Article

The Influence of Sleep Quality, Sleep Duration and Sleepiness on School Performance in Children and Adolescents: A Meta-Analytic Review

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  • University of Applied Science Fresenius, Germany
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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.

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... Inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness can result in worse school performance (Dewald et al., 2010). This diminished academic functioning is likely the consequence of lessened alertness, decreased focus, and/or napping in class, making it challenging for thorough encoding of information presented throughout the school day (Dewald et al., 2010). ...
... Inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness can result in worse school performance (Dewald et al., 2010). This diminished academic functioning is likely the consequence of lessened alertness, decreased focus, and/or napping in class, making it challenging for thorough encoding of information presented throughout the school day (Dewald et al., 2010). Hysing et al. (2016) found adolescents receiving an average of 7-9 h of sleep per night more likely to earn the highest GPAs compared to adolescents who received an average of less than 5 h of sleep per night and earned significantly lower GPAs. ...
... Worse sleep hygiene prior to participating significantly predicted lower participant GPA, poorer organizational skills, and increased academic problems at program conclusion, which is consistent with previous research (Dewald et al., 2010;LeBourgeois et al., 2005;Lin et al., 2018). This is likely because poor sleep hygiene practices increase the probability of not receiving adequate quality and quantity of sleep and can consequently lead to more daytime sleepiness, diminished focus on tasks, reduced class engagement, and overall lowered academic performance (LeBourgeois et al., 2005;Lin et al., 2018). ...
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Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at heightened risk of experiencing academic difficulties due to organizational deficits. Impairment can be exacerbated through poor sleep hygiene and excessive daytime sleepiness, prevalent sleep challenges for adolescents with ADHD. Given established relationships among sleep, memory consolidation, and executive functioning, sleep hygiene and daytime sleepiness may affect academic and organizational treatment outcomes. The current study examined the influence of pre-treatment daytime sleepiness and sleep hygiene on academic and organizational treatment outcomes in a randomized controlled trial of a multicomponent intervention for 171 high school students with ADHD. Participants were assigned to either the treatment group (n = 85, Mage = 15.0, SD = 0.8, 80% male, 71% White/Non-Hispanic) or the control group (n = 86, Mage = 15.1, SD = 0.9, 78% male, 87% White/Non-Hispanic). Multiple regression analyses with an interaction term were conducted, finding significant main effects for poor pre-treatment sleep hygiene and excessive daytime sleepiness predicting worse post-treatment GPA, organizational skills, academic problems, and homework problems. A significant moderation effect was found such that greater pre-treatment daytime sleepiness was associated with more post-treatment homework problems, but only for the control group. Incorporating efforts to improve sleep hygiene and daytime sleepiness in interventions for adolescents with ADHD may enhance treatment-induced improvements. Future studies should utilize objective sleep measures to gain greater understanding of sleep’s impact on adolescents’ response to psychosocial treatment.
... [1][2][3] Sleep of adequate duration and quality, and at appropriate circadian times, is crucial for physical and mental health and learning. [4][5][6][7][8] strEngths AnD lIMItAtIons of thIs stuDy ⇒ This study will use a longitudinal design to comprehensively and prospectively examine the relative contributions of multiple sleep and circadian factors to academic performance and sleepiness, for 2 years during adolescence (age 12-13 to 14-15 years). ⇒ A multi-method approach will be used, including objective measurement of sleep timing via wrist actigraphy, gold-standard circadian phase assessments via salivary dim light melatonin onset, and assessment of light exposure using a sensor validated for measurement of melanopic illuminance. ...
... 23 24 A systematic review and meta-analysis showed that shorter sleep duration, poorer sleep quality, and greater sleepiness are each associated with poorer school performance, with sleepiness showing the strongest effect size among the three. 7 Most prior studies have been cross-sectional and measured sleep and/or academic performance subjectively. Longitudinal studies with objective measures are needed to quantify developmental changes in sleep and circadian timing, and to examine their prospective associations with adolescents' cognitive functions and academic performance. ...
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Background: During adolescence, sleep and circadian timing shift later, contributing to restricted sleep duration and irregular sleep-wake patterns. The association of these developmental changes in sleep and circadian timing with cognitive functioning, and consequently academic outcomes, has not been examined prospectively. The role of ambient light exposure in these developmental changes is also not well understood. Here, we describe the protocol for the Circadian Light in Adolescence, Sleep and School (CLASS) Study that will use a longitudinal design to examine the associations of sleep-wake timing, circadian timing and light exposure with academic performance and sleepiness during a critical stage of development. We also describe protocol adaptations to enable remote data collection when required during the COVID-19 pandemic. Methods: Approximately 220 healthy adolescents aged 12-13 years (school Year 7) will be recruited from the general community in Melbourne, Australia. Participants will be monitored at five 6 monthly time points over 2 years. Sleep and light exposure will be assessed for 2 weeks during the school term, every 6 months, along with self-report questionnaires of daytime sleepiness. Circadian phase will be measured via dim light melatonin onset once each year. Academic performance will be measured via national standardised testing (National Assessment Program-Literacy and Numeracy) and the Wechsler Individual Achievement Test-Australian and New Zealand Standardised Third Edition in school Years 7 and 9. Secondary outcomes, including symptoms of depression, anxiety and sleep disorders, will be measured via questionnaires. Discussion: The CLASS Study will enable a comprehensive longitudinal assessment of changes in sleep-wake timing, circadian phase, light exposure and academic performance across a key developmental stage in adolescence. Findings may inform policies and intervention strategies for secondary school-aged adolescents. Ethics and dissemination: Ethical approval was obtained by the Monash University Human Research Ethics Committee and the Victorian Department of Education. Dissemination plans include scientific publications, scientific conferences, via stakeholders including schools and media. Study dates: Recruitment occurred between October 2019 and September 2021, data collection from 2019 to 2023.
... For depressive adolescents, their intrusive and negative thoughts at bedtime may lead to delayed sleep onset and exacerbate insomnia symptoms (Hellberg et al., 2019). Ultimately, insomnia may reduce academic engagement because sleep is an optimal state of brain activity linked to neurocognitive functioning, which is crucial for one to maintain cognitive performance throughout the day (Dewald et al., 2010). Therefore, insomnia that reduces general alertness, impairs one's attention, and slows down cognitive processing (Alhola and Polo-Kantola, 2007), may finally lower academic engagement. ...
... Similar to depression, anxiety is a precursor for insomnia with growing worry and ruminative thinking during the pre-sleep period (Akram et al., 2019). This pre-sleep state arousal can subsequently cause insomnia (Cain and Gradisar, 2010) and ultimately reduce the academic engagement of adolescents (Dewald et al., 2010). ...
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Background During the COVID-19 pandemic, the transition of online learning introduces challenges for adolescents to engage in learning. The increased access and persistent Internet use could heighten the risk of problematic Internet use (PIU) that has been increasingly recognized as a risk factor for academic engagement. This study aims to investigate the direct and indirect relationships between PIU and academic engagement through psychopathological symptoms (i.e., depression, anxiety, insomnia) in early, middle, and late adolescence. Methods In all, 4852 adolescents (51.5% females; Mage = 13.80 ± 2.38) from different regions of Chinese mainland participated in the study and completed questionnaires. Results Depression and then insomnia as well as anxiety and then insomnia mediated the relationship between PIU and academic engagement. Anxiety exhibited a double-edged effect, that is, a positive relation with academic engagement directly and a negative relation with academic engagement indirectly through insomnia. Multigroup analyses showed that the indirect effects of PIU on academic engagement through depression and subsequent insomnia in middle and late adolescence were stronger than that in early adolescence, whereas the direct effect in early adolescence was stronger than that in middle adolescence. Limitation This study was cross-sectional in design and relied upon self-report measures. Conclusion These findings improve the understandings of how PIU relates to academic engagement through psychopathological symptoms and highlight developmental differences of adolescence.
... Actualmente, otro factor muy investigado por su influencia negativa sobre el sueño es el uso de dispositivos tecnológicos. Las tecnologías de la información y de la comunicación (TIC) son esenciales en la sociedad actual, sobre todo entre adolescentes (Díaz-Vicario et al., 2019;Rebelo-Pinto et al., 2014), pero su uso excesivo o inadecuado podría alterar los hábitos del sueño, retrasando su inicio (Scott et al., 2019) e incluso propiciar trastornos del sueño y de la atención (Hysing et al., 2015;Solari, 2015;Thomée et al., 2011), hiperactividad (Pérez-Lloret et al., 2013, así como la disminución del rendimiento académico (Dewald et al., 2010;Díaz-Vicario et al., 2019). ...
