem bebidas alcoólicas e que consomem diariamente bebidas com cafeína ou derivados. Verificou-se ainda que a qualidade do sono também se relaciona com o consumo de tabaco e bebidas com cafeína e derivados nas três horas antes de dormir, sendo o risco de má qualidade de sono superior nos adolescentes que frequentemente consomem bebidas com cafeína e nos que frequentemente fumam nesse período específico. As relações verificadas remetem-nos para a importância de intervir na educação e promoção da qualidade de sono dos adolescentes, associando o estilo de vida e o consumo de substâncias psicoativas. Este estudo pode ser uma importante ferramenta para educadores, decisores políticos e comunitários, no sentido de definirem planos de intervenção concretos em contexto escolar na área do sono, consumo de substâncias psicoativas, e no estabelecimento de rotinas promotoras da saúde.
... A systematic review which summarized 16 adolescent studies concluded that sleep deprivation, i.e. at least 1 whole night without sleep, is followed by poor performance in vigilance tasks [3], while sleep extension by as little as 13 min in those with chronic sleep reduction [4] and sleep improvement in insomniacs contributes to improvement in working memory [5]. A meta-analysis showed that poor sleep quality and excessive daytime sleepiness were even stronger contributors to poor school performance than sleep duration [6]. ...
... The association of poor sleep quality and daytime sleepiness with cognition has been well documented in pediatric population. A meta-analysis involving more than 13,000 children confirmed that poor sleep quality (measured by PSG, actigraphy, or questionnaires) and daytime sleepiness (measured by questionnaires) were modestly associated with worse school performance [6]. However, relevant evidence specifically within the obese subgroup is scarce. ...
Objective
To evaluate the associations of OSA severity, snoring symptoms, subjective sleep quality, and daytime sleepiness with executive functioning and behaviors in children with obesity.
Methods
This was a cross-sectional study of children aged 8–18 years with obesity and symptoms suggestive of OSA. All participants underwent an overnight polysomnography and completed a set of questionnaires to assess their sleep-related breathing disordered (SRBD) symptoms [Pediatric Sleep Questionnaire (SRBD-PSQ)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], executive function [Behavior Rating Inventory of Executive Function (BRIEF)], and inattention and hyperactivity symptoms (Conners-3 Parent Short Form).
Results
A total of 85 children (62% male, mean age: 13.9 ± 3.0 years) were included in this analysis, of whom 36, 16, and 33 were categorized into the non-OSA (obstructive apnea hypopnea index, OAHI < 1.5/h), mild OSA (OAHI 1.5–5/h), and moderate-severe OSA (OAHI ≥ 5/h) groups, respectively. Of 85 participants, 27 (32%) were classified with poor sleep quality (PSQI composite score ≥ 8). From multiple linear regression analyses, poor sleep quality and sleepiness were both independently associated with higher BRIEF behavioral regulation T-score, metacognition T-score, and global executive composite T-score in the fully adjusted model. In addition, poor sleep quality was also independently associated with higher Conners-3 inattention and executive functioning T-scores, while greater sleepiness was also associated with a higher learning problem T-score. The presence of OSA and snoring were not associated with any cognitive outcomes.
Conclusions
Subjective sleep quality and daytime sleepiness, but not OSA severity and snoring symptoms, were independently associated with executive functioning and behavioral problems in children with obesity.
... Objective data on sleep efficiency from actigraphy and polysomnography are mixed, with some studies finding evidence of poor sleep efficiency in youth with anxiety disorders ( [17,28,57] while others do not (see McMakin and Alfano for a review). Regardless, the high rate of subjective poor sleep efficiency among anxious youth represents a public health concern given adverse outcomes associated with perceptions of disturbed sleep, including impaired family functioning [3], increased daytime sleepiness [2], poor academic performance [15], and suicidal thoughts and behaviors [6,18]. Although the presence and impact of poor sleep efficiency among anxious youth are well documented, understanding of variables that explain the link between anxiety and poor sleep efficiency in youth is underdeveloped. ...
Youth with anxiety disorders report difficulty falling asleep and returning to sleep after sleep onset (i.e., poor sleep efficiency). Anxiety sensitivity, the excessive attention to physical symptoms of anxiety and their threatening interpretations, has been linked to poor sleep efficiency. We tested a conceptual model wherein attentional control, attentional focusing and attentional shifting would account for the relationship between anxiety sensitivity and poor sleep efficiency. 255 youths (6–17 years old, 78% Hispanic/Latino) who presented to a university-based research clinic completed measures on anxiety sensitivity, sleep, and attentional control. Poorer sleep efficiency was significantly correlated with higher anxiety sensitivity and lower attentional control, attentional focusing, and attentional shifting. Higher anxiety sensitivity was significantly correlated with lower attentional control and attentional focusing. Attentional control and attentional focusing, not attentional shifting, accounted for the relationship between anxiety sensitivity and poor sleep efficiency. These findings identify attentional control and attentional focusing as variables that may explain the association between anxiety sensitivity and sleep efficiency in youth.
... Adequate duration and quality of sleep influences the physical health and learning in children [1][2][3] . Several studies have demonstrated that sleep is associated with academic performance and cognitive skills 3-5 . ...
This study investigated the relationship between sleep habits in early childhood and academic performance and non-cognitive skills in the first grade. We retrospectively analyzed a longitudinal population-based cohort from birth through early childhood, up to elementary school, in Amagasaki City, Japan. The primary outcome was academic performance in the first grade. Other outcomes were self-reported non-cognitive skills. Overall, 4395 children were enrolled. Mean national language scores for children with bedtimes at 18:00–20:00, 21:00, 22:00, and ≥ 23:00 were 71.2 ± 19.7, 69.3 ± 19.4, 68.3 ± 20.1, and 62.5 ± 21.3, respectively. Multiple regression analysis identified bedtime at 3 years as a significant factor associated with academic performance. However, sleep duration was not significantly associated with academic performance. Bedtime at 3 years also affected non-cognitive skills in the first grade. Diligence decreased with a later bedtime (21:00 vs. 18:00–20:00; odds ratio [OR]: 1.98, 95% confidence interval [CI] 1.27–3.09; 22:00 vs. 18:00–20:00; OR: 2.15, 95% CI 1.37–3.38; ≥ 23:00 vs. 18:00–20:00; OR: 2.33, 95% CI 1.29–4.20). Thus, early bedtime at 3 years may be associated with a higher academic performance and better non-cognitive skills in the first grade. Optimum early-childhood sleep habits may positively impact academic future.
... Therefore, in recent years, researchers have shifted their attention towards psychological investigation, noting that excessive usage of social media causes various issues and interferes with people's everyday lives. The researchers point out the negative effects of how social media directly influences the daily life of individuals such as their sleep quality, excessive mental occupation, failure in repeated attempts to control their thoughts about the internet, failure to prevent the desire they have for access, and the desire they felt when they are not connected (Andreassen et al., 2012;Dewald et al., 2010;Kuss & Griffiths, 2011). ...
Aim of the Study: The current study aimed to determine the association between social networking addiction and self-esteem in Pakistani university students as there is a dearth of indigenous empirical literature on the issue.
Methodology: A cross-sectional research design was used in the current study.
Using the stratified random sampling technique, 300 university students (i.e., BS
& MS) were selected from a university in Faisalabad city, Pakistan. The Social
Networking Addiction Scale (Shahnawaz & Rehman, 2020) and the Rosenberg
Self-Esteem Scale (Rosenberg, 1965) was used to assess the social networking
addiction and self-esteem of university students respectively. The Pearson
product-moment correlation and regression analysis were carried out using
Statistical Package for Social Sciences (SPSS v-23) for data analysis.
Findings: The findings of the study revealed a significant negative correlation (-
.39**, p<.01) between social networking addiction and the self-esteem of the
participants. Moreover, social networking addiction was found to be a significant
predictor (p<.001) of lower levels of self-esteem in the participants.
Conclusion: The study concluded that the community should take some remedial
measures targeting the excessive use of social media which is identified as a risk
factor to develop low self-esteem in the youth.
... Current published evidence suggests that sleep may be associated with overall HRQoL, mood and emotional regulation, which could be postulated to influence social relationships and academic performance. 14,15,[58][59][60] These would explain our observations that when sleep was displaced, there was a negative impact on these HRQoL domains and consequentially, overall HRQoL scores. However, existing studies, including the present, have only assessed total sleep duration without considering other sleep dimensions such as sleep disturbances, patterns and quality, that could drive associations between sleep and HRQoL, 11,28,61 warranting future studies to examine the role of these dimensions in children's HRQoL more deeply. ...
Background
Promoting active, balanced lifestyles among children may be an important approach to optimising their health-related quality of life (HRQoL). However, the relationships between children's movement behaviours and HRQoL remain unclear.
Methods
We examined the associations between movement behaviours (sleep, inactivity, light and moderate-to-vigorous intensity physical activity) assessed using accelerometers at ages 8 and 10 years and self-reported HRQoL scores (overall, and physical and emotional well-being, self-esteem, relationship with family and friends, and school functioning domains) at age 10 years among 370 children in a local birth cohort using compositional isotemporal substitution techniques.
Findings
Cross-sectionally, light and moderate-to-vigorous intensity physical activities were associated with better self-esteem (β = 15.94 [2.71, 29.18]) and relationship with friends (β = 10.28 [3.81, 16.74]) scores respectively. Prospectively, inactivity was associated with lower overall HRQoL (β = −10.00 [−19.13, −0.87]), relationship with friends (β = −16.41 [−31.60, −1.23]) and school functioning (β = −15.30 [−29.16, −1.44]) scores, while sleep showed a positive trend with overall HRQoL (β = 10.76 [−1.09, 22.61]) and school functioning (β = 17.12 [−0.87, 35.10]) scores. Children's movement behaviours were not associated with their physical and emotional well-being, or relationship with family scores. The isotemporal substitution analyses suggest that increasing time spent in physical activity and/or sleep at the expense of inactivity may benefit children's HRQoL.
Interpretation
Our findings suggest that sleep and physical activity may be associated with better HRQoL, with the inverse for inactivity. However, the relationship between children's movement behaviours and HRQoL is complex and warrants further research.
Funding
10.13039/501100001381Singapore National Research Foundation, 10.13039/501100001355Singapore Institute for Clinical Sciences, 10.13039/501100001348Agency for Science, Technology and Research.
... High-altitude exposure induces adverse effects on cognitive performance and mood, potentially due to poor sleep quality (de Aquino Lemos et al., 2012;Morrison et al., 2017). High-altitude travelers experience frequent arousals and low slow-wave sleep duration, which can impair attention, memory, time to exhibit complex responses, and perceptual-motor function, resulting in increased irritability and depression (Dewald et al., 2010;Rosenzweig et al., 2015). HH triggers erythrocytosis, and research has found that soldiers with erythrocytosis stationed on the Tibetan plateau have poorer sleep quality than healthy soldiers, which negatively affects cognitive function. ...
Hypobaric hypoxia (HH) characteristics induce impaired cognitive function, reduced concentration, and memory. In recent years, an increasing number of people have migrated to high-altitude areas for work and study. Headache, sleep disturbance, and cognitive impairment from HH, severely challenges the physical and mental health and affects their quality of life and work efficiency. This review summarizes the manifestations, mechanisms, and preventive and therapeutic methods of HH environment affecting cognitive function and provides theoretical references for exploring and treating high altitude-induced cognitive impairment.
