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Published in: BMC Public Health 5/2017

Open Access 01-11-2017 | Research

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

Authors: Jean-Philippe Chaput, Casey E. Gray, Veronica J. Poitras, Valerie Carson, Reut Gruber, Catherine S. Birken, Joanna E. MacLean, Salomé Aubert, Margaret Sampson, Mark S. Tremblay

Published in: BMC Public Health | Special Issue 5/2017

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Abstract

Background

The 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.

Methods

Electronic 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.

Results

A 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.

Conclusions

Despite 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.
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Metadata
Title
Systematic review of the relationships between sleep duration and health indicators in the early years (0–4 years)
Authors
Jean-Philippe Chaput
Casey E. Gray
Veronica J. Poitras
Valerie Carson
Reut Gruber
Catherine S. Birken
Joanna E. MacLean
Salomé Aubert
Margaret Sampson
Mark S. Tremblay
Publication date
01-11-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue Special Issue 5/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4850-2

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