... La bibliografía evidencia que el uso de dispositivos tecnológicos hasta altas horas de la noche está relacionado con la alteración del horario y de la calidad de su sueño (Hysing et al., 2015) y con mayor somnolencia diurna (Dewald et al., 2010), dado que la luz de las pantallas estimulan el retraso de fase del ritmo circadiano y el inicio del sueño (Crowley et al., 2018). Estos hechos se constataron especialmente en las personas adolescentes mayores (15-16 años), quienes retrasaban más el inicio del sueño, tenían mayor uso de los dispositivos tecnológicos y se desconectaban más tarde, lo que pudo influir en la frecuente somnolencia en general. ...
Article
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Introducción. La higiene y la calidad del sueño se ha relacionado con el funcionamiento cognitivo en la adolescencia. El creciente uso de dispositivos tecnológicos puede afectar negativamente su sueño y rendimiento académico. Objetivo. Estudiar algunas variables que pueden estar implicadas en la higiene o alteraciones del sueño, uso de dispositivos tecnológicos y rendimiento académico, para detectar diferencias y asociaciones según edad y sexo. Metodología. Estudio descriptivo transversal en el que participaron 53 estudiantes entre 13-16 años que responden sobre su higiene de sueño y su uso de dispositivos tecnológicos. También se les aplicó el cribado de BEARS y la “Escala breve de ajuste escolar”. Sus padres informaron sobre calificaciones escolares y ejercicio físico de sus hijos. Resultados. Los principales resultados se observaron en adolescentes de 13-14 años, quienes presentaron más estrés (M = 4,33), consumo de bebidas estimulantes (M = 2,89) y problemas para dormir (50%). En general, hubo desfase significativo entre horas de dormir días escolares y fines de semana, acentuándose la diferencia con la edad. La somnolencia fue la alteración del sueño más referida (47%) y se asoció con desconexión más tardía de dispositivos electrónicos y menor duración del sueño. Las calificaciones, mejores en mujeres, correlacionaron con ajuste. Conclusiones. Las implicaciones teóricas del estudio podrían ser útiles para construir un modelo que aúne estas variables y las implicaciones prácticas para desarrollar propuestas de intervención socioeducativa enfocadas en mejorar la higiene del sueño y el uso a los dispositivos tecnológicos, a fin de minimizar su impacto negativo sobre el rendimiento académico.
... 15 In addition, screen time was found to correlate with sleep deprivation 25 especially with using screen in the hour before bed resulting in sleep disturbances. [25][26][27][28] In addition to screens, the perceived triggers and associations of headaches include school, smoking and lower socioeconomic classes, and depression. [28][29][30][31] In Brazil, 80.6% of adolescents aged 14 to 19 years using computers and videogames reported having headaches, including 17.9% TTH, 19.3% migraine, and 43.4% undifferentiated headache. ...
... [25][26][27][28] In addition to screens, the perceived triggers and associations of headaches include school, smoking and lower socioeconomic classes, and depression. [28][29][30][31] In Brazil, 80.6% of adolescents aged 14 to 19 years using computers and videogames reported having headaches, including 17.9% TTH, 19.3% migraine, and 43.4% undifferentiated headache. Screen use was associated with a 20% more headaches especially migraines. ...
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Background Headache is a common symptom affecting children and adolescents. The medical literature over the last three decades reveals a variable prevalence and triggers in different countries, regions, circumstances and times. This study aims to assess the prevalence, frequency and quality of headaches in the Lebanese adolescent population under the COVID-19 confinement and study its triggers and relationship to screen time, self-reported anxiety, and sleep. Methods A cross sectional design was used to collect two survey results by snowball distribution using social media targeting adolescents aged 15 to 17 years of age. The first survey included 13 questions with a single best answer about screen time, feeling anxious, sleep time, schedule and consistency, and headaches. The second survey included 3 questions about the quality of the headaches, anxiety and its triggers. Results Among 433 responders to the first survey, the prevalence of headaches, especially pressure points and band-like pressure was higher than any previously reported among adolescents in the literature, reaching 93.4%. Screen time was also higher than any previous reports with 95.6% spending 9 hours or more on screen while 64% of adolescents spending at least 12 hours a day on screen. In addition, the majority (82%) don't have consistent sleep habits and 41.8% consider themselves anxious. School was considered the main source of stress by 82.8% of the responders. The frequency of headache correlated significantly with increased screen time, self-reported anxiety and inconsistent sleep habits. Conclusions Headaches among adolescents are associated with increased screen use, sleep disorders, and self-reported anxiety. It is one of the primary somatization symptoms in this group expressing their extreme stress under the current economic, political, and health crisis. The present trends are likely to have major long term implications on adolescents’ health and academic achievements and should alarm educators and health officials to intervene in this situation.
... can be conceptualized as a consequence of sleep disorders but also because it is an easily observable behavior in the school context (Holdaway and Becker, 2018). In addition, EDS was more associated with school functioning than other sleep disorders (Dewald et al., 2010). Therefore, studying daytime sleepiness and its impact on children's other behaviors (e.g., prosocial behaviors), as well as the mediating and moderating mechanisms in this relationship, might help us better understand children's behaviors in school context and further help us develop some possible intervention programs. ...
... Thus, in turn, this increases the child's distress and does not facilitate the good social adjustment of the child in the class context, thus leading to fewer prosocial behaviors. In addition, children with EDS may present themselves as tired and socially unresponsive; they may also have internalizing disorders (Astill et al., 2012;Reynaud et al., 2018) and difficulties in a cognitive performance (Dewald et al., 2010), thus demonstrating less autonomy and making the student appear more dependent on the teacher. Children with much dependency on the teacher tend to present internalizing symptoms and avoid class activities, which results in greater rejection by their peers and prevents students from having more social interactions. ...
Article
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High sleep quality is an important indicator of children’s development as well as their good health. The aim of this study was to examine the relationship between excessive daytime sleepiness (EDS) and prosocial behaviors in kindergarten-aged children, as well as exploring the possible mediating role of the teacher-student relationship underlying them. Participants included 60 teachers aged from 23 to 62 (M = 47.9, SD = 9.73) in Italy who completed the student-teacher relationship scale, the daytime sleepiness questionnaire, and the strength and difficulties questionnaire. The children who were rated by teachers were 936 kindergarten children aged from 3 to 6 (M = 4.20, SD = 0.91). The results showed that children’s daytime sleepiness significantly predicted all three dimensions of the student-teacher relationship. Specifically, children’s EDS negatively predicted closeness and positively predicted conflict and dependence, and furthermore, these three dimensions of the relationship significantly predicted children’s prosocial behaviors. For older children in our sample, their EDS was more significantly and positively associated with conflict in their relationship with teachers. Our data seem to support the importance of good teacher-student relationship quality in promoting a child’s positive social adjustment, especially in children with behavioral difficulties. Our data also suggest the importance of evaluating the quality of the student-teacher relationship as well as the sleep quality in the children’s daytime sleepiness.
... En esa línea, Cain y Gradisar (2010) y Hale y Guan (2015) concluyen que el empleo y exposición a medios electrónicos tiene un impacto en la calidad de sueño. De otro lado, un estudio de meta-análisis desarrollado por Dewald et al. (2010) evaluó la relación de la calidad y duración del sueño con el rendimiento académico, encontrando que existe una relación significativa pero con tamaño de efecto moderado. No se han encontrado otras investigaciones de tipo revisión o meta-análisis que hayan abordado la variable calidad de sueño. ...
... En la revisión efectuada se observan distintas variables asociadas al estudio de la calidad de sueño. Sin embargo, todavía resultan escasos para realizar revisiones o trabajos de meta-análisis como los señalados en la investigación (Cain & Gradisar, 201;Dewald et al., 2010;Hale & Guan, 2015). Lo que no se puede negar, es la existencia de producción científica en lo que respecta a la calidad de sueño, lo que concuerda con la sugerencia que la producción latinoamericana aparentemente suele reportarse en revistas de la región (Gantman, 2011). ...
Article
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Este estudio buscó describir la literatura científica con relación a la calidad de sueño en escolares y universitarios. Para tal fin, se realizó un estudio de revisión sistemática, identificándose mediante la combinación de palabras clave, investigaciones empíricas publicadas en revistas científicas indizadas a la Biblioteca Científica Electrónica en Línea Scielo y al Sistema de Información Científica RedALyC, en el periodo 2001-2016. La revisión incluyó 29 artículos, codificándose distintas características. Los hallazgos revelan el liderazgo de Perú y Brasil en la institución de filiación del autor principal y en el país de edición de las revistas que publican mayor cantidad de trabajos. Asimismo, la mayoría de las publicaciones se reportaron en revistas del área médica, observándose un incremento de las publicaciones a partir del año 2011. Por su parte, el análisis de la colaboración indica la presencia de la autoría múltiple en la mayoría de los trabajos, siendo esta de tipo nacional e institucional. De igual forma, se identifican que todos los trabajos siguieron metodología cuantitativa, adoptando preferentemente la estrategia asociativa. Así también, la mayoría de las investigaciones tuvieron como muestra a universitarios, emplearon como instrumento el Índice de calidad de sueño de Pittsburg y reportaron el cumplimiento
... Adolescents who continuously experience sleep disorders show increases in cortisol secretion [7]. This reduces memory and leads to a lack of concentration, which adversely affects their academic performance [8]. Healthy sleep habits in adolescence are very important because insufficient sleep during adolescence is likely to have a negative effect on adulthood [9]. ...