... OSA has predictable negative economic consequences and is associated with an increased risk of car accidents (12). It also negatively impacts children, who often experience cardiovascular issues such as pulmonary hypertension, systemic hypertension, left ventricular hypertrophy, reduced oxygen saturation, changes in vascular tone (13), growth disorders (14), as well as neurobehavioral functioning, including poor academic performance and difficulties in social and emotional development (15)(16)(17). ...
Background
Obstructive sleep apnea (OSA) is a type of sleep-disordered breathing disease, with high prevalence and multiple complications. It seriously affects patients’ quality of life and even threatens their lives. Early and effective treatment can significantly improve patients’ health conditions.
Objective
In this study, the main treatment methods, research hotspots and trends of OSA were summarized through bibliometric and visualization analysis.
Methods
From the Web of Science Core Collection database, articles on the treatment of OSA from 1999 to 2022 were obtained. CiteSpace and VOSviewer were comprehensively used to visualization of journals, co-authorship of countries, institutions and authors, co-citation of references, keywords cluster and burst.
Results
A total of 2,874 publications were obtained, of which 2,584 were concerned adults and 290 about children. In adults’ research, Sleep and Breathing is the most published journal (280, 10.84%), the largest number of publications come from the United States (636,24.61%) and the University of Sydney (88, 3.41%), and Pepin JL is the most published author (48, 18.58%). In children’s studies, International Journal of Pediatric Otorhinolaryngology is the most published journal (41, 14.14%), the maximum number of publications were also from the United States (123, 42.41%), with the University of Pennsylvania (20, 6.90%) and Marcus CL (15, 5.17%) being the most published institutions and authors. High-frequency keywords for adults’ researches include positive airway pressure, oral appliance, surgery and positional therapy. On these basis, children’s studies also focus on myofunctional therapy, rapid maxillary expansion and hypoglossal nerve Stimulation.
Conclusion
Over the past two decades, research in the field of OSA therapeutics has experienced significant growth in depth and breadth. The author cooperation network has already established a solid foundation, while there is potential for further strengthening the cooperation network between countries and institutions. Currently, positive airway pressure and surgery are the primary treatments for OSA in adults and children. Future research will focus on multidisciplinary combination targeted therapy, which presents a key area of interest and challenge.
... Insufficient sleep has been linked to a broad range of negative mental and physical health outcomes such as lower quality of life and wellbeing, increased risk of depression, obesity, physical inactivity, cardiovascular disease, diabetes mellitus, and even mortality (Cappuccio et al., 2011;Lippman et al., 2016;Strine & Chapman, 2005;Yin et al., 2017). Among student populations, the focus is less on physical risks, however, research has robustly shown the importance of sufficient sleep for learning capacity and memory outcomes (Harrison et al., 2000;Yoo et al., 2007), whereas poorly sleeping students exhibit lower academic performance at university and school (Dewald et al., 2010;Gomes et al., 2011). Nonetheless, there is research linking poorer sleep to poorer health (i. ...
Sleep problems and stress are common among students and are associated with negative effects on academic performance as well as mental and physical health risks, but studies exploring mediating factors between stress and sleep on a daily basis are scarce. This study aimed to investigate the relationship of daily stress, bedtime procrastination (i.e., postponing bedtime without external reasons), and sleep outcomes controlling for trait factors such as self-control.
N=96 students at a German university (M=22.2 years, SD=4.0) wore a sleep-tracking wearable (Fitbit Charge HR) for two weeks to assess sleep duration and to calculate the gap between the intended time to go to sleep and the objectively measured time of falling asleep. Stress, intended time to go to sleep, and sleep quality were assessed via daily diaries. Established questionnaires were used to measure trait self-control, trait bedtime procrastination, and smartphone addiction.
Multilevel analyses indicated that more stress experienced during the day was associated with more bedtime procrastination (b=2.32, p=.008), shorter sleep duration (b=-3.46, p=.003), and lower sleep quality (b=1.03, p=.005) after controlling for several trait factors. The association of daily stress with sleep outcomes (quality and duration) was partly mediated by bedtime procrastination.
Our findings indicate that bedtime procrastination might be one factor that contributes to stress-linked decreases in sleep duration and quality. Potential reasons for stress-related later time to fall asleep – like higher physiological arousal or stress-related worries – should be investigated in future studies.
... The main research instrument used in the present research was a structured questionnaire developed after a critical examination of the objectives of the study. The research instrument was a 27-item questionnaire that had four (4) parts numbered 1, 2, 3, and 4. Part 1 low overall sleep quality tend to have lower Cumulative Grade Point Averages (CGPAs) compared to those who reported adequate sleep 31,32,33 quality. ...
Context: University students who deprive themselves of enough nocturnal sleep due to academic activities are at risk of the deleterious effects of sleep deprivation that usually follow. To reverse these effects, they tend to consume substances such as caffeine to counteract fatigue and possibly give them the feeling of alertness they need to perform their daily activities given that there is a popular concern that the academic demands of University training can cause significant stress and the need to gain insight into the effects of caffeine on students.Objective: This study set out to assess the self-reported effects of the consumption of caffeine-containing products on nocturnal sleep and daytime functioning among students of Novena University, Ogume Delta State, Nigeria.Materials and Methods: The study adopted a descriptive cross-sectional design conducted among 400 students comprising 217 males and 183 females selected through random sampling. Data were collected using a 27-item questionnaire containing four sections; socio-demographic characteristics, caffeine consumption pattern, sleeping habits, and daytime functioning. The data was analysed using SPSS version 23 and presented in descriptive and inferential statistics at P <0.05 level of significance.Results: More than one-third of the respondents (68.50%) affirmed consuming caffeine-containing products such as caffeinated drinks and beverages. Only 21.50% affirmed practicing sleep deprivation and 40.10% agreed that their consumption of caffeine-containing products increases during times of academic stress. There was a significant relationship between the hours of sleep of the respondents and their consumption of caffeine. More than half of the respondents (71.90%) affirmed experiencing daytime sleepiness while about 40% affirmed experiencing caffeine-induced daytime dysfunction.Conclusion: There was a significant relationship between the level of caffeine consumption and students’ sleep quality. Caffeine-induced sleep deprivation and caffeine-induced daytime dysfunction are widespread among undergraduate students in the study population.
... Sleep and attentional problems are even so highly intertwined that it becomes indistinguishable if a child expresses symptoms of sleep deprivation or of attention deficit disorder (for review, see Dahl, 1996). As a consequence of inadequate sleep, children's school performance might suffer (Dewald et al., 2010;Shochat et al., 2014). These negative outcomes reported from previous research have led many Asian countries (e.g., China, Korea, Thailand, Vietnam), where smartphone gaming is prevalent, to impose an online game curfew for minors to avoid media-induced sleep displacement (Lee et al., 2017). ...
During early adolescence children are increasingly using their smartphones not only throughout the day, but also before or even during the nighttime. Prior research has revealed that children’s school performance might suffer because of late-night smartphone use. To gain a further understanding of the consequences of nighttime smartphone use on school performance, this study set out to examine whether children’s nighttime smartphone use is associated with children’s attentional problems over time and with their achieved and subjective school performance. We tested these associations using a two-wave panel study among children aged 10–14 years and one of their parents (parent-child pairs, N Time2 = 384). The findings revealed that children’s nighttime smartphone use was positively related to parent-reported perceptions of children’s attentional problems over time which were negatively related to both subjective and achieved school performance. We discuss the implications of these results for the regulation of children’s smartphone use at night.
... Due to the importance of sleep for adolescents' health (Bartel et al., 2015), the trend poses a significant risk for physical and psychological well-being, and other areas of adolescents' functioning (Brand & Kirov, 2011). Researchers found negative associations between inadequate sleep and performance in school (Dewald et al., 2010), obesity (Park, 2011), mental health (Kaneita et al., 2009), including depression (Lovato & Gradisar, 2014), and other outcomes. ...
Previous research associated smartphone use with worsened sleep among adolescents. However, the prior findings were mainly based on cross-sectional, self-reported data, and a between-person level of analysis. This study examined between- and within-person associations for adolescents’ smartphone use and multiple sleep outcomes: sleep onset time, sleep onset latency, sleep duration, subjective sleep quality, and subjective daily sleepiness. The participants were 201 Czech adolescents (aged 13–17) who daily reported their sleep outcomes, daily stressors, and other media use for 14 consecutive days via a custom-made research app on their smartphones. The app also collected logs of the participants’ smartphone use. We found that interindividual differences within the average volume of smartphone use before sleep were not associated with differences in sleep outcomes. At the within-person level, we found that, when adolescents used smartphones before sleep for longer than usual, they went to sleep earlier (β = − .12) and slept longer (β = − .11). However, these two associations were weak. No other sleep outcomes were affected by the increased use of a smartphone before sleep on a given day. We found no interaction effects for age, gender, insomnia symptoms, media use, or daily stressors. However, the association between smartphone use and earlier sleep onset time was stronger on nights before a non-school day. Our findings suggest that the link between smartphone use and adolescent sleep is more complex, and not as detrimental, as claimed in some earlier studies.
... Sleep supports many key physiological and psychological processes such as innate and adaptive immune responses, metabolism, memory consolidation, and affective, executive, and cognitive function (Zielinski et al., 2016). Sleep also plays an important role in child development and inadequate sleep is linked to deterioration in mental and physical health (Sutton 2014), neurocognitive functioning (Fortier-Brochu et al., 2012), social functioning (Shochat et al., 2014) and academic performance (Dewald et al., 2010). ...
Objectives:
Sleep problems are common amongst children and adolescents with attention deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate sleep problems in children and adolescents attending a specialist ADHD service.
Methods:
This was a cross-sectional online survey combined with a retrospective chart review, conducted in the ADHD Assessment, Diagnosis, Management, initiation, Research and Education (ADMiRE) service, the first public specialist ADHD service for young people in Ireland. Participants were caregivers of children and adolescents with ADHD attending ADMiRE. Sleep was assessed using The Children's Sleep Habits Questionnaire (CSHQ) and ADHD symptoms were assessed using an abbreviated version of the Swanson, Nolan and Pelham Teacher and Parent Rating Scale (SNAP-IV). Details regarding patient demographics, co-morbidities and medication were collected from patient records.
Results:
Eighty-four percent of young people scored above the clinical cut-off for a sleep disorder. The most frequently reported sleep problems were related to sleep onset and sleep duration, and 64% of respondents met the criteria for two or more sleep problems. ADHD severity was associated with greater sleep problems. Co-morbid physical, neurodevelopmental, and mental health disorders as well as stimulant use were not associated with greater sleep problems.
Conclusion:
Sleep problems are very common amongst children and adolescents with ADHD. This study has demonstrated an association between more sleep problems and ADHD severity. These findings highlight the need for both effective ADHD treatment to ensure optional sleep in young people as well as effective interventions for sleep problems to prevent worsening of ADHD symptoms.
... This change causes adolescents to experience insufficient sleep, late bedtimes, and possibly poor sleep quality, which progress into insomnia, delayed sleep phase disorders, and daytime sleepiness [17][18][19]. According to the literature, sleep disturbance is associated with poor mental health status, poor academic performance, aggressive behavior, and suicide among adolescents [20][21][22][23][24]. A previous review reported that the prevalence of sleep disturbance among adolescents in China was 28%, ranging from 8 to 54.7% [8]. ...
