Abstract
A cross-sectional survey was conducted to simultaneously evaluate sleep quality, duration, and phase in school-aged children and correlations between each dimension of sleep and daytime sleepiness were comprehensively examined. A cross-sectional survey was conducted with school-aged children enrolled in four public elementary schools in Joetsu city, Niigata prefecture in Japan (n = 1683). Among the collected responses (n = 1290), 1134 valid responses (547 boys and 587 girls) were analyzed (valid response rate was 87.90%). Data on daytime sleepiness, sleep quality (problems in sleeping at night), sleep duration (the average sleeping time during a week), and sleep phase (sleep timing: bedtime and rising time on weekdays, and sleep regularity: differences in bedtime and rising time between on weekdays and weekends) were collected. The results of multivariate logistic regression analysis indicated that the following dimensions were significantly correlated with daytime sleepiness: the decline in sleep quality [adjusted odds ratio (AOR) = 2.62, 95% confidence interval (CI) = 1.71–4.00], bedtime after 21:30 on weekdays (AOR = 1.58, 95% CI = 1.15–2.18), bedtime delay on weekends, compared to weekdays (AOR = 1.75, 95% CI = 1.27–2.41), and bedtime advance on weekends, compared to weekdays (AOR = 3.33, 95% CI = 1.78–6.20). Sleep dimensions that significantly affected daytime sleepiness in school-aged children are sleep quality, bedtime-timing, and regularity of bedtime. It is important to detect problems in night sleep and establish treatments, as well as to provide support for early bedding on weekdays and for a regular bedtime both on weekdays and on weekends to prevent daytime sleepiness in school-aged children.
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References
Fallone G, Owens JA, Deane J. Sleepiness in children and adolescents: clinical implications. Sleep Med. 2002;6:287–306.
Shochat T, Cohen-Zion M, Tzischinsky O. Functional consequences of inadequate sleep in adolescents: a systematic review. Sleep Med Rev. 2014;18:75–87.
Perez -Lloret S, Videla AJ, Richaudeau A, Vigo D, Rossi M, Cardinali DP, Perez-Chada D. A multiple-step pathway connecting short sleep duration to daytime somnolence, reduced attention, and poor academic performance: an exploratory cross-sectional study in teenagers. J Clin Sleep Med. 2013;9:469–73.
Curcio G, Ferrara M, Gennaro LD. Sleep loss, learning capacity and academic performance. Sleep Med Rev. 2006;10:323–37.
Dewald JF, Meijer AM, Oort FJ, Kerkhof GA, Bögels SM. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: a meta-analytic review. Sleep Med Rev. 2010;14:179–89.
Slater G, Steier J. Excessive daytime sleepiness in sleep disorders. J Thorac Dis. 2012;4:608–16.
Yamamoto R, Kaneita Y, Harano S, Yokoyama E, Tamaki T, Munezawa T, Suzuki H, Ohtsu T, Aritake S. New onset and natural remission of excessive daytime sleepiness and its correlates among high-school students. Sleep Biol Rhythm. 2011;9:117–26.
Hirshkowitsz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, Hazen N, Herman J, Hillgard PJA, Katz ES, Kheirandish-Gozal L, Neubauer DN, O’Donnel AE, Ohayon M, Peever J, Rawding R, Sachdeva RS, Setters B, Vitiello MV, Ware JC. National sleep foundation’s updated sleep duration recommendations: final report. Sleep Health. 2015;1:233–43.
NHK Broadcasting Culture Research Institute. Report of the survey on living hours of Japanese people, 2010 (in Japanese). Nihon Housou Kyoukai (Tokyo). 2010. https://www.nhk.or.jp/bunken/research/yoron/pdf/20160217_1.pdf. Accessed 19 Oct 2017.
Gaina A, Sekine M, Hamanishi S, Chen X, Wang H, Yamagami T, Kagamimori S. Daytime sleepiness and associated factors in japanese school children. J Pediatr. 2007;151:518–22.
Matsumoto Y, Uchimura N, Ishida T, Toyomasu K, Kushino N, Mori M, Morimatsu Y, Hoshiko M, Ishitake T. Reliability and validity of the 3dimensional sleep scale (3DSS)-day worker version-in assessing sleep phase, quality, and quantity (in Japanese). J Occup Health (Tokyo). 2014;56:128–40.
Gradisar M, Gardner G, Dohnt H. Recent worldwide sleep patterns and problems during adolescence: a review and meta-analysis of age, region, and sleep. Sleep Med. 2011;12:110–8.