Article
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The purpose of this study was to analyze the relationship between smartphone addiction and sleep satisfaction in 54,948 Korean adolescents. This study utilized the Korea Youth Risk Behavior Web-Based Survey (KYRBS). The dependent variable was sleep satisfaction. Independent variables were smartphone addiction level and usage time. Gender, school grade, stress, depression, regular physical activity (PA), asthma, allergic rhinitis, and atopic dermatitis were selected as confounding variables. A chi-squared test, logistic regression, and independent t-test were performed for data analysis. As a result of the chi-squared test, sleep satisfaction showed significant relationships with all confounding variables (all p < 0.001). As a result of adjusting all confounding variables, sleep satisfaction of smartphone normal users was significantly higher (odds ratios: 1.372, p < 0.001) than that of high-risk users with smartphone addiction. Smartphone users with a daily smartphone usage time from 2 h to 8 h a day were 1.096–1.347 times (p = 0.014 to p < 0.001) more likely to be satisfied with their sleep than smartphone users with a daily smartphone usage time over 8 h, who were unsatisfied with their sleep. The group that was not satisfied with their sleep had a significantly higher average daily smartphone usage time and total score on the smartphone addiction scale than the group that was satisfied with their sleep (both p < 0.001). In conclusion, it will be necessary to manage the use of smartphones to improve the sleep satisfaction of Korean adolescents.
... Eine Verschlechterung der Schlafqualität kann mit einem Defizit in der Konzentrationsfähigkeit, Stress und schlechterem psychischen Wohlbefinden in Verbindung gebracht werden [14][15][16][17][18]. Die Studienergebnisse sprechen dafür: Die Studierenden mit einer schlechten Schlafqualität arbeiteten im Durchschnitt etwa eine Stunde mehr für ihr Studium als gut schlafende Studierende. ...
Article
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IntroductionThe restorative effects of sleep are essential for physical, cognitive, emotional, and behavioral daily performance in college. In addition to the stress of everyday student life, the use of screen devices at the forefront of pandemic-related online teaching is also increasing dramatically. Particularly during evening and nighttime hours, increased screen use may contribute to physical, psychological, and cognitive activation, which in turn may negatively affect students’ sleep quality.Methods To determine possible associations between screen use in online teaching and its effects on sleep hygiene and quality, 216 students at Magdeburg-Stendal University of Applied Sciences anonymously and voluntarily participated in the online survey in May 2021. The positive ethics vote is available.ResultsThe general sleep quality of the student body can be rated as poor in 68.9% (n = 149) of the surveyed students. In particular, students who worked predominantly on screen devices in the evening or at nighttime for their studies, and thus had a chronobiological tendency to be a night person, tended to have poorer sleep.DiscussionThe effects of long screen time in the evening and nighttime hours can have far-reaching consequences on sleep patterns and awareness of physical needs for breaks and sleep. Online teaching in times of the COVID-19 pandemic in particular led to an increase in screen time alongside equally high levels of personal use. This could result in a continued negative impact on sleep hygiene and quality, not only at the expense of daytime concentration and performance but rather of physical and mental health.
... The negative influences of sleep problems on academic performance have also been reported in both children and college students, even though the mechanisms underlying the relationships remain to be explored. It has been widely observed that various sleep-related measures, such as sleep duration and sleep quality, are associated with academic performance [23,[31][32][33], indicating the importance of normal sleep patterns in school education. ...
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Although the relationship between sleep and academic performance has been extensively examined, how sleep predicts future academic performance (e.g., 2–3 years) remains to be further investigated. Using wearable smartwatches and a self-report questionnaire, we tracked sleep activities of 45 college students over a period of approximately half a month to see whether their sleep activities predicted their academic performance, which was estimated by grade point average (GPA). Results showed that both nighttime sleep awakening frequency and its consistency in the tracking period were not significantly correlated with the GPA for the courses taken in the sleep tracking semester (current GPA). However, both nighttime sleep awakening frequency and its consistency inversely predicted the GPA for the rest of the courses taken after that semester (future GPA). Moreover, students with more difficulty staying awake throughout the day obtained lower current and future GPAs, and students with higher inconsistency of sleep quality obtained lower future GPA. Together, these findings highlight the importance of nighttime sleep awakening frequency and consistency in predicting future academic performance, and emphasize the necessity of assessing the consistency of sleep measures in future studies.
... Another aspect of sleep is the feeling of being tired or sleepy during the day. According to a meta-analysis, this daytime sleepiness has shown higher correlations to school performance than sleep quality and sleep duration [30]. This indicates that feelings of sleepiness might be partly independent from the actual sleeping time but still have an impact on self-regulation [26]. ...
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Sleep and Attention-Deficit/Hyperactivity Disorder (ADHD) have repeatedly been found to be associated with each other. However, the ecological validity of daily life studies to examine the effect of sleep on ADHD symptoms is rarely made use of. In an ambulatory assessment study with measurement burst design, consisting of three bursts (each 6 months apart) of 18 days each, 70 German schoolchildren aged 10–12 years reported on their sleep quality each morning and on their subjective ADHD symptom levels as well as their sleepiness three times a day. It was hypothesized that nightly sleep quality is negatively associated with ADHD symptoms on the inter- as well as the intraindividual level. Thus, we expected children who sleep better to report higher attention and self-regulation. Additionally, sleepiness during the day was hypothesized to be positively associated with ADHD symptoms on both levels, meaning that when children are sleepier, they experience more ADHD symptoms. No association of sleep quality and ADHD symptoms between or within participants was found in multilevel analyses; also, no connection was found between ADHD symptoms and daytime sleepiness on the interindividual level. Unexpectedly, a negative association was found on the intraindividual level for ADHD symptoms and daytime sleepiness, indicating that in moments when children are sleepier during the day, they experience less ADHD symptoms. Explorative analyses showed differential links of nightly sleep quality and daytime sleepiness, with the core symptoms of inattention and hyperactivity/impulsivity, respectively. Therefore, future analyses should take the factor structure of ADHD symptoms into account.
... Other studies have suggested that children whose average sleep duration, as measured via actigraphy, was short (<7.7 h), demonstrated a higher hyperactivity/impulsivity score as well as a higher attention-deficit/hyperactivity disorder total score but a similar inattention score compared with children sleeping more than 9.4 h (Paavonen et al., 2009). Furthermore, inadequate sleep has been linked to poor school performance (Dewald et al., 2010;Astill et al., 2012), and an increase in behavioral problems such as attention deficit, and emotional conditions such as anxiety and depression (Gregory and Sadeh, 2012;Maski and Kothare, 2013). In a longitudinal study, shorter sleep duration in children between 2.5 and 6 years old age range was associated with high levels of hyperactivity and engagement in disruptive behavior at school (Touchette et al., 2008(Touchette et al., , 2009. ...
Article
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Adequate sleep especially during developmental stages of life, is considered essential for normal brain development and believed to play an important role in promoting healthy cognitive and psychosocial development, while persistent sleep disturbances and/or sleep deprivation during early life are believed to trigger many mental ailments such as anxiety disorders, depression, and cognitive impairment. Initially it was suggested that adverse mental health conditions adversely affect sleep, however, it is now accepted that this association is bidirectional. In fact, sleep disturbances are listed as a symptom of many mental health disorders. Of special interest is the association between early life sleep deprivation and its negative mental health outcomes. Studies have linked persistent early life sleep deprivation with later life behavioral and cognitive disturbances. Neurobiological underpinnings responsible for the negative outcomes of early life sleep deprivation are not understood. This is a significant barrier for early therapeutic and/or behavioral intervention, which can be feasible only if biological underpinnings are well-understood. Animal studies have provided useful insights in this area. This article focusses on the knowledge gained from the research conducted in the area of early life sleep deprivation, brain development, and behavioral function studies.
... Sleep quality is also associated with academic achievement [38] and internet usage appears to be a mechanism in that relationship [39]. ...