Purpose
Sleep disturbance has become a major challenge among adolescents worldwide. Substance use is among the most common factors contributing to sleep disturbance. This systematic review and meta-analysis examined the prevalence and categories of sleep disturbance among adolescents with substance use.
Methods
We comprehensively searched for relevant studies published in the following databases from inception to August 2022: CINHAL (via EBSCOhost), PubMed, Scopus, Ovid Medline, Embase, ProQuest, and Web of Science. Data analysis was performed using Comprehensive Meta-Analysis version 3 software. We used a random-effects model to pool prevalence rates with 95% confidence intervals (CIs). Forest plots and p values for the Cochran Q statistic were used to evaluate heterogeneity among studies. Subgroup and meta-regression analyses were performed to compare the groups and identify the sources of heterogeneity.
Results
We examined 18 studies that reported insomnia, hypersomnolence, sleep-related breathing disorders as sleep disturbances among adolescents with the use of alcohol, smoking, marijuana, and coffee. The total sample was 124,554. The overall prevalence rate of sleep disturbance was 29% (95% CI: 0.201–0.403). Subgroup analysis revealed that the prevalence rates of insomnia and hypersomnolence were higher among alcohol users (31%; 95% CI: 0.100–0.654) and smokers (46%; 95% CI: 0.232–0.700). The study design and method of assessment groups were the significant moderators that showed the source of variation in the included studies.
Conclusion
Sleep disturbance is highly prevalent among adolescents with substance use. Insomnia and hypersomnolence are more prevalent among alcohol users and smokers, respectively. On the basis of our findings, health-care providers can develop effective targeted interventions to reduce substance use, prevent sleep disturbance, and promote healthy sleep habits among adolescents.
... In the study of Boscolo, Sacco, Antunes, Mello and Tufik (2007), it was verified that the period of study and sleep habits are associated and can influence academic performance, being that students with fewer complaints about sleep showed better performance in memorising words. When inefficient diurnal behaviours occur in which there is greater instability in the overall performance of the youth, including their academic performance, they occur simultaneously with interrupted nights of sleep or insufficient quantity (Dewald, Meijer, Oort, Kerkhof & Bögels, 2010). ...
Sleep disturbance has consequences on cognitive level as well as on the metabolic balance of youth. The improvement of literacy levels on sleep habits and rest promotes their suitability. This study aimed to evaluate the mental health levels (anxiety, depression and stress) and sleep quality of higher education students through a descriptive and correlational study, quantitative and transversal in nature, on a non-probabilistic and by convenience sample of 510 higher education students. The Pittsburgh Sleep Quality Index and the Depression, Anxiety and Stress Scale were used. Among the results we underline a poor quality of sleep in most of the sample as well as a statistically significant correlation between sleep quality and mental health in the analysed aspects, noting also the statistically significant poorer quality of sleep among female students and higher levels of depression and anxiety among male students. We conclude that the Sleep Hygiene Consultations performed by the clinical office of the Polytechnic Institute of Bragança, are appropriate and timely to improve the literacy levels about sleep and rest habits, and to promote its fitness in the course of academic activities, contributing to a healthy development with less risk of anxiety, depression, stress and other risk behaviours.
... Inadequate sleep duration, later sleep timing, and sleepiness are significantly associated with a range of adverse health outcomes in adolescents such as poorer mental health, cognitive function, and school performance. 13 Indeed, sleep has emerged as an important factor associated with mental health during adolescence, however the evidence base is largely cross-sectional. 14 In 2016, the first 24-h movement guidelines were released in Canada which included recommendations for physical activity, sedentary behaviors, and sleep. ...
Purpose
Our study explored the mediating effect of sleep‐related variables on older adolescents' mental health in the context of a school‐based physical activity intervention.
Methods
We evaluated the Burn 2 Learn (B2L) intervention using a cluster randomized controlled trial, which included two cohorts. Participants for this sub‐study were from the second cohort, which included 292 older adolescents (16.0 ± 0.5 years) from 10 secondary schools in New South Wales, Australia. Teachers at intervention schools delivered two high‐intensity activity breaks (approximately 10 mins) per week to students during academic lessons. Participants completed measures of mental health (i.e., perceived stress and internalizing problems) and hypothesized mediators (i.e., sleep duration, sleep latency, awakenings, and daytime sleepiness) at baseline (February–April 2019) and post‐intervention (August–September 2019). Single mediation analyses were conducted to explore the potential mediating effects of sleep variables on mental health outcomes using a product‐of‐coefficient test.
Results
We observed a small statistically significant effect for perceived stress (β = −0.11, SE = 0.034, p = 0.002), but not for internalizing problems (β = 0.02, SE = 0.051, p = 0.760). There were no significant intervention effects for sleep‐related variables. Several sleep‐related variables were associated with mental health outcomes but no mediated effects were found.
Conclusion
The B2L intervention had a small beneficial effect on perceived stress, however our mediation analyses suggest this was not explained by changes in sleep‐related variables. Markers of sleep were associated with mental health constructs, highlighting the importance of sleep for good psychological health. However, in the context of a physical activity intervention, effects on mental health may be driven by other behavioral, neurobiological, or psychosocial mechanisms.
... Moreover, 60% of middle school and 70% of high school students do not get enough sleep on school nights (Wheaton, Jones, Cooper, & Croft, 2018). This high prevalence of insufficient sleep duration has proven to be consequential; research confirms that sleep-deprived adolescents experience a host of negative behavioral and health outcomes, including obesity (Mitchell, Rodriguez, Schmitz, & Audrain-McGovern, 2013), lower academic performance (Dewald, Meijer, Oort, Kerkhof, & Bögels, 2010), suicidality (Wong, Brower, & Zucker, 2011) and engaging in various forms of delinquency (Jackson & Vaughn, 2017;Meldrum, Jackson, Zgoba, & Testa, 2020;O'Brien & Mindell, 2005;Peach & Gaultney, 2013;Semenza & Gentina, 2023), and substance use (Kwon, Seo, Park, & Chang, 2021;Mike, Shaw, Forbes, Sitnick, & Hasler, 2016;Miller, Janssen, & Jackson, 2017;O'Brien & Mindell, 2005;Winsler, Deutsch, Vorona, Payne, & Szklo-Coxe, 2015). ...
Purpose: Prior research reveals many risk factors related to adolescent substance use. In this study, we build an argument that insufficient sleep partially explains the effects of multiple risk factors (neighborhood disorder, unstructured socializing, bullying victimization, family conflict, and weak family social control) on substance use. Method: We tested this argument with a large sample of middle and high school students. The causal pathway for each risk factor was estimated with a series of negative binomial models and generalized structural equation modeling. Indirect effects were also estimated. Results: The analysis revealed that each risk factor and shorter sleep duration significantly increased adolescent substance use. Moreover, it was found that sleep duration partially mediated each risk factor’s effect on substance use. The degree of mediation varied by the risk factor that was examined. Conclusions: Findings from this study indicate that sleep duration is an important risk factor for adolescent substance use. Moreover, sleep duration appears to explain a portion of the effect of the other risk factors on substance use. In considering these issues, this study offers new insights into the predictors of insufficient sleep and its consequences on adolescent development.
... Department of Health and Human Services, 2019). While getting enough sleep during childhood and adolescence is critical (Matricciani et al., 2019), good quality sleep is likewise important (Dewald et al., 2010). ...
Up to 50% of children and adolescents in the United States (U.S.) experience sleep problems. While existing research suggests that perceived stress in caregivers is associated with poorer sleep outcomes in children, research on this relationship is often limited to infant and early childhood populations; therefore, we investigated this association in school-age children and adolescents. We used cross-sectional caregiver-reported surveys and applied item response theory (IRT) followed by meta-analysis to assess the relationship between caregiver perceived stress and child sleep disturbance, and moderation of this relationship by child age and the presence of a child mental or physical health condition. We analyzed data from the National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) Program, a collaboration of existing pediatric longitudinal cohort studies that collectively contribute a diverse and large sample size ideal for addressing questions related to children’s health and consolidating results across population studies. Participants included caregivers of children ages 8 to 16 years from four ECHO cohorts. Caregiver perceived stress was measured using the Perceived Stress Scale (PSS), and child sleep disturbance was assessed using five sleep-related items from the School-Age version of the Child Behavior Checklist (CBCL). Increases in caregiver perceived stress and child mental or physical health condition were independently associated with greater sleep disturbance among children. The findings reinforce the importance of accounting for, and potentially intervening on, the broader family context and children’s mental and physical health in the interest of improving sleep health.
... The prevalence of sleep disorders in dialysis patients is 50 -80 percent worldwide and 70 -95 percent in Iran (10)(11)(12)(13)(14). Sleep disorders cause many problems, including sleep apnea syndrome (SAS), periodic limb movement disorder (PLMD), restless leg syndrome (RLS), and extreme daytime sleepiness (EDS) (10,12,15,16). These problems ultimately lead to disturbances in the quality of sleep (17). Sajjadi et al. showed that more than 60 percent of hemodialysis patients in Iran suffer from severe fatigue (18). ...
Background: One of the conservative treatment methods for patients with end-stage renal failure is hemodialysis. Although hemodialysis contributes to patients’ lives, it has adverse emotional and psychological effects, including sleep problems, fatigue, and depression. Objectives: The present study aimed to examine the effect of sleep hygiene education on sleep quality, depression, and fatigue among hemodialysis patients admitted to hospitals affiliated with Zahedan University of Medical Sciences in 2021. Methods: This quasi-experimental study was conducted on 80 hemodialysis patients in Khatam Al-Anbia and Ali Ibne Abi Talib hospitals affiliated with Zahedan University of Medical Sciences in 2021. The participants were selected through convenience sampling and randomly assigned to intervention and control groups using permuted block randomization. The data were collected using a demographic information form, Pittsburgh Sleep Quality Index (PSQI), Multidimensional Fatigue Inventory (MFI), and Beck Depression Inventory-II (BDI-II). The patients in the control group received routine care, and the patients in the intervention group attended a sleep hygiene education program in three consecutive face-to-face dialysis sessions using educational pamphlets for 40 to 60 minutes, depending on the patient’s tolerance. Two months after the training program, the quality of sleep, fatigue, and depression were measured for patients in both groups. The patients’ data were analyzed with SPSS software (version 25) using the paired samples t-test, independent samples t-test, chi-square test, and analysis of covariance (ANCOVA) at a significant level of 0.05 (P < 0.05). Results: The mean scores of sleep quality for the patients in the intervention and control groups changed from 12.05 ± 2.18 to 10.85 ± 2.00 and from 10.28 ± 1.85 to 10.45 ± 1.85, respectively, and the paired samples t-test showed significant differences in both groups before and after the intervention, but the sleep quality scores increased for the patients in the intervention group (P = 0.001). Moreover, the mean fatigue scores for the patients in the intervention and control groups changed from 57.98 ± 13.48 to 52.25 ± 13.23 and from 48.88 ± 8.97 to 52.20 ± 8.80, respectively. The paired samples t-test showed significant differences in both groups before and after the intervention, but fatigue scores increased for the control group (P = 0.001). The data also indicated that the mean depression scores for the patients in the intervention and control groups changed from 24.20 ± 6.26 to 22.28 ± 5.26 and from 25.18 ± 7.70 to 25.68 ± 7.54, respectively. The independent samples t-test showed significant differences in both groups before and after the intervention (P = 0.001). By controlling the pre-test effect, the analysis of covariance (ANCOVA) revealed significant differences in the mean scores of sleep quality (P = 0.001), fatigue (P = 0.001), and depression (P = 0.001) in hemodialysis patients in both intervention and control groups after two months. Conclusions: The study’s findings indicated that sleep hygiene education significantly improves sleep quality, depression, and fatigue in hemodialysis patients. Given that sleep hygiene education is a simple and easy-to-use method, sleep hygiene training courses need to be organized and held for dialysis patients.
