Sleep Duration and Factors Related to Sleep Loss in 3-14-Year-Old Children in Beijing： A Cross-Sectional Survey

Background： It is known that short sleep duration adversely affects children＇s behavior and physical development. This study aimed to investigate the status of sleep duration in 3-14-year-old children in Beijing and explore the related factors of sleep loss with them. Methods： In this study, a cross-sectional study of random stratified cluster sampling was conducted on 3-14-year-old children and adolescents in Beijing. According to the proportion of children in each district and school, the final cohort included a total of 11 kindergartens, 7 primary schools, and 8 junior high schools from 7 districts of Beijing. Children of sampled classes were included, and their parents were invited to fill a series of questionnaires including the simplified Chinese version of Pediatric Sleep Questionnaire, Sleep Questionnaire Scale, and Hong Kong-Children Sleep Questionnaire about the performance of the last 6 months. Results： Out of the total 11,420 questionnaires, 9198 questionnaires were valid and effective with the response rate of 80.54%. The age of the investigated children was 8.8 ± 3.8 years, including 4736 males and 4462 females. The daily sleep duration of children in Beijing was 9.7 ± 0.7 h. The prevalence of sleep loss （〈9 h/day） of children in Beijing was 11.8%. The daily sleep duration of children aged 〈6, 6 ≤ age 〈11, and ≥11 years was 9.7 ± 0.6 h, 9.6 ± 0.6 h, and 9.5 ± 0.8 h, respectively. The sleep duration reduced significantly in children aged ≥11 years as compared to younger children in Beijing which was mainly contributed by the variation tendency of sleep duration on weekdays. The multivariate logistic regression analysis identified factors associated with sleep loss （P 〈 0.05）： male （odds ratio [OR] = 1.32, 95% confidence interval [CI ]： 1.15-1.51 ）, age ≥11 years （OR = 2.37, 95% CI： 1.92-2.93）, overweight （OR = 1.34, 95% CI： 1.17-1.54）, family history of snoring （OR - 1.35, 95% CI： 1.13-1.61 ） and activities before bedtime with watching TV （OR = 1.24, 95% CI： 1.08 1.43）, sports （OR = 1.22, 95% C/： 1.01-1.48）, playing cellphone （OR = 1.91,95% CI： 1.31-2.73） and surfing the Internet （OR = 1.27, 95% CI： 1.06-1.52） and among them age 〉11 years and playing cellphone betbre bedtime had greater impact on children＇s short sleep duration than that of other factors. Conclusions： Sleep loss was common among 3-14-year-old children in Beijing. Sleep duration decreased with age, especially among children over 11 years old. Factors associated with sleep loss covered sociodemographic characteristics, family sleep habits and routine activities before bedtime, and among those variables, age ≥11 years and playing with cellphones before bedtime had a greater impact on sleep duration, indicating that existing sleep loss in 3-14-year-old children could be, at least partly, improved by paying more attention to children aged of l I years or entering Grade 5 and Grade 6 and to children with a family history of snoring; by reducing the use of electronic products betbre bedtime, especially cellphones; by managing weight and keeping fit; and by improving the bedtime routine.

Debates in pediatric obstructive sleep apnea treatment

Pediatric obstructive sleep apnea(OSA)is among the most common sleep-disordered breathing(SDB)diseases in children.Its high prevalence and multiple systemic complications lead to increasing numbers of children and families affected by OSA.Timely diagnosis and effective intervention in children with this condition is extremely important in improving their prognosis.The major approaches in the treatment of OSA in children are to eliminate the causes of upper airway obstruction and prevent and treat complications.Considering the specific individual differences in children’s growth and development,as well as the diversity of etiologies in children’s OSA,pediatric treatment strategies need to be precise,multidisciplinary,and individualized.First-line clinical treatment consists of surgical(adenotonsillectomy)and non-surgical therapies[including anti-inflammatory medications and non-invasive ventilation(NIV)].However,a considerable controversy exists concerning the indications,treatment standards,and the evaluation of the efficacy of the aforementioned treatment methods.In this review,reviews and assessment of literature studies and multidisciplinary clinical experience were performed to analyze the application of each treatment and discuss controversial issues and future research directions.We suggest that the above interventions should be tailored to each child’s needs,comorbidities,and the availability and expertise of the practitioner.The ideal case is when a multidisciplinary team of doctors together with the patients and their parents,or guardians,have a thorough discussion regarding the benefits and risks of all available treatment options and all agree on an effective treatment plan.