... This study set out to capture a broad picture of correlations between sleep and anxiety in children in the UK over the COVID-19 lockdown, and as such we For example, self-reported sleepiness has been shown to be a stronger predictor of school performance than sleep duration in children and adolescents [39]. Other difficulties include the relatively high SES of the sample, and its self-selecting nature, especially at Phase 2. While we were not able to consider the internal reliability of our questionnaire (in the interests of brevity), we do see indications of reliability with strong correlations between responses at Phase 1 and Phase 2 (see Additional file 2: Table A3), and strong correlations between self-reported daytime sleepiness and whether children felt they were getting enough sleep at both Phase 1 and Phase 2. ...
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Background: Sleep and mental wellbeing are intimately linked. This relationship is particularly important to understand as it emerges over childhood. Here we take the opportunity that the COVID-19 pandemic, and resulting lockdown in the UK, presented to study sleep-related behaviour and anxiety in school-aged children. Methods: Parents and children were asked to complete questionnaires towards the start of the UK lockdown in April-to-May of 2020, then again in August of that year (when many restrictions had been lifted). We explored children's emotional responses to the pandemic and sleep patterns at both time points, from the perspectives of parents and children themselves. Results: Children's bedtime anxiety increased at the start of the lockdown as compared to a typical week; however, by August, bedtime anxiety had ameliorated along with children's COVID-19 related anxiety. Bedtime anxiety predicted how long it took children to fall asleep at night at both the start and the end of the lockdown. Bedtime and wake-up time shifted at the start of lockdown, but interestingly total sleep time was resilient (likely owing to an absence of early school start times) and was not predicted by child anxiety. Conclusions: These findings further support calls for sleep quality (in particular, time taken to fall asleep) to be taken as a key indicator of mental health in children, particularly under usual circumstances when schools are open and sleep duration may be less resilient.
... Although the four scenarios are possible, we know that: 1-Argentinian adolescents exhibit later chronotypes than adolescents from other countries 7,8,53,[64][65][66] , and their baseline chronotypes are particularly late; and 2-school timing, as a social cue, has been shown to modulate chronotype 54,57 . Consistently, we think that the independent association of both school timing and baseline chronotype will better explain the age-related changes in chronotype (i.e. ...
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The misalignment between late chronotypes and early school start times affect health, performance and psychological well-being of adolescents. Here we test whether, and how, the baseline chronotype (i.e. chronotype at the beginning of secondary school) and the school timing affect the magnitude and the direction of the developmental change in chronotype during adolescence. We evaluated a sample of Argentinian students (n = 259) who were randomly assigned to attend school in the morning (07:45 a.m.–12:05 p.m.), afternoon (12:40 p.m.–05:00 p.m.) or evening (05:20 p.m.–09:40 p.m.) school timings. Importantly, chronotype and sleep habits were assessed longitudinally in the same group of students along secondary school (at 13–14 y.o. and 17–18 y.o.). Our results show that: (1) although chronotypes partially align with class time, this effect is insufficient to fully account for the differences observed in sleep-related variables between school timings; (2) both school timing and baseline chronotype are independently associated with the direction and the magnitude of change in chronotype, with greater delays related to earlier baseline chronotypes and later school timings. The practical implications of these results are challenging and should be considered in the design of future educational timing policies to improve adolescents’ well-being.
... Although a strong relationship has been found between sleep duration and EF, it is unclear whether other types of sleep parameters (i.e., sleep rhythmicity, daytime sleepiness) may affect EF in children. For example, in a meta-analytic review of research on sleep and academic performance in children, Dewald et al. (2010) found that daytime sleepiness was significantly correlated to poor academic achievement. Daytime sleepiness may be a result of sleep duration; however, they are different sleep parameters. ...
Thesis
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The current study investigated the relationship among sleep parameters, executive functioning, and behavioral problems in school-aged children. One hundred twenty school-age children (6-10 years old) participated in the week-long study. Children’s executive functioning was assessed using tasks that measure inhibition, set shifting, and updating. Parents completed a one-week sleep diary for their child, the Pediatric Sleep Questionnaire (PSQ), and the Child Behavioral Checklist (CBCL). Data were collected and multiple regression analyses were conducted to determine the relationships between sleep, executive function, and behavior problems. Daytime sleepiness predicted inhibition. Mediation analyses were used to examine whether executive functions (i.e., set shifting, inhibition, and updating) mediated the relationships between sleep parameters (i.e., sleep duration, sleep difficulties, daytime sleepiness, and sleep rhythmicity) and behavioral problems (i.e., externalizing and internalizing behaviors). Both daytime sleepiness and sleep difficulties predicted more externalizing and internalizing problems. Executive functions did not mediate the relationship between sleep variables and behavior problems. Exploratory analyses investigated the relationship between the individual sleep parameters, inattention, and behavior problems. Inattention mediated the relationship between daytime sleepiness and externalizing behaviors in children. The findings in this study demonstrate the importance of investigating individual sleep parameters as they relate to other factors, instead of aggregating sleep parameters into a total sleep problems score. Implications and future research directions were discussed.
... The literature has well documented the incompatibility between adolescents' sleep patterns and morning school schedules 1,2 . Its more evident consequence is chronic sleep deprivation associated with a negative impact on academic performance 3,4 . Already discussed and implemented countermeasures have focused on reducing these undesirable consequences 5 . ...
Article
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Objective: To investigate the occurrence of daytime sleepiness and associated sleep factors in a sample of elementary school students who attended school in the afternoon schedule. Methods: Sleep data from 363 Brazilian public school students (12.78 ± 1.36 years, 206 girls) were obtained by applying questionnaires in classrooms. All subjects attended school in the afternoon schedule, with classes starting between 1:00 and 1:20 p.m. Daytime sleepiness was assessed by the pediatric daytime sleepiness scale; sleep quality, by the mini-sleep questionnaire; and sleep patterns and chronotypes, by the Munich chronotype questionnaire. Scores equal to or greater than 15 pediatric daytime sleepiness scale points were considered as excessive daytime sleepiness. The predictive power of sleep variables on daytime sleepiness was evaluated by a multiple linear regression. Results: The subjects in the sample had an average time in bed greater than nine hours both on school days and on weekends. Nevertheless, 52.1% had an average pediatric daytime sleepiness scale score equal to or greater than 15 points, indicative of excessive daytime sleepiness. As for their quality of sleep, 41.1% had a very altered sleep. We observed, by a multiple linear regression, that quality of sleep (β = 0.417), chronotype (β = 0.174), mid-sleep on school days (β = 0.138), and time in bed (β = - 0.091) were all significant in predicting daytime sleepiness. Conclusion: This study showed the occurrence of excessive daytime sleepiness in non-sleep deprived students who attended school in the afternoon. The worst quality of sleep and eveningness had a greater predictive power on daytime sleepiness than time in bed. Therefore, we must consider other factors in addition to sleep duration when planning interventions for daytime sleepiness.
... Some experimental studies also find that adolescents who are assigned to sleep restriction conditions do not perform worse in EF tasks than those in non-restriction conditions (Beebe et al., 2019;Suppiah et al., 2016;Voderholzer et al., 2011). The inconsistent findings regarding sleep and EF could be a result of the specific measures of sleep and EF that have been used across studies (Dewald et al., 2010;Reynaud et al., 2018). However, the variation in findings across these variable-focused investigations could also be due to unassessed but meaningful variation in person-specific sleep needs or reactivity to sleep changes (Banks & Dinges, 2007;Belenky et al., 2003;Van Dongen et al., 2003). ...
Article
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Executive functioning (EF) is a series of fundamental goal-directed cognitive abilities that enable effective learning. Differences in daily sleep quality may covary with fluctuations in EF among youth. Most studies linking sleep to EF rely on between-person differences and average effects for the sample. This study employed an intensive longitudinal design and examined the within-person relations between self-reported prior night’s sleep quality and next day’s EF. Students from Grades 4 to 12 (M age= 14.60, SD = 2.53) completed three behavioral EF tasks repeatedly across approximately one semester. The final analytic sample included 2898 observations embedded in 73 participants. Although, on average, sleep did not significantly covary with EF, there was heterogeneity in within-person sleep-EF relations. Moreover, individuals’ average sleep quality moderated within-person effects. For individuals with low mean sleep quality, a better-than-usual sleep quality was linked to better EF performance. However, for individuals with high mean sleep quality, better-than-usual sleep quality was linked to worse EF performance. Understanding person-specific relations between sleep and EF can help educators optimize EF and learning on a daily basis and produce positive academic outcomes across longer time periods.
... 11,12 It is well-documented throughout various studies, that sleeping is a necessary requirement for optimal cognitive and physical functioning. 13,14 It is believed that regular disturbances to an adolescent's sleep cycle might increase the risk of physical and mental issues. 15 Sleep deprivation among adolescents has probably always occurred due to the hormonal influence within the body for that age demographic. ...