... This, in turn, has a huge impact on both the quality and duration of sleep among children and youth. A study by Dewald et al. [21] found strong associations between three sleep variables [sleep quality (r = 0.096), duration (r = 0.069), and sleepiness (r = -0.133)] and school performance, especially in boys. ...
Background
High levels of physical activity (PA), low levels of screen time, combined with sufficient sleep time, provide better health benefits. However, few studies have examined the association of these behaviours with academic skills. Therefore, this study aims to determine how PA, screen time, and sleep time are related to selected academic skills of 8/9-year-old children while examining compliance with the guidelines on PA, sedentary behaviour, and sleep among this population group.
Methods
This cross-sectional study included 114 primary school children (50% girls) aged 8–9years old from 2nd grade. The levels of PA, screen time, and sleep were assessed using self-reported questionnaires. The selected academic skills (based on reading and writing) were assessed by a battery of methods designed to diagnose the causes of school failure in students aged 7–9. Non-linear regression was applied to build multivariate models aimed at finding the most significant predictors for the selected academic skills separately.
Results
Sixty-seven percent of children met the sleep guidelines, 22% met the screen time guidelines, and only 8% met PA guidelines. In terms of screen time, boys spent more time playing games than girls (p = .008). Moderate to vigorous intensity physical activity (MVPA) was associated with higher/better scores of the visual-auditory integration (B = -0.07, p = .040). Not meeting the sleep guidelines was associated with lower scores in visual-auditory integration among children (B = 0.12, p = .042). Children who did not meet the screen time guidelines had lower scores in perceptual-motor integration (B = -0.09, p = .040).
Conclusions
Participating in PA, limiting screen time and sufficient sleep time may benefit/support academic skills in children.
... Meta-analyses and systematic reviews have concluded that sleep quality and duration have an association on academic performance (Dewald et al., 2010;Shochat, Cohen-Zion & Tzischinsky, 2014), however, there are no conclusive results about the impact of sleep duration and efficiency on learning and academic performance (Hershner & Chervin, 2014;Taras & Potts-Datema, 2005;Gruber et al., 2010). In this sense, there is a possibility of sleep disturbance in students, and this possibility is expressed as lack of academic performance, however, this relationship has not been clearly explained (Gaultney et al., 2010). ...
The Colegio de Ingenieros en Energías Renovables de Querétaro A.C. (CIER-QUERÉTARO), and its chapters of Renewable Energy, Industrial Maintenance, Mechatronics and Informatics, technical sponsors of the International Interdisciplinary Congress on Renewable Energy, Maintenance, Mechatronics and Informatics, CIERMMI 2022 has as general objective to establish a space for discussion and reflection on issues related to the areas of: renewable energy, industrial maintenance, mechatronics and informatics with the participation of students, teachers, researchers and national and international speakers, promoting the formation and consolidation of research networks. Contributing to provide a space for dissemination and discussion of the presentations of students, graduates, academics and researchers, representatives of various higher education institutions, research centers in our country, as well as educational institutions beyond our borders. Promoting the formation of research networks between different institutions. Offering a space for undergraduate, master's, doctoral and postdoctoral students, in which they can present the progress of the research they carry out in their different educational centers. Providing a space in which study groups and members of academic bodies, linked to the curricular program of renewable energy, industrial maintenance, mechatronics and computer science careers, can present the research work developed within their institution and in collaboration with other national or international educational institutions. Establishing a training space for the attendees, through the development of specific lectures and conferences. This volume, Women in Science T-XVIII-2022 contains 8 refereed chapters dealing with these issues, chosen from among the contributions, we gathered some researchers and graduate students from the 32 states of our country. We thank the reviewers for their feedback that contributed greatly in improving the book chapters for publication in these proceedings by reviewing the manuscripts that were submitted. CARDENAS, ALTAMIRANO, ARREOLA and RESÉNDEZ introduce the Modelling of human polyglutamine neurological disorders in Drosophila, DÍAZ, GONZÁLEZ, UVALLE and MEDEROS analyse the association between triglycerides and insulin resistance as a predictor of cardiometabolic diseases in university students; REYES, ROMERO, MIGUEL and FERNANDEZ present the use of medicinal plants by dentists in the state of Guerrero, Mexico; MERAZ, HERNÁNDEZ, GARCÍA and CÁRDENAS are investigating the association between sleep quality and executive functions in a sample of first-semester medical students at a public university; VALLEJO, ROJAS, VERDUGO and LIMON welcome us to the omics era: proteomics importance in cancer research; CERÓN, CERÓN, LARA and VICHIQUE submit diurnal variation and health risk of atmospheric aromatic hydrocarbons concentrations in an urban site located in Nuevo Leon, Mexico; QUITL & JIMÉNEZ expose mental health and family dynamics in university students from Tlaxcala after confinement. Finally, SALGADO, AGUILAR, CRUZ and CÉLIS study the effects of a training program for fitness instructors based on STD and BPN on the attitude of users of a private university gym.
Perfectionism is associated with sleep as well as with academic and sports performance. Given the importance of sleep for performance and the sleep changes that occur during adolescence, the present study aimed to explore the relationship between sleep, two dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns), with academic and sports performance in young athletes. The occurrence of perfectionistic strivings was identified as a tendency to set high personal standards for oneself, while the occurrence of perfectionistic concerns was identified as a tendency to feel pressure to be perfect and have concerns about imperfections. A total of 32 athletes aged 13 to 16 years old participated in this study. Perfectionism, sleep, and course grades were measured at the end of the school year. Sleep was measured by actigraphy, and sports performance improvement was obtained by comparing individual performance at the beginning and the end of the school year. The moderating effect of both dimensions of perfectionism on the relationships between sleep and academic and sports performance improvement was measured. First, results showed no significant relationship between sleep and academic/sports performance. Further analyses revealed that perfectionistic strivings moderated the relationship between certain aspects of sleep with academic and sports performance improvement. Delayed and suboptimal sleep habits were associated with lower academic and sports performance improvement when low levels of perfectionistic strivings were present. Results with perfectionistic concerns showed that this dimension did not moderate the relationship between sleep and academic and sports performance improvement. This study supports the notion that high levels of perfectionistic strivings in young athletes may mitigate the adverse effects of poor sleep habits in young athletes.
The creative performance, as well as other exclusively human capabilities will be the qualities that the future workers must have, due to what has been called the fourth industrial revolution. Therefore, teachers have the obligation to investigate and innovate on new techniques and implement methodologies that promote these skills. The Project-Based Learning (PBL) methodology has shown great benefits in this regard, and there are innovative fields, such as lucid dreams, which could be a new tool for enhancing creative performance. Therefore, the aims of this work were to review the related literature to verify that an intervention using the PBL methodology could be combined with research in lucid dreams in an applicable, relevant, well-founded, coherent, and original way. The second aim was to develop an ABP proposal with these elements to enhance the critical skills that students will need in the future, with special emphasis on creativity. We conclude that this proposal meets the revised characteristics, and we include the design of the proposal, gathering these elements. As a continuation of this work, we intend to carry out an investigation analyzing the data that may be offered by different classrooms that apply the program.
The quality of one's sleep has a significant influence on overall health and happiness. It is the most crucial physiological mechanism in human health. Getting adequate sleep at the correct times helps to safeguard mental and physical health, as well as the quality of life and safety. People's lives have been hastened by societal growth, which has also raised their life pressure. As a result, a rising number of individuals are experiencing poor sleep quality, and the disorders that arise are also on the rise. In response to this issue, this research presents an Electroencephalogram (EEG)-based technique for detecting and managing the quality of sleep. A robust automatic sleep classification framework is designed to observe the knowledge of the efficiency of sleep which might act as deciding factor in determining the sleep quality which will further be useful in detecting and curing sleep issues. This study relies on Physionet's proprietary EEG datasets of the Sleep Heart Health Study (SHHS) database, which have been acquired and recognized by researchers for the inspection and detection of cardiovascular and other sleep-related disorders. A few limited features that have the most significance in sleep efficiency were extracted to decrease the complexity and improve the performance of the framework. Support Vector Machine (SVM), Light Gradient Boosting Machine (LightGBM), Logistic Regression, Decision Tree, K-Nearest Neighbor (KNN), and Random Forest algorithms were trained, evaluated, and tested for classification of sleep stages and thereby measuring the quality of sleep. The experiment results revealed that the sleep quality detection accuracy of 99.7% is obtained for the SVM classifier.
Background
The negative effects of insomnia on adolescents’ development, academic performance, and quality of life place a burden on families, schools, and society. As one of the most important research directions for insomnia, adolescent insomnia has significant research value, social value, and practical significance. Unfortunately, there is no bibliometric analysis in this field of study. This study aims to analyze published articles using bibliometrics, summarize the current research progress and hot topics in this field systematically and exhaustively, and predict the future direction and trend of research.
Methods
For this study, the Web of Science Core Collection (WoSCC) database was searched between 2002 and 2022 for publications related to adolescent insomnia. The R–bibliometrix, VOSViewer, and CiteSpace software were utilized for bibliometric analysis.
Results
This investigation included 2468 publications from 3102 institutions in 87 countries, led by China and the United States. This field of research has entered a period of rapid development since 2017. The journal with the most publications on adolescent insomnia is Sleep , which is also the most co–cited journal. American Journal of Psychology has the highest impact factor among the top 10 journals. These papers were written by 10605 authors; notably, Liu Xianchen emerged as the author with the highest frequency of publications, while Mary A. Carskadon was the most frequently co–cited author. Mental health and comorbid diseases were the main research directions in this field. “Depression,” “anxiety,” “mental health,” “COVID–19,” “stress,” “quality of life,” “heart rate variability,” and “attention–deficit hyperactivity disorder” were hot spots and trends in this field at the current moment.
Conclusion
The research on adolescent insomnia has social value, research value, and research potential; its development is accelerating, and an increasing number of researchers are focusing on it. This study summarized and analyzed the development process, hot spots, and trends of adolescent insomnia research using bibliometric analysis, which identified the current hot topics in this field and predicted the development trend for the future.
Objectives
Children with ADHD commonly exhibit sleep disturbances, but there is limited knowledge about how sleep and sleep timing are associated with cognitive dysfunction in children with ADHD.
Methods
Participants were 350 children aged 5 to 12 years diagnosed with ADHD. Three sleep-related constructs—time in bed, social jetlag (i.e., discrepancy in sleep timing pattern between school nights and weekend nights), and sleep disturbances were measured using a caregiver-report questionnaire. Linear regression models assessed the associations between sleep-related constructs and cognitive performance.
Results
After adjustment for sociodemographic variables, there were few associations between time in bed or sleep disturbances and cognitive performance, however, greater social jetlag was negatively associated with processing speed (β = −.20, 95% CI [−0.35, −0.06]), visually-based reasoning (β = −.13, 95% CI [−0.27, 0.00]), and language-based reasoning (β = −.22, 95% CI [−0.36, −0.08]); all p < .05).
Conclusion
Social jetlag, but not time in bed or disturbances, was associated with lower cognitive performance among children with ADHD.
