Systematic review of the relationships between sleep duration and health indicators in the early years (0–4 years)

BMC Public Health

Research

Joanna E. MacLean¹  Reut Gruber²  Catherine S. Birken³  Valerie Carson⁴  Jean-Philippe Chaput⁵  Casey E. Gray⁵  Veronica J. Poitras⁵  Mark S. Tremblay⁵  Salomé Aubert⁵  Margaret Sampson⁵ 

[1] Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, T6G 1C9, Edmonton, AB, Canada;Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, H3A 1A1, QC, Canada;Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, M5G 1X8, Toronto, ON, Canada;Faculty of Physical Education and Recreation, University of Alberta, T6G 2H9, Edmonton, AB, Canada;Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, K1H 8L1, Ottawa, ON, Canada;

关键词: Adiposity;    Emotional regulation;    Cognitive development;    Motor development;    Growth;    Cardiometabolic health;    Physical activity;    Sedentary behaviour;    Quality of life;    Well-being;    Injuries;    Newborns;    Infants;    Toddlers;    Preschoolers;   

DOI  :  10.1186/s12889-017-4850-2

来源: Springer

【 摘 要 】

BackgroundThe objective of this systematic review was to examine for the first time the associations between sleep duration and a broad range of health indicators in children aged 0 to 4 years.MethodsElectronic databases were searched with no limits on date or study design. Included studies (published in English or French) were peer-reviewed and met the a priori determined population (apparently healthy children aged 1 month to 4.99 years), intervention/exposure/comparator (various sleep durations), and outcome criteria (adiposity, emotional regulation, cognitive development, motor development, growth, cardiometabolic health, sedentary behaviour, physical activity, quality of life/well-being, and risks/injuries). The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Due to high levels of heterogeneity across studies, narrative syntheses were employed.ResultsA total of 69 articles/studies (62 unique samples) met inclusion criteria. Data across studies included 148,524 unique participants from 23 countries. The study designs were randomized trials (n = 3), non-randomized interventions (n = 1), longitudinal studies (n = 16), cross-sectional studies (n = 42), or longitudinal studies that also reported cross-sectional analyses (n = 7). Sleep duration was assessed by parental report in 70% of studies (n = 48) and was measured objectively (or both objectively and subjectively) in 30% of studies (n = 21). Overall, shorter sleep duration was associated with higher adiposity (20/31 studies), poorer emotional regulation (13/25 studies), impaired growth (2/2 studies), more screen time (5/5 studies), and higher risk of injuries (2/3 studies). The evidence related to cognitive development, motor development, physical activity, and quality of life/well-being was less clear, with no indicator showing consistent associations. No studies examined the association between sleep duration and cardiometabolic biomarkers in children aged 0 to 4 years. The quality of evidence ranged from “very low” to “high” across study designs and health indicators.ConclusionsDespite important limitations in the available evidence, longer sleep duration was generally associated with better body composition, emotional regulation, and growth in children aged 0 to 4 years. Shorter sleep duration was also associated with longer screen time use and more injuries. Better-quality studies with stronger research designs that can provide information on dose-response relationships are needed to inform contemporary sleep duration recommendations.

【 授权许可】

CC BY   
© The Author(s). 2017