Technical Report
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This report was written by the adult researchers, with contributions from young people from the country panels. It aims to draw together and reflect upon the learning from the project, as well as signposting to a wider range of project resources. In what follows, we provide an overview of key themes and messages from the study, foregrounding young people’s research and their creative and artistic work. We then go on to examine the role of the PAR within the project and how this shaped the ways in which evidence was produced and analysed. Finally, we present a set of recommendations for three main sets of key stakeholders. When the project started in April 2020, the impacts of the COVID-19 pandemic were yet to be tested. Since this time, the research evidence base has grown considerably. It is now well established that the crisis has had significant, far-reaching impacts on young people’s education (Blaskó & Schnepf, 2021, OECD, 2021), their physical and mental health and wellbeing (Carroll et al., 2020; Loades et al., 2020; Duan et al., 2020 Gadermann et al., 2021), and their family lives and peer relationships (Biroli et al, 2020; Branquinho et al, 2020; Lebow et al, 2020; Cluver et al, 2020). There is also stark evidence that it is often young people with pre-existing vulnerabilities, including from families experiencing poverty or violence and young people with special educational needs and disabilities for whom the effects of the crisis have been felt the most (Crawley et al, 2020; Gupta & Jawanda, 2020; Imran et al, 2020; Rosenthal et al, 2020; Thorisdottir et al, 2021).
... Students' readiness to learn, which refers to students' physiological readiness and prerequisite knowledge to engage in the content, is another crucial student context factor F o r P e e r R e v i e w KEY CONTEXTUAL FACTORS OF DIGITAL READING affecting reading suggested by the PIRLS 2016 assessment framework. It was found that nutritional problems seriously affected children's ability to learn and sleep deprivation was associated with lower achievement (Dewald et al., 2010;Taras, 2005). However, it should be noted that despite being student context factors, these factors might overlap students' home context factors such as students' family socioeconomic status (SES). ...
Article
Few of previous reading studies comprehensively examined the contributing factors of students’ digital reading literacy. To fill this gap, based upon the ecological perspective, this study aims to investigate which factors from the student, home, and school context are more important in discriminating high-performing digital readers from non–high-performing digital readers. The data of the Progress in International Reading Literacy Study 2016 with 74,692 Grade 4 students from 14 countries and economies was analyzed using the machine learning approach of support vector machine with recursive feature elimination. Results showed that except print reading levels, students’ reading self-efficacy, home resources for learning, talking about what have read in class, and the number of books in the home are the most influential contextual factors contributing to the high performance of digital readers. The selected 20 key contextual factors render a high prediction power for discriminating digital readers. Our findings show that, in general, home-related factors have overarching influences on children’s digital reading development; at the school level, instruction-related features are more influential than school characteristics.
... Esta relación parece ser bidireccional de forma que el nivel educativo afecta a la calidad de sueño y una mala calidad de sueño puede, a su vez, influir en un peor desempeño educativo. Investigaciones previas han demostrado el papel que juega el sueño en la consolidación de los recuerdos, el aprendizaje, el rendimiento cognitivo o los niveles de atención (Cain et al., 2011;Lowe et al., 2017), de forma que un sueño de pobre calidad se relaciona significativamente con un menor rendimiento académico (Dewald et al., 2010;Hysing et al., 2016). El sueño está considerado hoy en día uno de los tres pilares fundamentales de la salud junto con la dieta y el ejercicio físico. ...
... Healthy sleep is comprised of related, yet distinct, variables including adequate duration, perceived sleep quality, appropriate timing of sleep and the absence of diagnosable sleep disorders (1). Multiple aspects of childhood sleep are linked to important long-term consequences across health and development, including obesity, mood, cognitive development, academic performance, and social adjustment (2)(3)(4)(5)(6)(7)(8). Subsequently, there is increasing evidence that chronic insufficient sleep is associated with elevated mortality risk (9). ...
Preprint
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Context: Socioeconomic status (SES) is increasingly understood to be a key contributor to sleep health, but the research in childhood has not been synthesized.Objective: To examine the associations between indicators of child SES and child sleep (≤18 years old), we conducted a systematic review and meta-analyses. Data Sources: CINAHL with Full Text, PsycINFO, and MEDLINE/PubMed were searched using terms to define SES and childhood to ascertain all relevant, peer-reviewed articles from database inception to 27 December 2019.Study Selection: Studies were included if an association between an indicator of parental SES and a measure of child sleep (duration, quality, and problems) was reported. Data Extraction: Data was extracted from 46 studies (N=72,915). Across these studies, total sample size across participants included in the meta-estimate was N=69,373. Results: Higher parental education was associated with longer childhood sleep duration (stronger in samples with a higher proportion of White children) and better sleep quality. Parental education was not directly associated with child sleep problems; moderation occurred by continent and the relationship was more pronounced in the Asian meta-estimate. Higher household income was not directly associated with longer childhood sleep duration, but moderation occurred by higher quality studies and the proportion of White children in the sample. Higher household income was associated with fewer sleep problems (moderated by continent) and higher sleep quality. Limitations: This review was limited by the number and methods of available published studies meeting inclusion criteria.Conclusions: Preventative programs that emphasize improvements in sleep of children and adolescents growing up in lower SES families are needed.
... Short sleep duration can result in poor mental and somatic health, and poor academic performance in adolescents [1,2]. According to the sleep recommendation by the US National Sleep Foundation, adolescents aged 14-17 years should obtain 8-10 h of sleep each night [3]. ...
Article
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Background Adolescents are recommended to get 8–10 h of sleep at night, yet more than 80% fail to obtain this goal. Energy drink (ED) consumption has been linked to later bedtime in adolescents. Therefore, we aimed to investigate the potential association between ED consumption and sleep duration, and shuteye latency among adolescents in Norway. Methods This study was based on data from 15- to 16-year-old adolescents living in Oppland County in 2017. In total, 1353 adolescents were included in the analysis. Multiple regression models were used to estimate the associations between the frequency of ED consumption with sleep duration, shuteye latency, and getting 8 h of sleep. Results Forty-six point five percent of the adolescents reported sleeping more than 8 h at night. Those who reported ED consumption at any frequency had significantly shorter sleep duration than those who did not. On average, high consumers of ED (consuming ED ≥ 4 times a week) had 0.95 (95% CI: 0.61, 1.28) hours (i.e., 57 min) less sleep than those who never consumed ED. In addition, high consumers had more than 25 min (95% CI: 13.95, 36.92) longer shuteye period than those who never consumed ED. Conclusion Most ED consumers fail to obtain the recommended 8 h of sleep at night, which could be a consequence of shorter sleep duration and longer shuteye latency. We found a dose-response relationship between frequency of ED consumption and reduced sleep. Yet, the potential long-term effects of both ED consumption and insufficient sleep among adolescents remain unclear.
... Intrinsic to this sense of rest and satisfaction is also the concept of sleep hygiene, which portraits a variety of different practices and habits that are necessary to have good quality of nocturnal sleep and allow for daytime alertness. The amount of sleep is a bigger influence on the possibility of daytime sleepiness, changes in emotional state, behavioral and cognitive functions 13 . ...
Article
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Introduction: Sleep is a physiological necessity that interferes with the activity during the day. This study aimed to analyze child perception about sleep quality and compare it with parent's perception about the quality of their children's sleep, and to investigate the sleep quality of Portuguese schoolchildren. Analyze the differences between the sexes and the type of school attended. Material and Methods: Cross-sectional study, quantitative methodology. The results of two questionnaires, the Pittsburgh sleep quality index (PSQI) answered directly by the children, and the children's sleep habits questionnaire (CSHQ), answered by the parents of 883 children, were analyzed and compared. Results: PSQI reveals good sleep quality, which contradicts the results of CSHQ. The CSHQ indicates a mean sleep deterioration index (IPS) value of 46.12 (above the cutoff point, 44) indicating that on average the children in this sample have poor sleep quality. There is no significant difference between girls and boys regarding IPS. There is a significant difference in the level of daytime drowsiness (p=.018), girls wake up moodier (p=.011), have more difficulty getting out of bed in the morning (p=.019), and take longer to fully awaken than boys (p=.004). Conclusion: The data show that children seem to have poor sleep quality and that they erroneously evaluate it, but these same data should be read with caution since the reason for the different perception between parents and children is not known.
... Memory consolidation and learning, which are essential for success at school and at work, are processes developed during sleep [ 1 , 2 ]. According to Dewald, sleep problems (inadequate sleep duration, poor sleep quality, and sleepiness) may impair neural development, emotional regulation, processing speed and prevent memory consolidation, affecting cognitive functions and academic performance [3] . ...
