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Research Article|Articles in Press

Examination of parent-reported differences in children's daily screen use, sleep, and sleep hygiene behaviors during the school year and summer and their association with BMI

Published:February 12, 2023DOI:https://doi.org/10.1016/j.sleh.2023.01.013

      Abstract

      Objective

      The current study examined school-summer differences in children's sleep patterns and sleep hygiene. Cross-sectional relationships with children's sleep, sleep hygiene, and weight status were explored during the school year and summer.

      Methods

      Children (5-8 years) and their parents (n = 197 dyads) were recruited from 4 schools in southeastern Texas and via Facebook. Parents reported children's school year and summer sleep, sleep hygiene, and screen media use. Children's body mass index (BMI) was objectively assessed at the beginning and end of the summer. Associations between children's sleep hygiene and screen media use, sleep duration, and weight status were explored.

      Results

      Children's sleep midpoint was earlier during the school year (1:54 AM ± 0.03) than in the summer (2:06 AM ± 0.03; t = 4.07, p < .0001). During summer, children increased their screen media use by 38 minutes (t = 2.32, p = .023) and decreased their caffeine intake from 7.43 to 7.0 (with scores ranging from 3 to 15; t = 2.83, p = .006). Greater sleep-inhibiting (β = 0.40, p = .011) and fewer sleep-promoting (β = −0.28, p = .049) behaviors during the school year were associated with having a higher BMI. There were no associations among sleep patterns, sleep hygiene and BMI during summer.

      Conclusions

      More positive school year sleep hygiene behaviors were supportive of having a healthier weight status. Changes in these behaviors during the summer did not portend worse weight outcomes. Supporting families in the establishment of sleep-promoting behaviors, particularly during the school year may help address the child obesity epidemic.