Yang C, Spielman AJ. The effect of delayed weekend sleep pattern on sleep and morning function. Psychol Health. 2001;16:715–25.
Blunden SL, Chapman J, Rigney GA. Are sleep education programs successful? The case for improved and consistent research efforts. Sleep Med Rev. 2012;16:355–70.
Yamamoto R. Public health activities for ensuring adequate sleep among school-age children: current status and future directions. Sleep Biol Rhythm. 2016;14:241–7.
Oka Y, Horiuchi H, Tanigawa T, Suzuki S, Kondo T, Sakurai S, Saito I, Tanimukai S, Ueno S, Inoue Y. Development of a new sleep screening questionnaire: child and adolescent sleep checklist (CASC) (in Japanese). Jpn J Sleep Med (Tokyo). 2009;3:404–8.
Olds TS, Maher CA, Matricciani L. Sleep duration or bedtime? Exploring the relationship between sleep habits and weight status and activity patterns. Sleep. 2011;34:1299–307.
Miller AL, Kaciroti N, Lebourgeois MK, Chen YP, Sturza J, Lumeng JC. Sleep timing moderates the concourrent sleep duration-body mass index association in low-income preschool-age children. Acad Pediatr. 2014;14:207–13.
Owens JA, Spirito A, McGuinn M, Nobile C. Sleep habits and sleep disturbance in elementary school-aged children. Dev Behav Pediatr. 2000;21:27–34.
Picchietti D, Allen RP, Walters AS, Davidson JE, Myers A, Ferini-Strambi L. Restless legs syndrome: prevalence and impact in children and adolescents-the Peds REST study. Pediatr. 2007;120:253–66.
Kitamura T, Miyazaki S, Kadotani H, Suzuki H, Kanemura T, Komada I, Nishikawa M, Kobayashi R. Prevalence of obstructive sleep apnea syndrome in Japanese elementary school children aged 6–8 years. Sleep Breath. 2014;18:359–66.
Carskadon MA, Wolfson AR, Acebo C, Tzoschinsky O, Seifer R. Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days. Sleep. 1998;21:871–81.
Winn B, Whitaker D, Elliott DB, Phillips NJ. Factors affecting light-adapted pupil size in normal human subjects. Invest Ophthalmol Vis Sci. 1994;35:1132–7.
Boettner EA, Wolter JR. Transmission of the ocular media. Invest Ophthalmol Vis Sci. 1962;1:776–83.
Higuchi S, Nagafuchi Y, Lee S, Harada T. Influence of light at night on melatonin suppression in children. J Clin Endocrinol Metab. 2014;99:3298–303.
Taylor A, Wright HR, Lack LC. Sleeping-in on the weekend delays circadian phase and increases sleepiness the following week. Sleep Biol Rhythm. 2008;6:172–9.
Carskadon MA, Vieira C, Acebo C. Association between puberty and delayed phase preference. Sleep. 1993;16:258–62.
Li S, Jin X, Yan C, Wu S, Jiang F, Shen X. Bed- and room-sharing in Chinese school-aged children: prevalence and association with sleep behaviors. Sleep Med. 2008;9:555–63.
Oka Y, Suzuki S, Inoue Y. Bedtime activities, sleep environment, and sleep/wake patterns of Japanese elementary school children. Behav Sleep Med. 2008;6:220–33.
Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Med. 2007;8:602–12.
Taylor DJ, Jenni OG, Acebo C, Carskadon MA. Sleep tendency during extended wakefulness: insights into adolescent sleep regulation and behavior. J Sleep Res. 2005;14:239–44.
Wheaton AG, Chapman DP, Croft JB. School start times, sleep, behavioral, health, and academic outcomes: a review of the literature. J Sch Health. 2016;86:363–81.
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This study was funded by Research Project of Joetsu University of Education (General Research 2014–2015) and JSPS KAKENHI Grant No. JP 16H03247.
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All procedures performed studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was permitted by the Ethics Committee of Joetsu University of Education (Permission number: 56).
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Hara, S., Yamamoto, R., Maruyama, M. et al. Relationships between daytime sleepiness and sleep quality, duration, and phase among school-aged children: a cross-sectional survey. Sleep Biol. Rhythms 16, 177–185 (2018). https://doi.org/10.1007/s41105-018-0148-8
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DOI: https://doi.org/10.1007/s41105-018-0148-8