Article
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Purpose : The aim of this study was to systematically review the literature about the relationship between sleep duration and cognitive, academic and socioeconomic outcomes. Methods : We performed a systematic search in PubMed, Psyinfo, Scopus, Web of Science, ERIC, and Socindex up to June 2022, independently by two researchers. Original studies testing the association between sleep duration (as exposure) and academic, cognitive and socioeconomic variables (as outcomes) among all age groups in population-based studies were included. We excluded studies assessing participants with specific diseases or specific populations. Quality assessment was evaluated considering three domains: internal validity, study design, and adjustments. Results : After the study selection process, a total of 56 manuscripts were selected. Most studies were from high-income countries with a large variability of instruments and cutoff points to measure sleep duration and outcomes. Cognitive outcomes were evaluated in 35 manuscripts, academic outcomes in 22, and socioeconomic outcomes in one. Long sleep seems to be associated with poor cognitive outcomes in older adults. In contrast, short sleep duration seems to be associated with poor cognitive and school outcomes among children and adolescents. Studies evaluating cognition in children and adolescents and academic outcomes presented lower scores in the quality assessment. Conclusion : More well designed and well-adjusted studies evaluating cognitive and academic outcomes in children, adolescents, and mainly, in adult population are necessary. Furthermore, studies from low- and middle- income countries, evaluating sleep duration and exploring the relationship between sleep duration as exposure variable and human capital characteristics as outcomes variables should be included in the research agenda.
... Sleep is a relevant factor for the healthy development of children and adolescents and, due to the regenerative processes associated with it, is central for health and wellbeing. Sufficient and undisturbed sleep is essential for cognitive functioning and performance [1][2][3] and is positively associated with academic performance in children and adolescents (for an overview, see [3][4][5]). Physical parameters, such as, for example, overweight/obesity and cardiovascular risk factors (e.g. ...
Article
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Sleep is a relevant factor for functioning and well-being of young people. The paper provides a differentiated description of sleep difficulties in this population group including social, health-related, and environmental factors. The analyses included n=6,728 11- to 17-year-olds of the KiGGS baseline study (2003-2006) and 6,072 young adults (age 18-31), who provided information relating sleep in the survey KiGGS Wave 2 (2014-2017). Information from 3,567 people was evaluated at two survey points. 22.0% of the 11- to 17-year-olds reported sleep difficulties. A significant impact for the sex (female), living with a single parent, and with siblings is reflected in the logistic regression. The risk for sleep difficulties increases significantly in the case of mental problems and pain. Among the 18- to 31-year-olds, 19.6% complained of difficulties falling asleep and sleeping through the night. In addition to sex, noise exposure, a low level of education, the professional situation, and living with children were reflected as important influencing factors in the logistic regressions. Over one third of those, who suffered from sleep problems as children and adolescents, also indicated sleep difficulties almost ten years later. The high prevalence of sleep problems and the associated health risks illustrate the high public health relevance of the topic. In addition to sex, health-related and environmental variables also turned out to be significant and need to be considered in the development of interventions.
... 11,12 It is well-documented throughout various studies, that sleeping is a necessary requirement for optimal cognitive and physical functioning. 13,14 It is believed that regular disturbances to an adolescent's sleep cycle might increase the risk of physical and mental issues. 15 Sleep deprivation among adolescents has probably always occurred due to the hormonal influence within the body for that age demographic. ...
Article
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Background: This study evaluated the effect of the school-based intervention Charge Your Brainzzz on adolescents' social-cognitive determinants, sleep hygiene and sleep duration and quality. Methods: A cluster-randomized controlled trial was conducted with 972 students from 10 Dutch high schools. Schools were randomly allocated to the intervention (N = 5) or control condition (N = 5). Outcomes were measured with the digital Consensus Sleep Diary and via a digital questionnaire, based on valid measures. Data were collected at baseline (T0), ±1.5 weeks post-intervention (T1) and ±3 months post-intervention (T2). Mixed model analyses were performed to estimate the effects on social-cognitive determinants, sleep hygiene, and sleep outcomes. Results: The intervention increased sleep knowledge post-intervention (b = 1.91; 95%CI: 1.22-2.60) and at follow up (b = 1.40; 95%CI: 0.70-2.10). The intervention was also effective in changing adolescents' attitudes (b = 0.10; 95%CI: 0.01-0.19) and perceived behavioral control (b = 0.11; 95%CI: 0.01-0.22) post-intervention. No positive changes were found regarding subjective norms, behavioral intentions, sleep hygiene, or sleep outcomes. Conclusions: The intervention improved adolescents' sleep knowledge, attitude, and perceived behavioral control. To significantly impact sleep health, theoretically sound and systematically developed interventions are needed which take into account the interplay between sleep, sleep-related behaviors, and adolescents' social and physical environment. Clinical trial registration: Trial name: Evaluation of the school-based intervention Charge Your Brainzzz promoting sleep in adolescents; URL: https://doi.org/10.1186/ISRCTN36701918; ID: ISRCTN36701918.
Article
Childhood sexual abuse has pervasive effects on well-being and psychosocial functioning in children and adolescents, including negative impacts on sleep. This study aimed to systematically review and assess the literature documenting associations between childhood sexual abuse and sleep in minors (0-18 years old) and provide recommendations for future studies and clinical practice. A systematic search was conducted independently by two researchers in six databases. Inclusion criteria included English or French published articles and dissertations/theses/abstracts reporting original quantitative data examining at least a bivariate association between childhood sexual abuse and sleep. A total of 5031 titles and abstracts and 70 full articles were screened. The final sample included 26 studies. Most studies (88%) reported a significant association between childhood sexual abuse and several sleep dimensions (such as difficulty falling asleep, complaints of poor sleep, nightmares). Studies’ quality, as rated using the National heart, lung, and blood institute’s quality assessment tool, varied greatly: 23% were rated as good, 38.5% as fair, and 38.5% as poor. Childhood sexual abuse negatively impacts sleep in childhood and adolescence. These results inform future research, ideally with strong prospective/longitudinal designs and using more specific sleep measures, aiming to promote optimal sleep in sexually abused minors.
Article
Introduction Misalignment of chronotype and social schedules result in sleep and health impairments. Presenteeism, the work productivity loss caused by health problems, has much more social costs than absenteeism and is associated with sleep disturbance. However, little is known about the link between chronotype and presenteeism. In this study, the associations between chronotype, sleep schedules, presenteeism, and the mediating role of sleep disturbance were examined. Methods A cross-sectional survey was conducted on 8,155 office workers from 42 companies in Japan, from 2017 to 2019. The participants answered self-administered questionnaires asking about presenteeism (Work Limitations Questionnaire [WLQ]), sleep disturbance (Pittsburgh Sleep Quality Index [PSQI]), and habitual sleep schedules which enable to calculate the midpoint of sleep on free days, sleep corrected (MSFsc). The mediating effect was examined by using structural equation modeling (SEM). Results The participants comprised 4,462 males and 3,677 females (mean age: 36.7 years), and their mean productivity loss was 5.97%. A later sleep onset (+0.29%/h), early wakeup (+0.14%/h), and eveningness (+0.27%/h, MSFsc) were associated with presenteeism in all participants; however, the effect size and significance differed depending on their chronotype. SEM demonstrated a complete mediation model between chronotype and presenteeism, mediated by sleep disturbance and adjusted by age. Conclusions Chronotype did not directly, but indirectly affected presenteeism through sleep disturbance. Eveningness leads to sleep disturbance, which then causes presenteeism. On workdays, early sleep times for morningness people, and late wakeup times for eveningness people may improve their work productivity.
Article
Ethnic/racial discrimination is associated with negative psychosocial outcomes, and this study considered sleep disturbance as a mediating pathway. Employing a combination of daily diary and biannual surveys, multilevel structural equation models estimated the indirect effects of sleep/wake concerns on negative, anxious, and positive mood, rumination, and somatic symptoms. In a sample of 350 urban Asian (74% Chinese, 8% Korean, 4% Indian, 1% Filipinx, 1% Vietnamese, and 12% other), Black, and Latinx (25% Dominican, 24% South American, 22% Mexican, 15% Puerto Rican, 5% Central American, and 9% other) youth (M = 14.27 years, 69% female, 77% U.S. born, 76% monoethnic/racial, data collected from 2015 to 2018), there was evidence for sleep disturbances mediating the impact of ethnic/racial discrimination on adjustment. Nighttime disturbance, daytime dysfunction, and daytime sleepiness evidenced partial or full mediation for daily‐ and person‐level outcomes (υ = 0.1%–17.9%). Reciprocal associations between sleep disturbances and negative mood and rumination were also observed.