      Keywords

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      References

        • Paruthi S
        • Brooks LJ
        • D'Ambrosio C
        • et al.
        Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine.
        J Clin Sleep Med. 2016; 12: 785-786
        • Wheaton AG
        • Claussen AH.
        Short sleep duration among infants, children, and adolescents aged 4 months-17 years - United States, 2016-2018.
        MMWR Morb Mortal Wkly Rep. 2021; 70: 1315-1321
        • Meltzer LJ
        • Wahlstrom KL
        • Plog AE
        • et al.
        Changing school start times: impact on sleep in primary and secondary school students.
        Sleep. 2021; 44: 1-14
        • Moreno JP
        • Razjouyan J
        • Lester H
        • et al.
        Later sleep timing predicts accelerated summer weight gain among elementary school children: a prospective observational study.
        Int J Behav Nutr Phys Act. 2021; 18: 94
        • Nixon GM
        • Thompson JM
        • Han DY
        • et al.
        Short sleep duration in middle childhood: risk factors and consequences.
        Sleep. 2008; 31: 71-78
        • Agostini A
        • Pignata S
        • Camporeale R
        • et al.
        Changes in growth and sleep across school nights, weekends and a winter holiday period in two Australian schools.
        Chronobiol Int. 2018; 35: 691-704
        • Weaver E
        • Gradisar M
        • Dohnt H
        • et al.
        The effect of presleep video-game playing on adolescent sleep.
        J Clin Sleep Med. 2010; 6: 184-189
        • Quante M
        • Wang R
        • Weng J
        • et al.
        Seasonal and weather variation of sleep and physical activity in 12-14-year-old children.
        Behav Sleep Med. 2019; 17: 398-410
        • Harbard E
        • Allen NB
        • Trinder J
        • et al.
        What's keeping teenagers up? Prebedtime behaviors and actigraphy-assessed sleep over school and vacation.
        J Adolesc Health. 2016; 58: 426-432
        • Olds T
        • Maher C
        • Dumuid D.
        Life on holidays: differences in activity composition between school and holiday periods in Australian children.
        BMC Public Health. 2019; 19: 450
        • Mathew GM
        • Reichenberger DA
        • Master L
        • et al.
        Too jittery to sleep? Temporal associations of actigraphic sleep and caffeine in adolescents.
        Nutrients. 2021; 14: 31
        • Uebergang LK
        • Arnup SJ
        • Hiscock H
        • et al.
        Sleep problems in the first year of elementary school: the role of sleep hygiene, gender and socioeconomic status.
        Sleep Health. 2017; 3: 142-147
        • Fiese BH
        • Cai T
        • Sutter C
        • et al.
        Bedtimes, bedtime routines, and children's sleep across the first 2 years of life.
        Sleep. 2021; 44: zsab045
        • Li S
        • Zhu S
        • Jin X
        • et al.
        Risk factors associated with short sleep duration among Chinese school-aged children.
        Sleep Med. 2010; 11: 907-916
        • Moreno JP
        • Crowley SJ
        • Alfano CA
        • et al.
        Potential circadian and circannual rhythm contributions to the obesity epidemic in elementary school age children.
        Int J Behav Nutr Phys Act. 2019; 16: 25
        • Brazendale K
        • Beets MW
        • Weaver RG
        • et al.
        Understanding differences between summer vs. school obesogenic behaviors of children: the structured days hypothesis.
        Int J Behav Nutr Phys Act. 2017; 14: 100
        • Pyper E
        • Harrington D
        • Manson H.
        Do parents' support behaviours predict whether or not their children get sufficient sleep? A cross-sectional study.
        BMC Public Health. 2017; 17: 432
        • LeBourgeois MK
        • Hale L
        • Chang AM
        • et al.
        Digital media and sleep in childhood and adolescence.
        Pediatrics. 2017; 140: S92-S96
        • Chang AM
        • Aeschbach D
        • Duffy JF
        • et al.
        Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness.
        Proc Natl Acad Sci U S A. 2015; 112: 1232-1237
        • Buxton OM
        • Lee CW
        • L'Hermite-Baleriaux M
        • et al.
        Exercise elicits phase shifts and acute alterations of melatonin that vary with circadian phase.
        Am J Physiol Regul Integr Comp Physiol. 2003; 284: R714-R724
        • Chen TA
        • Baranowski T
        • Moreno JP
        • et al.
        Obesity status transitions across the elementary years: use of Markov chain modelling.
        Pediatr Obes. 2015; 11: 88-94
        • Meltzer LJ
        • Avis KT
        • Biggs S
        • et al.
        The Children's Report of Sleep Patterns (CRSP): a self-report measure of sleep for school-aged children.
        J Clin Sleep Med. 2013; 9: 235-245
        • Lauderdale DS
        • Knutson KL
        • Yan LL
        • et al.
        Self-reported and measured sleep duration: how similar are they?.
        Epidemiology. 2008; 19: 838-845
        • Henderson JA
        • Jordan SS.
        Development and preliminary evaluation of the Bedtime Routines Questionnaire.
        J Psychopathol Behav Assess. 2010; 32: 271-280
        • Alfano CA
        • Smith VC
        • Reynolds KC
        • et al.
        The Parent-Child Sleep Interactions Scale (PSIS) for preschoolers: factor structure and initial psychometric properties.
        J Clin Sleep Med. 2013; 9: 1153-1160
        • Borzekowski DLG
        • Robinson TN.
        Viewing the viewers: ten video cases of children's television viewing behaviors.
        J Broadcast Electron Media. 1999; 43: 506-528
        • O'Connor TM
        • Chen TA
        • del Rio Rodriguez B
        • et al.
        Psychometric validity of the parent's outcome expectations for children's television viewing (POETV) scale.
        BMC Public Health. 2014; 14: 894
        • Kakinami L
        • Henderson M
        • Chiolero A
        • et al.
        Identifying the best body mass index metric to assess adiposity change in children.
        Arch Dis Child. 2014; 99: 1020-1024
        • von Hippel PT
        • Nahhas RW
        • Czerwinski SA.
        How much do children's body mass indices change over intervals of 6-12 months? Statistics from before and during the obesity epidemic.
        Pediatr Obes. 2015; 10: 468-475
        • Cole TJ
        • Faith MS
        • Pietrobelli A
        • et al.
        What is the best measure of adiposity change in growing children: BMI, BMI %, BMI z-score or BMI centile?.
        Eur J Clin Nutr. 2005; 59: 419-425
        • Berkey CS
        • Colditz GA.
        Adiposity in adolescents: change in actual BMI works better than change in BMI z score for longitudinal studies.
        Ann Epidemiol. 2007; 17: 44-50
        • Blom G.
        Statistical Estimates and Transformed Beta-Variables.
        John Wiley & Sons, Inc, New York1958
      1. Dinno A. paran: Horn's test of principal components/factors. 2018. Available at: https://CRAN.R-project.org/package=paran. Accessed May 12, 2022.

