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


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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    ABSTRACT: The national quality framework for Early Childhood Education and Care (NQF) in Australia identifies the need for services to make provision for each child’s sleep, rest and relaxation within a national early years’ policy framework. The framework also requires that opportunities for learning and physical health are optimised, and that the agency of each child and their family is respected. Against this background, the scheduling of a standard sleep time in early childhood education and care (ECEC) centres remains a common practice, even in rooms catering for older children for whom daytime sleep may no longer be necessary. This article draws upon existing scholarship to explore the issues and tensions associated with sleep/rest, in the context of Australian curriculum and quality standards documents. We review accounts from educators, parents and children and contemporary views regarding high-quality practice in ECEC, with an aim of supporting critical reflection on practice and continuous quality improvement in ECEC.
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