Article
Executive functioning, composed of higher-order cognitive skills, rapidly develops in early childhood and is foundational for school readiness and school-age academic achievement. Identifying constellations of factors that are related to the development of executive functioning may inform interventions that prepare children for academic success. This study examined sleep disturbances as a moderator of the association between effortful control, defined as temperament-based self-regulation, and executive functioning among young children. Multiple regressions controlling for child gender and age and caregiver education tested the study research question. Participants were 54 children (Mage = 4.25 years, SD = 0.98; 56% male, 85% White) and their primary caregivers. Caregivers reported on children’s effortful control and sleep disturbances via questionnaire, and executive functioning was objectively measured using two well-validated assessment tools. Results showed that high effortful control was associated with better performance on both executive functioning tasks for children with few sleep disturbances. Effortful control was not related to executive functioning in the context of high levels of sleep disturbances. Thus, children whose caregivers observed them to have a temperamental predisposition for higher self-regulation as well as fewer sleep disturbances had the highest executive functioning, suggesting that better-quality sleep may enhance the association between high effortful control and children’s executive functioning. Self-regulation and sleep both are responsive to intervention and may be useful targets to improve executive functioning and in turn academic preparedness and success.
Article
Objectives : This study examined socio-demographic factors of sleep reduction in adolescents and whether differences in sleep reduction were mediated by their sleep hygiene practices. It also provides more insight into the prevalence of sleep reduction in a sample of Dutch adolescents. Design : Cross-sectional study using baseline data from the cluster-randomized controlled trial Charge Your Brainzzz. Participants 972 adolescents in the second or third grade of secondary school, aged 13.3 (± 0.7) years, of which 55% were girls. Methods : Socio-demographic differences (gender, age, education types, cultural groups) in sleep reduction and the mediating effects of sleep hygiene practices (i.e., caffeine use, behavioral arousal, cognitive/emotional arousal) were assessed with linear regression analyses and the product-of-coefficient test with percentile-based confidence intervals, respectively. Sleep reduction was measured using the Sleep Reduction Screening Questionnaire, whereas sleep hygiene practices were measured via the Adolescent Sleep Hygiene Scale. Results : 33% of adolescents reported sleep reduction. Girls and older-aged adolescents experienced more sleep reduction than boys and younger-aged adolescents, respectively. The association between gender and sleep reduction was mediated by cognitive/emotional arousal but suppressed by caffeine use, while behavioral arousal and cognitive/emotional arousal mediated the association between age and sleep reduction. Conclusions : Sleep reduction was shown to be common in Dutch adolescents, especially in girls and older-aged adolescents. Sleep hygiene practices partly explained the differences in sleep health and sleep reduction between different socio-demographic risk groups. Further research is needed to provide more insight into the complexity of sleep reduction and its interrelated behaviors and risk factors.
Article
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Aims: It is important to assess sleep quality during epidemiological surveillance of psychological and physical health among nonclinical adolescents. The Pittsburgh Sleep Quality Index (PSQI) is a self-report screening tool that measures sleep quality. This study aimed to assess the validity and reliability of the Chinese version of the PSQI among nonclinical adolescents. Methods: In total, 5,399 Chinese students (51.1% female) were included in the study (mean age = 15.13, SD = 1.56). Participants completed a comprehensive questionnaire including the PSQI. Statistical analyses to evaluate the reliability, structural validity, measurement invariance, criterion validity and optimal cutoff point of the PSQI were performed. Results: The internal consistency of the PSQI was moderate. Confirmatory factor analysis supported the three-dimensional model and the configural and metric invariance across gender and age. The correlations between scores on the PSQI and the Minneapolis-Manchester Quality of Life Instrument (as a measure of positive life aspects) as well as between scores on the PSQI and the Hospital Anxiety Depression Scale (as a measure of mental illness and distress) yielded support for criterion validity. The receiver operating characteristic analysis revealed that a score of 6.5 was the optimal cutoff point for the PSQI to diagnose sleep disturbance. Conclusion: The main findings of this study are consistent with many studies from other countries that evaluated the psychometric properties of the PSQI and support the use of this instrument in assessing sleep quality in Chinese nonclinical adolescents. Future studies should continue to verify the ability to monitor sleep quality across the lifespan using the PSQI.
Article
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The sleep needs, experiences and viewpoints were explored for UK adolescents who have been excluded from mainstream education. Qualitative data was gathered through interviews with 9 participants, aged 11–15 years, who also completed questionnaires. The participants had symptoms of inadequate sleep, poor sleep hygiene behaviours and were not getting the recommended amount of sleep on school nights. Participants described sleep patterns involving often staying up late and having different sleep timing on weekends than weekdays and having difficulties with their sleep. Use of technology and the relevance of family were identified as important and associated with facilitating and hindering factors for sleep. Participants communicated that they lack control over aspects of their sleep and their lives. The experiences and views of the participants can inform professionals’ understanding of how to collaborate with adolescents to improve their sleep and highlight that continued development of sleep education programmes is timely.
Article
Objective /Background: Different aspects of sleep problems tend to occur simultaneously, which could lead to adolescent health problems. We aimed to identify the distinct patterns of sleep problems and to explore their association with internalizing and externalizing problems. Methods Secondary data from 11,831 adolescents from the Shandong Adolescent Behavior and Health Cohort were obtained and after data cleaning, 9,871 (50.1% females, mean age was 15.02 ± 1.45 years) were used in this study. Sleep problems (short weeknight sleep duration, insomnia, daytime sleepiness, no post-lunch napping, and snoring), and covariates were measured at the baseline, and the internalizing and externalizing problems were measured at both the baseline and one-year follow-up. The latent class analysis was used to identify the patterns of sleep problems at the baseline. Linear mixed effect models were used to examine the relationship between classes of sleep problems and internalizing and externalizing problems. Results Three classes of sleep problems were identified, named as “short and disturbed sleep” (34.1%), “no post-lunch napping” (16.7%), and “no/mild sleep disturbance” (49.2%), respectively. The “short and disturbed sleep” class exhibited higher levels of internalizing and externalizing problems than the other two classes. Also, it showed a steeper decreasing trend in internalizing and externalizing problems over time. Conclusions The findings shed light on the importance and significance of identifying the patterns of multiple sleep problems to effectively identify adolescents at higher risk of developing internalizing and externalizing problems, and to designate tailored intervention to eliminate co-occurring sleep problems to promote adolescent emotional and behavioral health.
Article
Résumé La durée de sommeil des adolescents a connu un déclin important pendant le dernier siècle, il n’est donc pas surprenant que nombre d’entre eux éprouvent de la somnolence diurne. Cette recension de la littérature actualise les connaissances disponibles sur ce sujet d’importance. L’étiologie du manque de sommeil et de la somnolence chez les adolescents peut s’expliquer par différents facteurs tant biologiques, psychologiques que sociétaux. Le cycle veille-sommeil des adolescents connaît un décalage d’origine biologique dès le début de la maturation pubertaire, mais il est également affecté par l’exposition aux écrans, l’utilisation de substances psychoactives, l’heure de début des cours, leurs occupations extrascolaires, les réglementations parentales et certaines caractéristiques sociodémographiques. En outre, des troubles du sommeil d’origine physiologique peuvent être en cause, tels que la narcolepsie, l’apnée du sommeil ou le syndrome des jambes sans repos. Le manque de sommeil et la somnolence chez les adolescents ont des conséquences sur leur fonctionnement cognitif ainsi que sur leur régulation émotionnelle et attentionnelle, avec d’importantes conséquences sur la réussite académique. La mise en lumière des problématiques associées à la somnolence chez les adolescents peut servir de guide aux chercheurs et cliniciens vers le développement de pistes d’intervention. Enfin, des mesures de santé publique et de programmes de transfert de connaissances quant aux facteurs psychosociaux et sociétaux modifiables associés à la biorégulation veille-sommeil pourront être mieux considérés auprès des parents ainsi qu’aux niveaux politique et sociétal.
Article
Objective: To evaluate the association between health behaviors with academic performance among tertiary education students. Methods: Six databases were searched until July 2020 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and academic performance. Results: Thirty-four studies were included (18 assessed sleep, 16 alcohol intake, 12 illicit drug use, 10 physical activity, 8 diet, 4 smoking, 2 sedentary behavior). A consistent negative association with academic performance was demonstrated for sleep (12/18 studies), alcohol intake (13/16) and illicit drug use (9/12). Most (7/10) studies found no association between physical activity and academic performance. Conclusion: Findings suggest interventions to mitigate the influence of poor sleep, high alcohol intake, and illicit drug use on academic performance may be needed. Further research of other health behaviors, along with their co-occurrence, with academic performance, is required.