El presente artículo científico tiene como objetivo analizar la relación entre el ejercicio físico y la calidad del sueño en adultos mayores. La calidad del sueño es un factor clave para la salud y el bienestar de los individuos, especialmente en la tercera edad. A pesar de ello, muchas personas mayores experimentan problemas relacionados con el sueño, como despertares nocturnos, insomnio y somnolencia diurna. El tipo de investigación llevada a cabo fue un estudio cuasi-experimental, con un enfoque cuantitativo, con el fin de determinar la eficacia del ejercicio físico en la mejora de la calidad del sueño en adultos mayores. Los participantes fueron seleccionados de manera aleatoria y se dividieron en dos grupos: un grupo de control y un grupo de intervención. El grupo de intervención realizó ejercicios aeróbicos moderados durante 30 minutos, tres veces por semana, durante 12 semanas. Los resultados obtenidos sugieren que la realización de ejercicios aeróbicos moderados durante 30 minutos, tres veces por semana, durante 12 semanas, puede mejorar significativamente la calidad del sueño en adultos mayores. Estos hallazgos son importantes porque la mejora de la calidad del sueño puede tener un impacto positivo en la salud y el bienestar de los adultos mayores.
p>Sleep-related complaints are common in children and affect their daytime sleepiness, success and quality of life. However, often parents are unaware of or do not consider them as a problem demanding treatment. Aim. To identify the parental appraisals of the patterns and difficulties with sleep in children aged 5—13 years and parental subjective qualification of them as a problem. Methods. In 147 pairs of «parent-child 5—13 years old without diagnosed sleep disorders» (47 pairs with a child 5—6 years old, 49 with a child 7—9 years old, 51 with a child 10—13 years old), parents answered questions about the pattern children’s sleep habits and completed the Children’s Sleep Habits Questionnaire. Children replied to Sleep Self-Report. Results. Difficulties with sleeping are common in children 5—13 years of age: irregular bedtimes, prolonged time falling asleep, falling asleep in someone else’s bed, night terrors, insufficient sleep time, frequent nocturnal awakenings, sleep-talking, early morning awakenings, long time to get up in the morning, fatigue in the afternoon 3 times a week or more are typical for every third child, while protests against going to bed, the impossibility of waking up on their own in the morning, difficulties in getting up in the morning — for every second child. For children 10—13 years old, lack of sleep was also wide-spread. Parents frequently do not consider sleep difficulties in children as a problem. The pattern of going to bed, sleeping, and waking up didn’t not differ between boys and girls, but girls rated their sleepiness higher, and rated sleep quality lower. With age, daytime and nighttime sleep was reduced, bedtime became later, while breathing problems during sleep, parasomnia symptoms and night terrors became rarer. Conclusion. Given the prevalence of complaints about various difficulties associated with sleep in children aged 5—13 years, the acute question is why parents do not qualify these difficulties as problems and do not seek help is relevant.</p
Owl monkeys are the only nocturnal primates in the New World and the only nocturnal anthropoids. They concentrate their activities during the dark phase of the 24-h cycle, with peaks of activity at dawn and dusk. This has been confirmed by observational studies of free-ranging A. nigriceps, A. a. boliviensis, A. a. azarae, A. vociferans, and A. miconax. While the species in the tropics are primarily nocturnal, at least one shows a remarkable temporal plasticity in its activity patterns. Azara’s owl monkeys (A. a. azarae) of the Argentinean and Paraguayan Chaco are cathemeral, showing bouts of activity during the day as well as during the night. This chapter reviews the research that we have done both in the lab and in the field to understand the ecological correlates of this unusual activity pattern and its possible underlying mechanisms.
Short duration of sleep and poor sleep quality have been linked to poor attention and impulse control in children. We aimed to determine the longitudinal predictive value of sleep quantity and quality during early childhood on objective and caregiver-report measures of attention, impulse control, and executive function in children at age 8 years. We used data from the Health Outcomes and Measures of the Environment (HOME) Study, a pregnancy and birth cohort. Caregivers reported on their child's sleep at ages 2, 2.5, 3, 4, and 5 years. Analysis included 410 participants. We used longitudinal growth curve models of early childhood sleep patterns to predict neurobehavioral functioning at age 8 years. Sleep problems did not predict any of our outcome measures at age 8 years. Sleep duration trended shorter as children matured, so predictive models examined both intercept and slope. Children with the least decline in sleep duration across early childhood had fewer impulsive errors at age 8 years on a continuous performance test (unadjusted p = .013; adjusted p = .013). Children with shorter duration of sleep across early childhood had worse caregiver-reported behavioral regulation at age 8 years (unadjusted p = .002; adjusted p = .043). Neither sleep duration slope nor intercept predicted inattention or metacognitive skills at age 8 years (p > .05). Total sleep time across early childhood predicts behavior regulation difficulties in school-aged children. Inadequate sleep during early childhood may be a marker for, or contribute to, poor development of a child's self-regulatory skills.
The purpose of the present study was to evaluate the reliability and validity of the General Aptitude Test (GAT), a national instrument for the measurement of aptitude/achievement in the Kingdom of Saudi Arabia as a function of daytime testing. Participants were 722 students who took on the GAT across morning and evening administrations in a within-person pre-post design. Participants were matched for gender, parental education, and test center characteristics (i.e., size). The GAT was tested for its psychometric properties and its measurement invariance across time of day. Results pointed to a significant misfit using an exact invariance protocol. Specifically, there was a large number of non-invariant items pointing to Differential Item Functioning (DIF). Second, internal consistency reliabilities were consistently lower during morning testing compared to evening testing as evidenced using both statistical and visual means. Concerns about dimensionality were also raised for the morning compared to the evening administration. Last, comparison of performance levels indicated that morning testing was associated with significant decrements in performance across all domains compared to performance levels during evening testing. The results have implications for the validity of measurement and public testing policy if test validity during morning administration is compromised.
Adolescents typically sleep too little and feel drowsy during morning classes. We assessed whether morning use of an LED bright light device could increase alertness in school students. Twenty-six (8M/18F) healthy, unmedicated participants, ages 13–18 years, (mean 17.1±1.4) were recruited following screenings to exclude psychopathology. Baseline assessments were made of actigraph-assessed sleep, attention, math solving ability, electroencephalography and structural and functional MRI (N = 10–11, pre-post). Participants nonrandomly received 3–4 weeks of bright light therapy (BLT) for 30 minutes each morning and used blue light blocking glasses for 2 hours before bedtime. BLT devices were modified to surreptitiously record degree of use so that the hypothesis tested was whether there was a significant relationship between degree of use and outcome. They were used 57±18% (range 23%–90%) of recommended time. There was a significant association between degree of use and: (1) increased beta spectral power in frontal EEG leads (primary measure); (2) greater post-test improvement in math performance and reduction in errors of omission on attention test; (3) reduced day-to-day variability in bed times, sleep onset, and sleep duration during school days; (4) increased dentate gyrus volume and (5) enhanced frontal connectivity with temporal, occipital and cerebellar regions during Go/No-Go task performance. BLT was associated with improvement in sleep cycle consistency, arousal, attention and functional connectivity, but not sleep onset or duration (primary measures). Although this was an open study, it suggests that use of bright morning light and blue light blocking glasses before bed may benefit adolescents experiencing daytime sleepiness.
Clinical trial registration: Clinicaltrials.gov ID— NCT05383690 .
Background:
Child maltreatment may lead to sleep disturbance during the critical period of child development. Our study examined the effect of maltreatment in early childhood on trajectories of sleep quality among early adolescents.
Methods:
The study included 1611 participants (mean ± standard deviation age at baseline: 12.5 ± 0.5 years) from a middle school in southeastern China. Of these participants, 60.5 % were males. Information on early childhood maltreatment during pre-seventh grade was obtained through a self-report questionnaire at baseline, and sleep quality was collected at baseline and during follow-up. We used a group-based trajectory model to characterize trajectories of sleep quality.
Results:
The study identified four trajectories of sleep quality, namely the low sleep score group (25.0 %), the moderate-low sleep score group (51.0 %), the moderate-increasing sleep score (17.0 %), and the high-decreasing sleep score (7.0 %) group. After adjusting for covariates, the findings revealed that emotional abuse and physical abuse were associated with an increased risk of developing new-onset sleep disturbances in early adolescents. Particularly, emotional abuse (incidence rate ratio = 1.71, 95 % confidence interval: 1.08-2.71) significantly increased the risk of belonging to the high-decreasing sleep score group. Moreover, there existed a dose-response relationship between early childhood maltreatment and sleep quality trajectories, with a higher number of maltreatment types in early childhood correlating with a greater risk of belonging to the high-decreasing sleep score group.
Conclusions:
The findings of our study provide compelling evidence indicating that specific types and cumulative maltreatment during early childhood contribute to sleep disturbances among early adolescents. The study findings highlight the significance of preventing and reducing early childhood maltreatment to enhance sleep quality during early adolescence.
The importance of sleep is often underestimated by students, especially when faced with academic stress. However, sleep plays a critical role in both physical and mental health. The study "STUDENTS' QUALITY OF SLEEP AND THEIR ACADEMIC PERFORMANCE" was conducted to examine the relationship between sleep quality and academic performance among Grade 11 STEM students of Zamboanga del Sur National High School Senior High School for the academic year 2022-2023. A final sample of 126 students was obtained using the convenience sampling technique, and a five-question survey questionnaire based on Likert's scale was utilized for each variable. Descriptive statistics such as percentage, weighted mean, and standard deviation were used to analyze and interpret the data. The study found that the overall status of sleep quality was high, with sleep efficiency, sleep duration, and sleep latency being the three sub-variables that substantiated this result. In contrast, the overall level of academic performance was found to be outstanding. To test the hypothesis of a significant correlation between sleep quality and academic performance, Pearson correlation was used. However, the study found no significant relationship between students' sleep quality and academic performance. The Pearson coefficient of correlation was used to confirm this result. In conclusion, the study emphasizes the importance of sleep quality in students' daily lives, especially concerning academic performance. The research findings show that there was no significant correlation between sleep quality and academic performance among Grade 11 STEM students. However, it is crucial for students to prioritize sleep quality to maintain their physical and mental well-being. By doing so, students can achieve their academic goals and succeed in their academic pursuits.
Este estudio científico se enfoca en analizar la relación entre el ejercicio físico y la calidad del sueño en adultos mayores. La calidad del sueño es esencial para la salud y el bienestar de las personas, especialmente en la tercera edad. Sin embargo, muchos adultos mayores enfrentan problemas relacionados con el sueño, como despertares nocturnos, insomnio y somnolencia diurna. El método utilizado fue un estudio cuasi-experimental con un enfoque cuantitativo, cuyo propósito fue determinar la efectividad del ejercicio físico en la mejora de la calidad del sueño en esta población. Los participantes fueron seleccionados de forma aleatoria y divididos en dos grupos: un grupo de control y un grupo de intervención. El grupo de intervención llevó a cabo ejercicios aeróbicos moderados durante 30 minutos, tres veces por semana, durante un periodo de 12 semanas. Los resultados obtenidos indican que la práctica de ejercicios aeróbicos moderados durante 30 minutos, tres veces por semana, a lo largo de 12 semanas, puede tener un impacto positivo y significativo en la calidad del sueño en adultos mayores. Estos descubrimientos son de gran relevancia, ya que una mejora en la calidad del sueño puede influir positivamente en la salud y el bienestar de este grupo poblacional.