        • Dinno A.
        Implementing Horn's parallel analysis for principal component analysis and factor analysis.
        Stata J. 2009; 9: 291-298
        • Horn JL.
        A rationale and test for the number of factors in factor analysis.
        Psychometrika. 1965; 30: 179-185
        • Glorfeld LW.
        An improvement on Horn's parallel analysis methodology for selecting the correct number of factors to retain.
        Educ Psychol Meas. 1995; 55: 377-393
        • Zwick WR
        • Velicer WF.
        Factors influencing four rules for determining the number of components to retain.
        Multivariate Behav Res. 1982; 17: 253-269
        • Tabachnick B
        • Fidell L.
        Using Multivariate Statistics.
        Pearson Education, Upper Saddle River2018
        • Howard MC.
        A review of exploratory factor analysis decisions and overview of current practices: what we are doing and how can we improve?.
        Int J Hum Comput Interact. 2016; 32: 51-62
        • Thurstone LL.
        The Vectors of Mind.
        University of Chicago Press, Chicago, IL1935
        • Cohen JE.
        Statistical Power Analysis for the Behavioral Sciences.
        Lawrence Erlbaum Associates, Inc, Hillsdale, NJ1988
        • Brazendale K
        • Beets MW
        • Turner-McGrievy GM
        • et al.
        Children's obesogenic behaviors during summer versus school: a within-person comparison.
        J Sch Health. 2018; 88: 886-892
        • Jenni OG
        • Achermann P
        • Carskadon MA.
        Homeostatic sleep regulation in adolescents.
        Sleep. 2005; 28: 1446-1454
        • Crowley SJ
        • Wolfson AR
        • Tarokh L
        • et al.
        An update on adolescent sleep: new evidence informing the perfect storm model.
        J Adolesc. 2018; 67: 55-65
        • Wang YC
        • Vine S
        • Hsiao A
        • et al.
        Weight-related behaviors when children are in school versus on summer breaks: does income matter?.
        J Sch Health. 2015; 85: 458-466
        • Moreno JP
        • Johnston CA
        • Chen TA
        • et al.
        Seasonal variability in weight change during elementary school.
        Obesity (Silver Spring). 2015; 23: 422-428
        • von Hippel PT
        • Workman J.
        From kindergarten through second grade, U.S. children's obesity prevalence grows only during summer vacations.
        Obesity (Silver Spring). 2016; 24: 2296-2300
        • Mazza S
        • Bastuji H
        • Rey AE.
        Objective and subjective assessments of sleep in children: comparison of actigraphy, sleep diary completed by children and parents' estimation.
        Front Psychiatry. 2020; 11: 495
        • Robinson JL
        • Winiewicz DD
        • Fuerch JH
        • et al.
        Relationship between parental estimate and an objective measure of child television watching.
        Int J Behav Nutr Phys Act. 2006; 3: 43
        • Radesky JS
        • Weeks HM
        • Ball R
        • et al.
        Young children's use of smartphones and tablets.
        Pediatrics. 2020; 146e20193518