Conference Paper
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Background - According to National Institute for Health and Care Excellence quality standards, the assessment of fall risk and preventing falls should be multifactorial and include self-reported questions like fall history, fear of falling (FoF), self-perception of functional ability, environment hazards, gait pattern, balance, mobility and muscle strength. Concerning the self-reported data, some studies described subjectivity and difficulty in extracting reliable information when using such methods. History and number of previous falls are often used as golden standard in fall risk assessment studies; however, these questions are source of misjudgement, in part, due to difficulty for an older person remember exactly how many times he/she had fallen in a past period of time. Objective - The study aimed to compare self-reported questions and standard and validated measures for screening risk of fall to verify the confidence of the self-reported data. Methods - 506 community-dwelling adults aged 50+ years old (mean age 69.56 ± 10.29 years old; 71.7% female) were surveyed regarding demographics, history of fall, FoF, sedentary lifestyle, use of upper extremities to stand up from a chair, by self-reported questionnaire; analysis of gait, balance and muscle strength, by standard and validated measures for screening risk of fall - 10 meters walking speed test, Timed Up & Go test and 30 second sit to stand test, respectively. Independent samples t tests were performed to compare groups. Results - 33.2% of the sample reported at least one fall in the last year (fallers), 50% reported FoF, 46.4% sedentary lifestyle, 31.8% needed their upper extremities assistance to stand from a chair. Fallers demonstrated lower scores of gait velocity (p < 0.001), lower extremities strength (p < 0.001) and balance (p = 0.034) compared with nonfallers; who reported sedentary lifestyle also showed lower scores of gait velocity (p < 0.001), lower extremities strength (p = 0.001) and balance (p < 0.001) compared with non-sedentary. Simultaneously, who assumed FoF showed lower scores of gait velocity (p < 0.001), lower extremities strength (p < 0.001) and balance (p < 0.001) compared with who had no FoF. Finally, those who use the upper extremities to stand up from a chair showed lower scores of gait velocity (p < 0.001), lower extremities strength (p < 0.001) and balance (p < 0.001) compared with those who do not. Conclusions - The findings suggest that self-reported data like history of falls, sedentary lifestyle, FoF and use of upper extremities to stand up from a chair, obtained by simple questions, have emerged as reliable information on risk factors for falling and can be used to complete the fall risk screening.
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Background: There are profound consequences when developing youth do not get adequate sleep. Adolescents who experience poor sleep may be more likely to engage in offending behavior. While there is a documented association between the number of hours youth sleep and their likelihood of offending, it is unclear how youths' perceptions of their sleep quality contribute to offending. Further, scholars have yet to rigorously examine the relation between sleep problems and offending in young adulthood, a developmental stage, which is both critical for desistance and in which sleep may play an important role. Methods: Using a sample of 1,216 justice-involved male youth, this study uses within-individual longitudinal methods (fixed-effects Poisson regression models) to examine the relation between changes in perceptions of sleep quality and changes in offending behavior from ages 13 to 24. Results: Increases in sleep problems are associated with increases in offending, particularly aggressive/person-related offenses, for both adolescents and young adults. This holds true even after controlling for time-varying anxiety, substance use, and violence exposure. Conclusions: Improving sleep quality may be critical for reducing aggressive behavior in at-risk adolescents and young adults. Interventions that address sleep quality, and not just quantity, may be particularly beneficial.
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Prior research suggests that sleep is associated with increased subjective stress and aggression, but important questions remain about the typical magnitude of these relationships, as well as their potential moderators. We therefore conducted the first meta-analysis of this literature. Across 340 associational and experimental studies, significant associations were identified between sleep with both subjective stress (r =.307, p <.001) and aggression (r =.258, p <.001) in individuals from the general population, as well as between sleep with subjective stress (r =.425, p <.001) in individuals with sleep disorders. Experimental sleep restriction also led to increased subjective stress (g = 0.403, p =.017) and aggression (g = 0.330, p =.042). These findings suggest that poorer sleep is associated with - and leads to - heightened levels of subjective stress and aggression. These findings, and their implications, are discussed in relation to neurobiological literature, which highlights the complex interplay between metabolic activity in the brain, hormonal changes, and behavior.
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In recent years, online classes have become popular because of the Philippines' high number of COVID-19 cases. Furthermore, given the pandemic, it forces students to study at home. Thus, students in the Philippines have been exposed to online learning for two years; despite its slow progress, many students have received awards for their hard work and motivation. However, their mental health and depression remain their primary concerns amid the current pandemic. Burnout is one of the difficulties students face during this period, as being alone can impact students' mental health and academic performance. Thus, this study aims to discover and investigate the relationship between academic burnout and depression among college students. According to the statistical findings, there is a significant relationship between academic burnout and depression (r=0.135).
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Objectives: There is increased recognition that young people (<25 years) may occupy a carer role for family or others with health conditions or disability. This is often in addition to study and social activities. This means competing demands on time, and insufficient sleep. Our aim was to determine the contribution of caring duties to problematic sleep in young carers. Methods: A survey of Australian carers was conducted, including questions on demographics, characteristics of the carer and care recipient, and sleep quality and quantity. Participants were eligible if they reported sleep time <7 hr or dissatisfaction with their sleep, and were aged 15-24 years. Results: A total of 110 participants (71.8%_female = 79, 15-17 years = 62, 18-24 years = 48) were included in analysis; 55.5% (n= 61) reporting dissatisfaction with their sleep and 62.7% (n= 69) reporting typically less than 7 hr sleep per night. Sleep duration was significantly shorter for those who reported 1-2 or ≥3 awakenings to provide care, compared with no awakenings (p_< .05). Sleep quality, as described by scores on the Pittsburgh Sleep Quality Index (PSQI) was also significantly worse for those who were frequently awoken by their care recipient (p < .05). Worrying about the care recipient, being woken by the care recipient, and listening out for the care recipient were the most frequently identified factors impacting on sleep. Conclusion: Young carers experience reduced sleep duration and poor sleep quality. Strategies to alleviate the burden of care work on young carer's sleep would benefit the health and safety of this group.
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Background: There is growing evidence for the role of circadian factors in adolescents' sleep and academic adjustment, with greater evening preference being linked to poorer academic functioning. However, studies have yet to evaluate this association prospectively in adolescence, nor have studies examined daytime sleepiness as a putative mechanism linking evening preference to poor academic functioning. The current study used a multi-informant design to test the prospective association of evening circadian preference, daytime sleepiness, and academic functioning (e.g., global academic impairment and grades) across 2 years in adolescence. As evening circadian preference, sleepiness, and academic problems are elevated in adolescents with ADHD, we used a sample enriched for adolescents with ADHD and explored whether ADHD moderated effects. Method: Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD). In the fall of eighth grade, adolescents reported on their circadian preference, and in the fall of ninth grade, adolescents and parents completed ratings of daytime sleepiness. In the middle of 10th grade, parents and teachers reported on adolescents' academic impairment and at the end of 10th grade, adolescents' grade point average (GPA) was obtained from school records. Results: Above and beyond covariates (e.g., adolescent sex, ADHD status, medication, sleep duration) and baseline academic impairment, greater self-reported evening preference in 8th grade predicted increased parent ratings of academic impairment in 10th grade indirectly via adolescent and parent ratings of daytime sleepiness in 9th grade. Furthermore, evening preference in 8th grade predicted greater teacher ratings of academic impairment and lower average GPA in 10th grade via parent ratings of daytime sleepiness in 9th grade, controlling for covariates and baseline GPA. ADHD status did not moderate indirect effects. Conclusion: Findings underscore daytime sleepiness as a possible intervening mechanism linking evening preference to poor academic functioning across adolescence. Intervention studies are needed to evaluate whether targeting circadian preference and sleepiness improves academic functioning in adolescents.
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Growing evidence suggests sleep plays an important role in the development of healthy adolescents, with increased interest in the associations between sleep and mental health. Higher duration and quality of sleep has been suggested as a mechanism for increased wellbeing in adolescents. Cross sectional data was collected from 5,661 Irish adolescents. 55% of Irish adolescents reported meeting the guidelines for adolescents of 8-10 hours per night. This was found to decrease with age. Higher duration and quality of sleep was positively associated with wellbeing and negatively associated with symptoms of anxiety and depression. A higher frequency of physical activity was associated with longer duration and higher quality of sleep. 9-10 hours of sleep was associated with the highest levels of wellbeing and lowest symptoms of anxiety and depression. The relationship between physical activity and increased wellbeing may be impacted by physical activity leading to higher durations and quality of sleep. Higher frequencies of physical activity may increase sleep quality and quantity thereby improving markers of mental health in adolescents.
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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.
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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).
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
Article
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.
Article
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.
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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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.