Abstract Daytime napping, a habit widely adopted globally, has an unclear association with obesity. In this study, we executed a meta-analysis to explore the relationship between daytime napping and obesity. We conducted a comprehensive search of the PubMed, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science databases for pertinent articles published up to April 2023. Random-effects models were utilized to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and we assessed the heterogeneity of the included studies using the I 2 statistic. To explore potential sources of heterogeneity, subgroup analyses were performed. The methodological quality of the studies was evaluated using the Newcastle–Ottawa Scale (NOS), and funnel plots were employed to detect any publication bias. Sensitivity analyses were conducted by sequentially omitting each study. We conducted a meta-analysis of twelve studies that included one each from the UK and Spain, five from the USA, and five from China, totalling 170,134 participants, to probe the association between napping and obesity. The pooled analysis suggested a higher risk of obesity in individuals who nap (OR: 1.22 [1.10–1.35], p
The study highlights a rising number of fluids such as nanofluids that encountered in daily life exhibit non-Newtonian behavior and it is exploited in manufacture due to their high heat transfer rate becoming more and more important as time goes on. Brownian motion provided by the bombardment of fluid particles from the surrounding medium. In this article, we address the influence of the Brownian motion with thermophoresis on the flow of Casson- magnetohydrodynamics nanofluid. flow over a non-linear stretching surface have analysed. Impact of the viscous dissipation, heat absorption and suction introduce in the system. Using proper similarity conversion, the controlling PDEs turned into ODEs. The conversion governing equations of first-order ODEs are solved numerically by utilizing an explicit finite difference technique. The similarity equations elucidated in the view of shooting technique and used with software package bvp4c MATLAB. The flow velocity, temperature and concentration followed up with the nonlinearity nature and the influence results are displayed in graphical form. The outcomes of skin frictions, Nusselt and Sherwood numbers are summarized for various leading parameters are in the form of table. Activation energy enhanced the mass transfer rate. However, a reverse phenomenon detected with the higher value of chemical reaction parameter. According to the results of the simulation, the skin friction decreased with the Casson and permeability parameters, while the heat transmission remain constant with the increased values of the constants.
Objective:
The present study investigates the association between sleep in late adolescence and completion of upper secondary school.
Methods:
The data are drawn from the youth@hordaland study, a large population-based study conducted in 2012, linked with official educational data in Norway (N = 8838).
Results:
High school dropout was more prevalent among adolescents who had insomnia (20.6%) compared to those without insomnia (14.3%; adjusted risk ratios = 1.50; 95% confidence intervals: [2.19-2.92]). There was also a higher rate of school dropout among those who had symptoms of delayed sleep-wake phase (21%) compared to those without delayed sleep-wake phase (14.3%); adjusted risk ratios = 1.43, 95% confidence intervals: (1.28-1.59). School noncompleters were also characterized by reporting 44 minutes shorter sleep duration, longer sleep onset latency, and wake after sleep onset (both approx. 15 minutes) compared to school completers.
Conclusion:
The importance of sleep for high school dropout rates highlights the importance of including sleep as a risk indicator and a possible target for preventive interventions in late adolescence.
No previous studies have assessed the relationship between sleep problems/habits and school performance in Saudi school children. Therefore, we surveyed parents of a sample of elementary school children in Riyadh to assess the relation between sleep problems/habits and school performance in this age group. The study was conducted in Riyadh city among elementary school children (boys and girls) during springtime of the year 1999. Questionnaires were distributed by trained medical students according to the sampling process and parents were asked to score each item that describes the child behavior within the past 6 months. School performance was assessed using the latest monthly evaluation report provided by the school. Students' performance was stratified as "excellent students" (≥85%) or "average students" (<85%). Completed questionnaires were returned from the households of 1012 students. Boys were 511 (50.5%) and girls 501 (49.5%). The mean age was 9.5±1.9 years ranging from 5 to 13 years. Six hundred and forty nine students (64.1 %) of students had "excellent" performance and 363 students (35.9%) had "average" performance. School performance was significantly associated with children's age, gender, father's educational level, and mother's educational level. It was evident that the presence of sleep problems, poor sleep habits, or shortened total sleep time was affecting the students' school performance. Sleep problems and habits may negatively affect school performance. Schools, parents, and pediatricians need to take an active role to consider sleep and sleep disorders in the context of school performance and daytime functioning.
Many adolescents are experiencing a reduction in steep as a consequence of a variety of behavioral factors (e.g., academic workload, social and employment opportunities), even though Scientific evidence suggests that the biological need for sleep increases during maturation. Consequently, the ability to effectively interact with peers while learning and processing novel information may be diminished in many sleep-deprived adolescents. Furthermore, sleep deprivation may account for reductions in cognitive efficieny in many children and adolescents with special education needs. In response to recognition of this potential problem by parents, educators, and scientists, some school districts have implemented delayed bits schedules and school start times to allow for increased sleep duration for high school students, in an effort to increase academic performance and decrease behavioral problems. The long-term effects of this change are yet to be determined; however preliminary studies suggest that the short-term impact on learning and behavior has been beneficial. Thus, many parents, teachers, and scientists are supporting further consideration of this information to formulate policies that may maximize learning and developmental opportunities jot children. Although changing school start times may be an effective method to combat sleep deprivation in most adolescents, some adolescents experience. sleep deprivation and consequent diminished daytime performance because of common steep disorders (e.g., asthma or steep apnea). In such cases, surgical, pharmaceutical, or respiratory therapy, or a combination of the three, interventions are required to restore normal sleep and daytime performance.
This paper reviews the evidence in support of the contention that publication bias is a potential threat to the validity of
meta-analytic results in criminology and similar fields. It then provides a critique of the traditional file drawer or failsafe
N method for examining publication bias, and an overview of four newer methods that can be used to detect publication bias.
These include two (trim and fill and cumulative meta-analysis) that enable the researcher to estimate the magnitude of the
influence of publication bias on the overall mean effect size. Advantages and limitations of both traditional and newer methods
are examined. The methods reviewed are illustrated through their application to a meta-analysis of the effects of drug courts
on recidivism by Wilson et al. (Journal of Experimental Criminology, 2, 459–487, 2006).
Memory (M) impairments have been suggested in pediatric Obstructive Sleep Apnea along with attention and executive (AE), language (L), and visuospatial (V) dysfunctions. NEPSY assessment of children aged 5-9 years who were either healthy (N = 43), or who had OSA without L, V, AE (OSA(-), N = 22) or with L (N = 6), V (N = 1), AE (N = 3) (OSA(+), N = 10) dysfunctions revealed no gross memory problems in OSA; however, over the three learning trials of cross-modal association learning of name with face, the OSA(-) progressively improved performance, whereas the OSA(+) failed to progress. No within-group differences between immediate and delayed memory tasks were apparent. The data suggest the presence of slower information processing, and/or secondary memory problems, in the absence of retrieval or recall impairments among a subset of children with OSA. We hypothesize that inefficient/insufficient encoding may account for the primary deficit.
Sleep deprivation is associated with considerable social, financial, and health-related costs, in large measure because it produces impaired cognitive performance due to increasing sleep propensity and instability of waking neurobehavioral functions. Cognitive functions particularly affected by sleep loss include psychomotor and cognitive speed, vigilant and executive attention, working memory, and higher cognitive abilities. Chronic sleep-restriction experiments--which model the kind of sleep loss experienced by many individuals with sleep fragmentation and premature sleep curtailment due to disorders and lifestyle--demonstrate that cognitive deficits accumulate to severe levels over time without full awareness by the affected individual. Functional neuroimaging has revealed that frequent and progressively longer cognitive lapses, which are a hallmark of sleep deprivation, involve distributed changes in brain regions including frontal and parietal control areas, secondary sensory processing areas, and thalamic areas. There are robust differences among individuals in the degree of their cognitive vulnerability to sleep loss that may involve differences in prefrontal and parietal cortices, and that may have a basis in genes regulating sleep homeostasis and circadian rhythms. Thus, cognitive deficits believed to be a function of the severity of clinical sleep disturbance may be a product of genetic alleles associated with differential cognitive vulnerability to sleep loss.
This study examined associations among adolescent sleepiness, sleep duration, variability in sleep duration, and psychological functioning (symptoms of anxiety, depression, externalizing behaviors, and perceived health).
This was a cross-sectional analysis of data from a community-based cohort study of sleep and health. Participants were 247 adolescents (48.6% female, 54.3% ethnic minority, mean age of 13.7 years). Sleep duration and variability in sleep duration were measured by actigraphy and sleepiness was measured by adolescent questionnaire. Primary outcomes were measured by parent, teacher, and adolescent questionnaires.
Sleepiness was associated with higher scores on measures of anxiety (Adjusted partial r(2) = .28, p < .001), depression (Adjusted partial r(2) = .23, p < .001), and perceived health (indicating more negative outcomes) (Adjusted partial r(2) = .19, p < .01). Significant associations between sleep duration or variability in sleep duration with psychological variables were not found.
Findings highlight the inter-relationships between sleepiness and psychological functioning and the potential importance of addressing sleepiness in health and psychological evaluations of adolescents.
The objective of the present study was to examine whether parent-reported short sleep duration and sleeping difficulties are related to behavioral symptoms among pre-school aged children. The study is a cross-sectional survey of 297 families with 5-6-year-old children. The Sleep Disturbance Scale for children was used to measure sleep duration and sleeping difficulties, and the Child Behavior Checklist and Teacher's Report Form were used to measure attention problems, and internalizing and externalizing symptoms. In multivariate logistic regression models, short sleep duration was according to parental reports related to inattention (adjusted odds ratio 4.70, 95% CI 1.58-14.00), internalizing (adjusted odds ratio 3.84, 95% CI 1.32-11.21), and total psychiatric symptoms (adjusted odds ratio 3.53, 95% CI 1.23-10.17) while according to teacher's reports it was almost significantly related to internalizing symptoms (adjusted odds ratio 4.20, 95% CI 0.86-20.51). Sleeping difficulties were strongly related to all subtypes of psychiatric symptoms according to parental reports (adjusted odds ratios ranging from 6.47 to 11.71) and to externalizing symptoms according to teachers' reports (adjusted odds ratio 7.35, 95% CI 1.69-32.08). Both short sleep duration and sleeping difficulties are associated with children's behavioral symptoms. Intervention studies are needed to study whether children's behavioral symptoms can be reduced by lengthening sleep duration or improving sleep quality.
To determine whether individual differences in developmental patterns of general sleep problems are associated with 3 executive function abilities-inhibiting, updating working memory, and task shifting-in late adolescence.
916 twins (465 female, 451 male) and parents from the Colorado Longitudinal Twin Study.
Parents reported their children's sleep problems at ages 4 years, 5 y, 7 y, and 9-16 y based on a 7-item scale from the Child-Behavior Checklist; a subset of children (n = 568) completed laboratory assessments of executive functions at age 17. Latent variable growth curve analyses were used to model individual differences in longitudinal trajectories of childhood sleep problems. Sleep problems declined over time, with approximately 70% of children having > or = 1 problem at age 4 and approximately 33% of children at age 16. However, significant individual differences in both the initial levels of problems (intercept) and changes across time (slope) were observed. When executive function latent variables were added to the model, the intercept did not significantly correlate with the later executive function latent variables; however, the slope variable significantly (P < 0.05) negatively correlated with inhibiting (r = -0.27) and updating (r = -0.21), but not shifting (r = -0.10) abilities. Further analyses suggested that the slope variable predicted the variance common to the 3 executive functions (r = -0.29).
