Article

Sleep deprivation and accidental fall risk in children

Department of Pediatrics, Hospital de Santa Maria, 1649-035 Lisboa, Portugal.
Sleep Medicine (Impact Factor: 3.15). 11/2011; 13(1):88-95. DOI: 10.1016/j.sleep.2011.04.010
Source: PubMed

ABSTRACT

To look for an association between sleep deprivation and risk of accidental falls (AF) in children.
A questionnaire was applied to two groups of children aged 1-14 years, encompassing children observed in an emergency room for AF (G1) and children attending health care visits (HV) (G2). Collected data included demographic characteristics, medical history, previous week's sleep pattern (PWSP), sleep duration and sleep pattern in the preceding 24 h, mechanism of fall, and injury severity. Exclusion criteria: acute or chronic disease or exposure to drugs interfering with sleep. Statistical analyses included Fisher's exact test, Pearson Chi-square, Fisher-Freeman-Halton test, T and Mann-Whitney tests for independent samples, and multivariate logistic regression (α=5%).
We obtained 1756 questionnaires in G1 and 277 in G2. Of those, 834 in G1 and 267 in G2 were analyzed. We found an increased risk of AF in boys (OR 1.6; 95% CI 1.2-2.4). After controlling for age, gender, summer holidays, parental education and profession, lack of naps and PWSP were associated with increased risk (OR 2.1; 95% CI 1.3-3.3 and OR 2.7; 95% CI 1.2-6.1). In 3-5 year-old children there was an association between AF and a shorter than usual sleep duration in the previous 24 h (p=0.02).
To our knowledge, our study is the largest so far to assess the association between sleep deprivation and childhood injury. It evidences a protective effect of naps in children. Sleep duration of less than 8 h increases risk of AF. Pre-schoolers may be particularly susceptible to sleep deprivation.

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    • "There is a growing body of evidence that testifies to the importance of sleep in early childhood. Disrupted and shorter duration of night sleep is associated with obesity (Bell & Zimmerman, 2010), raised risk for accidents (Boto et al., 2012), poorer cognitive functioning and behavioural difficulties (Lam, Mahone, Mason, & Scharf, 2011; Touchette et al., 2007). Establishing positive sleeping patterns early in life likely has long-term health promoting effects (Landhuis, Poulton, Welch, & Hancox, 2008). "
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    • "From the age of 5 years nocturnal sleep should be fully consolidated, without nocturnal awakenings or the need for daytime naps [6]. Sleep disturbances are among the most common medical concerns during the childhood period [7] [8], in which several schoolchildren report sleep problems [9] [10]. Some evidence suggests that psychologic factors may play a role in SB [5,11–13], and the presence of SB in children seems to be related to the use of some medications, restless sleep, anxiety, allergies, and headaches [14]. "
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