Early levels of sleep problems do not seem to have appreciable implications for later executive functioning. However, individuals whose sleep problems decrease more across time show better general executive control in late adolescence.
To establish the direction and etiology of longitudinal associations between sleep problems and depression symptoms in children.
Data on twins aged 8 and 10 years were obtained. At assessments, parents completed the Child Sleep Habits Questionnaire, and twins completed the Children's Depression Inventory.
Participants were mainly interviewed at the Institute of Psychiatry, London.
Three hundred twin pairs initially enrolled in the study.
N/A.
A genetically informative cross-lagged model examined links between sleep and depression. Sleep problems at age 8 predicted depression at age 10 (partial regression coefficient [95% confidence intervals] = 0.10 [0.01-0.18]). The converse was not found. Stability of sleep problems across time was mainly due to genes (46% of the genetic influence on sleep at 10 was due to the same genetic influence on sleep aged 8). Stability of depression was mainly due to non-shared environmental influences (19% of the nonshared environmental influence on depression at 10 was due to the same nonshared environmental influence on depression at age 8). The cross-lagged association between sleep problems at 8 and depression at 10 years was largely due to genes, although this finding was nonsignificant.
This study adds to our understanding of the temporal precedence of sleep problems and depression and the risks underlying their associations. There are implications regarding the value of specifying genes linked to sleep problems and potential opportunities for informing early intervention strategies in high-risk groups at key points in the progression to developing more serious problems.
Here we report preliminary findings from a small-sample functional magnetic resonance imaging (fMRI) study of healthy adolescents who completed a working memory task in the context of a chronic sleep restriction experiment. Findings were consistent with those previously obtained on acutely sleep-deprived adults. Our data suggest that, when asked to maintain attention and burdened by chronic sleep restriction, the adolescent brain responds via compensatory mechanisms that accentuate the typical activation patterns of attention-relevant brain regions. Specifically, it appeared that regions that are normally active during an attention-demanding working memory task in the well-rested brain became even more active to maintain performance after chronic sleep restriction. In contrast, regions in which activity is normally suppressed during such a task in the well-rested brain showed even greater suppression to maintain performance after chronic sleep restriction. Although limited by the small sample, study results provide important evidence of feasibility, as well as guidance for future research into the functional neurological effects of chronic sleep restriction in general, the effects of sleep restriction in children and adolescents, and the neuroscience of attention and its disorders in children.
Very few prospective studies examine the relationship between childhood sleep problems and subsequent substance use. In this study, we examined how sleep problems at ages 3-8 predicted onset of alcohol, cigarette, and marijuana use in adolescence. We also investigated the relationships between childhood sleep problems and adolescent internalizing and externalizing problems.
Study participants were 292 boys and 94 girls from a community sample of high risk families and controls in an ongoing longitudinal study.
Controlling for parental alcoholism, sleep problems at ages 3-8 predicted onset of alcohol, cigarette, and marijuana use among boys and onset of alcohol use among girls. Childhood sleep problems were related to maternal ratings of internalizing and externalizing problems during adolescence for both boys and girls. Adjusting for these problems did not weaken the effects of sleep problems on onset of substance use.
This is to our knowledge the first study that prospectively examines gender differences in the relationship between sleep problems and early onset of substance use. Childhood sleep problems predicted early onset of substance use for boys but not girls. If childhood sleep problems indeed increase the probability of substance use onset, greater attention by parents to sleep problems in children and adolescents would potentially have ameliorative long-term effects. Parents are encouraged to explore different ways to help their children sleep better, including obtaining information and suggestions from their primary care physicians.
Two studies assessed whether measures of health, well-being, and sleepiness are better related to sleep quality or sleep quantity. In both studies, subjects completed a 7-day sleep log followed by a battery of surveys pertaining to health, well-being, and sleepiness. In subjects sleeping an average of 7 hours a night, average sleep quality was better related to health, affect balance, satisfaction with life, and feelings of tension, depression, anger, fatigue, and confusion than average sleep quantity. In addition, average sleep quality was better related to sleepiness than sleep quantity. These results indicate that health care professionals should focus on sleep quality in addition to sleep quantity in their efforts to understand the role of sleep in daily life.
Poor school performance by adolescent students has been attributed in part to insufficient sleep. It is recognized that a number of factors lead to diminished total sleep time and chief among these are early school start times and sleep phase delay in adolescence. Political initiatives are gaining momentum across the United States to require later school start times with the intent of increasing total sleep time and consequently improving school performance. Later school start times come with significant costs and impact other activities of families and communities. The decision to implement later school start times cannot be made lightly and deserves support of well-performed research on the impact of these changes. A study evaluating the association of academic performance and total sleep time was performed in middle school and high school students in a suburban Maryland school system. Preliminary results of this study show no correlation of total sleep time with academic performance. Before mandating costly changes in school schedules, it would be useful to perform further research to determine the effects of increasing sleep time on the behaviors of adolescent students.
The aim of this study was to examine the associations between sleep and neurobehavioral functioning (NBF) in school-age children. These variables were assessed for 135 unreferred, healthy school children (69 boys and 66 girls), from second-, fourth-, and sixth-grade classes. Objective assessment methods were used on the participants in their regular home settings. Sleep was monitored using actigraphy for 5 consecutive nights; and NBF was assessed using a computerized neurobehavioral evaluation system, administered twice, at different times of the day. Significant correlations between sleep-quality measures and NBF measures were found, particularly in the younger age group. Children with fragmented sleep were characterized by lower performance on NBF measures, particularly those associated with more complex tasks such as a continuous performance test and a symbol-digit substitution test. These children also had higher rates of behavior problems as reported by their parents on the Child Behavior Checklist. These results highlight the association between sleep quality, NBF, and behavior regulation in child development; and raise important questions about the origins of these associations and their developmental and clinical significance.
This study assessed the effects of modest sleep restriction and extension on children's neurobehavioral functioning (NBF). The sleep of 77 children (age: M = 10.6 years; range = 9.1-12.2 years) was monitored for 5 nights with activity monitors. These children (39 boys and 38 girls) were all attending regular 4th- and 6th-grade classes. Their NBF was assessed using computerized tests on the 2nd day of their normal sleep schedule. On the 3rd evening, the children were asked to extend or restrict their sleep by an hour on the following 3 nights. Their NBF was reassessed on the 6th day following the experimental sleep manipulation. Sleep restriction led to improved sleep quality and to reduced reported alertness. The sleep manipulation led to significant differential effects on NBF measures. These effects may have significant developmental and clinical implications.
Study Objectives
To develop a measure of daytime sleepiness suitable for middle-school children and examine the relationship between daytime sleepiness and school-related outcomes.
Design
Self-report questionnaire.
Participants
Four hundred fifty, 11- to 15-year-old students, from grades 6, 7, and 8 of a public middle school in Dayton, Ohio.
Measurements and Results
A pediatric daytime sleepiness questionnaire was developed using factor analysis of questions regarding sleep-related behaviors. Results of the sleepiness questionnaire were then compared across other variables, including daily sleep patterns, school achievement, mood, and extracurricular activities.
Results
Factor analysis on the 13 questions related to daytime sleepiness yielded 1 primary factor (“pediatric daytime sleepiness”; 32% of variance). Only items with factor loadings above .4 were included in the final sleepiness scale. Internal consistency (Chronbach's alpha) for the final 8-item scale was .80. Separate one-way analyses of variance and trend analyses were performed comparing pediatric daytime sleepiness scores at the 5 different levels of total sleep time and academic achievement. Participants who reported low school achievement, high rates of absenteeism, low school enjoyment, low total sleep time, and frequent illness reported significantly higher levels of daytime sleepiness compared to children with better school-related outcomes.
Conclusions
The self-report scale developed in the present work is suitable for middle-school-age children and may be useful in future research given its ease of administration and robust psychometric properties. Daytime sleepiness is related to reduced educational achievement and other negative school-related outcomes.
The present paper reviews and critiques studies assessing the relation between sleep patterns, sleep quality, and school performance of adolescents attending middle school, high school, and/or college. The majority of studies relied on self-report, yet the researchers approached the question with different designs and measures. Specifically, studies looked at (1) sleep/wake patterns and usual grades, (2) school start time and phase preference in relation to sleep habits and quality and academic performance, and (3) sleep patterns and classroom performance (e.g., examination grades). The findings strongly indicate that self-reported shortened total sleep time, erratic sleep/wake schedules, late bed and rise times, and poor sleep quality are negatively associated with academic performance for adolescents from middle school through the college years. Limitations of the current published studies are also discussed in detail in this review.
From 2002 to 2005 a population based cross-sectional survey among 5-11 year old children was carried out in Cologne to assess the prevalence of sleep disorders and their relation to behavioural problems and school performance (Cologne Children's Sleep Study). Subgroups of children from the survey were enrolled in longitudinal studies. Parent completed questionnaires were used referring to the children aged 5. For the older children a questionnaire was completed by both the parent and the child. It could be proved that sleep onset delay and problems of sleep maintenance are particularly relevant in the primary school age, whereas in older children, there is an increased prevalence of daytime sleepiness. Children with sleep problems had a clearly increased risk of developing emotional or behavioural problems, such as hyperactivity. Viewing television or playing video games before sleeping was associated with sleep and behaviour problems in primary school children. Children with sleep problems and daytime sleepiness had significantly more often poor school performance, than children without these problems. The results of the Cologne Children's Sleep Study correspond with international research results and point out that there is an association between sleep disturbances, behavioural problems and poor school performance. The study results suggest, that early, preventative measures to improve the sleep quality in infancy and childhood could be of help.
The study objective was to find out the predictors which explain subjective daytime sleepiness (SDS) in schoolchildren. The questionnaire study included data on the child's sleeping habits, sleep disorders, daytime sleepiness, progress at school and TV/video watching. The corresponding parental data was also gathered. Bivariate cross-tabulations and multivariate log-linear modelling were used as statistical methods. The participants were 518 schoolchildren (9 to 17 years), 398 mothers and 345 fathers. SDS was reported in 21% of the children. The children with SDS slept less on weekdays and went to bed later on Saturday nights, reported a long sleep latency and more dreaming, night waking, insomnia, sleeptaking and video watching than the children without SDS. Their parents had more sleep disturbances than the parents of the alert children. This study shows that SDS in schoolchildren can be caused by poor sleeping habits and frequent sleep disorders, but that parental sleep problems may also have effect on the symptom.
Objective
To determine the prevalence of sleep disorders in adolescence.To describe sleeping habits of adolescents in relation to sleep disorders and associated factors. To determine the relation between sleep disorders/inappropiate sleeping habits and school performance.
Design
Observational, descriptive, crosssectional study.
Setting
Secondary school of Cuenca (city in Spain).
Participants
1293 school children of first and fourth curses of secondary education.
Main measures
Structured questionnaire with opened and closed questions on sleeping habits during weekdays and at weekends and sleep disorders to be answered by the adolescents anonymously and on their own. Student's school performance with relation with to sleeping habits and sleep disorders were determined.
Results
1155 students out of 1293 (response rate 89.33%) answered the questionnaire, 537 (45.9%) boys and 618 (54.1%) girls, 14 years old on average (between 11-18 years). On weekdays students went to bed at 23.17 h and got up at 7.46 h (average sleeping time =8 hours and 18 minutes). At weekends they went to bed at 1.02 h and got up at 10.42 h (average sleeping time =9 hours and 40 minutes). 45.4% of students said to sleep badly on Sunday night's.
On average the number of subjects failed in class is higher with adolescents who complain about sleep (2.28 vs 1.91; P=.04), who are tired at waking up time (2.17 vs 1.97; P=.048) and who have morning sleepiness (2.17 vs 1.75; P=.004).
Conclusions
Schools hours cause deficitsleeping time during weekdays which is partly made up for at weekend. At weekends there is an interruption of the adolescent's sleeping habits. School performance of adolescents with sleep disorders is lower.
Throughout early development, a child spends more time asleep than in any waking activity. Yet, the specific role of sleep in brain maturation is a complete mystery. In this article, the developmental psychobiology of sleep regulation is conceptualized within the context of close links to the control of arousal, affect, and attention. The interactions among these systems are considered from an ontogenetic and evolutionary biological perspective. A model is proposed for the development of sleep and arousal regulation with the following major tenets:
1. Sleep and vigilance represent opponent processes in a larger system of arousal regulation.
2. The regulation of sleep, arousal, affect, and attention overlap in physiological, neuroanatomical, clinical, and developmental domains.
3. Complex interactions among these regulatory systems are modulated and integrated in regions of the prefrontal cortex (PFC).
4. Changes at the level of PFC underlie maturational shifts in the relative balance across these regulatory systems (such as decreases in the depth/length of sleep and increased capacity for vigilance and attention), which occur with normal development.
5. The effects of sleep deprivation (including alterations in attention, emotions, and goal-directed behaviors) also involve changes at the level of PFC integration across regulatory systems.
This model is then discussed in the context of developmental pathology in the control of affect and attention, with an emphasis on sleep changes in depression.
Abstract The purpose of the present study was to determine the prevalence of excessive daytime sleepiness (EDS) and its associations with sleep habits, sleep problems, and school performance in high school students in South Korea. A total of 3871 students (2703 boys and 1168 girls with a mean age of 16.8 years and 16.9 years, respectively) aged 15–18 years in the 11th grade of high school completed a questionnaire that contained items about individual sociodemographic characteristics, sleep habits, and sleep-related problems. The overall prevalence of EDS was 15.9% (14.9% for boys and 18.2% for girls). Mean reported total sleep time was similar in EDS and non-EDS (6.4 ± 1.6 and 6.4 ± 1.3 h/day, respectively). The increased risk of EDS was related to perceived sleep insufficiency (P < 0.001), teeth grinding ≥ 4 days/week (P < 0.001), witnessed apnea ≥1–3 days/week (P < 0.01), nightmares ≥4 days/week (P < 0.05), low school performance (P < 0.01), and two or more insomnia symptoms (P < 0.05). Students with low school performance had a 60% excess in the odds of EDS compared to those whose school performance was high. These findings suggest that EDS is associated with multiple sleep-related factors in adolescents. Whether interventions to modify associated correlates can alter EDS warrants consideration, especially because it may also improve academic performance in high school students.
Most cognitive tests administered during sleep loss are well rehearsed to remove practice effects. This can introduce tedium and a loss of novelty, which may be the key to the test's subsequent sensitivity to sleep loss, and why it may need only a few minutes administration before sleep loss effects are apparent. There is little evidence to show that any of these tests are actually affected by sleep loss if given de novo, without practice, but using a non-sleep deprived control group. Although the sleep deprivation literature advocates that short, novel and stimulating tests would not be expected to be sensitive to sleep loss, recent sleep loss findings using neuropsychological tests focussing on the prefrontal cortex, indicate that such tests may challenge this maxim. Twenty healthy young adults were randomly assigned to two groups: nil sleep deprivation (control), and 36h continuous sleep deprivation (SD). Two, novel, interesting and short (6 min) language tests, known (by brain imaging) to have predominantly a PFC focus, were given, once, towards the end of SD: (i) the Haylings test – which measures the capacity to inhibit strong associations in favour of novel responses, and (ii) a variant of the word fluency test – innovation in a verb-to-noun association. Subjects were exhorted to do their best. Compared with control subjects both tasks were significantly impaired by SD. As a check on the effects on the Haylings test, a repeat study was undertaken with 30 more subjects randomly divided as before. The outcome was similar. Linguistically, sleep loss appears to interfere with novel responses and the ability to suppress routine answers.
This study examines the developmental changes of sleep patterns as a function of gender and puberty and assesses the prevalence of sleep habits and sleep disturbances in early adolescence. It also investigates the relationship between sleep patterns, sleep habits and difficulty falling asleep and nocturnal awakenings. The present analyses are based on results available for 588 boys and 558 girls for whom mothers completed questions concerning demographics and sleep at annual intervals when their child was aged 10–13 years. The results indicated that nocturnal sleep times decreased, bedtimes were delayed and differences between weekend and school day sleep schedules progressively increased with age. Gender and puberty were both associated with the timing of sleep on weekends. Girls presented longer weekend time in bed (TIB) and later weekend wake time than boys. Similarly, subjects with higher pubertal status showed longer weekend TIB and later weekend wake time than subjects with lower pubertal status. Difficulty falling asleep was associated with later weekend wake time and with sleeping with a night light. In conclusion, the gender differences commonly reported in adolescents’ sleep patterns are most likely explained by girls’ higher pubertal status. This study emphasizes the link between puberty and a putative physiological need for more sleep, in presence of a general reduction of sleep times during adolescence. From age 10–13 years, the delay and lengthening of the sleep period on weekends in comparison to schooldays is associated with difficulty falling asleep.
Conclusion
Meta‐analysis can be a powerful and useful technique. In the short term, the results of meta‐analysis can increase understanding and influence the future endeavors of researchers interested in a particular field. Over the long term, meta‐analysis provides a vehicle by which large bodies of research can be integrated and focused on public policy issues.
Administrative structures currently exist to foster the relationship between research findings and public policy. As one example, Saxe (1986) has described the activities of the Office of Technology Assessment (OTA) established by Congress to provide lawmakers with scientific information in such a way as to be useful for policy decision‐making. OTA is commissioned by Congress to provide assessments of scientific findings, and meta‐analyses are an ideal resource in this regard. Saxe (1986) notes “In almost all cases, the emphasis is on making sense of already collected data, thus literature reviews and methods for synthesizing research results are relied upon” (pp. 61–62).
Whether meta‐analysis actually plays an important role in public policy depends on many factors, not the least of which is the care with which meta‐analyses are conducted. Hopefully, our comments here will help investigators conduct methodologically rigorous meta‐analyses of research relevant to the field of community psychology.
In this study, a structural equation model was used to examine the contribution of sleep duration and sleep quality on school performance in the last two grades of elementary school. Intelligence, achievement motivation, and test anxiety were used as control variables. Mean age of the 153 children was 11 years and seven months. The relationship with school performance has been modelled more explicitly by two latent variables ‘chronic sleep reduction’ and ‘eagerness’. ‘Chronic sleep reduction’ is indicated by three variables: usual time in bed during school days, bedtime at the weekend, and allowance to children to set their own bedtime. The latent variable ‘eagerness’ is related to debilitatory and facilitatory test anxiety and it is influenced by the observed variable ‘sleep quality’. The relationship of chronic sleep reduction, eagerness, achievement motivation, and intelligence with school performance (as shown in the model) demonstrates that less chronic sleep reduction, greater eagerness, higher achievement motivation and intelligence give rise to a better school performance. The average contribution of each of these variables is 10%. Together, these variables explain 43% of the variance in school performance.
This study examined the interrelationship between children's test anxiety, sleep, and performance. The subjects, 239 sixth and seventh graders, responded to questionnaires examining sleep behavior and test anxiety on a day when they had a major exam in school, and on a day when they did not. They also completed a vigilance task on both days. The results showed that partial sleep loss (i.e., under 3 hr) did not adversely influence subjects' performance on the vigilance task or on the actual class exam. However, the results did reveal that test anxiety was negatively related to performance on the class exam.
Despite being used commonly in sleep medicine, the term "sleep quality" has not been rigorously defined. The purpose of this article is to consider objective measures of the subjective "sleep quality" experience. In order to do so, it was necessary to choose a definition of "sleep quality" as a basis for discussion. We have chosen to employ the simple Likert-style rating of (the previous night's) sleep quality, commonly included as an item on sleep diaries, as the core sleep quality indicator and focus of this article. The potential objective measures discussed include polysomnography, cyclic alternating pattern and actigraphy. We review the strengths and weaknesses of these measures as well as discuss challenges facing the development of an objective correlate of "sleep quality" ratings, including that such ratings may reflect non-sleep phenomena such as mood or health status and the possibility that "sleep quality" may reflect different aspects of sleep among people. We also discuss new approaches intended to address these challenges, including: (1) combining different types of measures; (2) sub-grouping individuals based on clinical or physiological characteristics and developing different measures in these subgroups; and (3) sub-grouping based on the association of potential measures and quality ratings over nights.
Relations between children's sleep and cognitive functioning were examined over 2 years, and race and socioeconomic status were assessed as moderators of effects. Third-grade African American and European American children (N = 166; M = 8.72 years) participated at Time 1 and again 2 years later (N = 132). At both Time 1 and Time 2, sleep was examined via self-report and actigraphy. Children were administered selected tests from the Woodcock-Johnson III Tests of Cognitive Abilities, and Stanford Achievement Test scores were obtained from schools. Children's sleep was related to intellectual ability and academic achievement. Results build substantially on an emerging literature supportive of the importance of sleep in children.
Adequate sleep optimizes children's learning and behavior. However, the natural history and impact of sleep problems during school transition is unknown.
To determine (1) the natural history of sleep problems over the 2-year period spanning school entry and (2) associations of children's health-related quality of life, language, behavior, learning, and cognition at ages 6.5 to 7.5 years with (a) timing and (b) severity of sleep problems.
Data were drawn from the Longitudinal Study of Australian Children. Children were aged 4 to 5 years at wave 1 and 6 to 7 years at wave 2. Parent-reported predictors included (1) timing (none, persistent, resolved, incident) of moderate/severe sleep problems over the 2 waves and (2) severity (none, mild, moderate/severe) of sleep problems at wave 2. Outcomes included parent-reported health-related quality of life and language, parent- and teacher-reported behavior, teacher-reported learning, and directly assessed nonverbal (matrix reasoning) and verbal (receptive vocabulary) cognition. Linear regression, adjusted for child age, gender, and social demographic variables, was used to quantify associations of outcomes with sleep-problem timing and severity.
Sleep data were available at both waves for 4460 (89.5%) children, of whom 22.6% (17.0% mild, 5.7% moderate/severe) had sleep problems at wave 2. From wave 1, 2.9% persisted and 2.8% developed a moderate/severe problem, whereas 10.1% resolved. Compared with no sleep problems, persistent and incident sleep problems predicted poorest health-related quality of life, behavior, language, and learning scores, whereas resolving problems showed intermediate outcomes. These outcomes also showed a dose-response relationship with severity at wave 2, with effect sizes for moderate/severe sleep problems ranging from -0.25 to -1.04 SDs. Cognitive outcomes were unaffected.
Sleep problems during school transition are common and associated with poorer child outcomes. Randomized, controlled trials could determine if population-based sleep interventions can reduce the prevalence and impact of sleep problems.