No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
The Association of Urbanicity with Infant Sleep Duration
Abstract
Short sleep duration is associated with multiple adverse child outcomes. We examined associations of the built environment with infant sleep duration among 1226 participants in a pre-birth cohort. From residential addresses, we used a geographic information system to determine urbanicity, population density, and closeness to major roadways. The main outcome was mother's report of her infant's average daily sleep duration at 1 year of age. We ranked urbanicity and population density as quintiles, categorized distance to major roads into 8 categories, and used linear regression adjusted for socio-demographic characteristics, smoking during pregnancy, gestational age, fetal growth, and television viewing at 1 year. In this sample, mean (SD) sleep duration at age 1 year was 12.8 (1.6)h/day. In multivariable adjusted analyses, children living in the highest quintile of urbanicity slept -19.2 min/day (95% CI:-37.0, -1.50) less than those living in the lowest quintile. Neither population density nor closeness to major roadways was associated with infant sleep duration after multivariable adjustment. Our findings suggest that living in more urban environments may be associated with reduced infant sleep.
... We summarize the recent literature on these topics concisely below. [4][5][6][7][8][9][10][11], adolescents [12,13], and, to a lesser extent, children [14]. ...
... Adverse associations between neighborhood factors and sleep outcomes are also found among children and adolescents [12][13][14]; however, the relationship has not been evaluated as extensively as for adults [12]. In an analysis of 1226 mother-child pairs in a prospective pre-birth cohort, infants living in the most urban areas slept significantly less per day than infants in the least urban areas [14]. ...
... Adverse associations between neighborhood factors and sleep outcomes are also found among children and adolescents [12][13][14]; however, the relationship has not been evaluated as extensively as for adults [12]. In an analysis of 1226 mother-child pairs in a prospective pre-birth cohort, infants living in the most urban areas slept significantly less per day than infants in the least urban areas [14]. Additionally, a crosssectional (n=263) and longitudinal assessment (n=7945) of teens living in the USA examines sleep outcomes in relation to two aspects of community disadvantage: hopelessness and violence exposure. ...
In this brief review article, we provide an overview of recent (since 2010) scientific contributions to our understanding of the social and environmental determinants of sleep health. In particular, we focus on three areas where we saw the most contributions to the determinants of sleep health among children, adolescents, and adults. First, studies of neighborhood context and sleep health find that sleep quality and quantity are lower in disadvantaged neighborhoods. These negative associations are often stronger for women than for men. Second, family factors matter for sleep health. Children from families with more parental resources sleep better than do children from families without such resources. Adults with children sleep less than those without, and work-family conflict is an impediment to good sleep. Third, media use is problematic for sleep health. Around the world, higher levels of screen media use are associated with lower quality and quantity of sleep. Future research on the social and environmental determinants of sleep health will grow out of these three areas of current research. In addition, we anticipate new research in the international realm and in the area of interventions designed to improve the population’s sleep health.
... While the authors theorized that crowding, thin walls, busy streets, noise, and light pollution in these areas may heighten the risk of short sleep, these potential mediators were not empirically tested due to lack of data. A related study also found that the level of urbanicity was negatively associated with infant sleep duration (Bottino et al. 2012). Infants in areas characterized by the highest level of urbanicity slept 19 minutes less (95 percent CI: À37.0 to À1.5 minutes) than infants living in non-urban environments after adjusting for infants' and mothers' characteristics. ...
... With respect to our finding that there was an association between population density and sleep duration, a study of infant sleep duration (Bottino et al. 2012) found that population density was not significantly associated with sleep duration. However, our study suggests that population density may increase the likelihood of short sleep duration and sleep problems among adults (potentially through the mechanisms of traffic and noise). ...
... Studies have also shown that neighbourhood characteristics may impact other risk factors for sleep disorders, which include smoking (Saelens et al. 2003), poor selfrated health (Inagami et al. 2007), and low levels of physical activity (Humpel et al. 2002). We made the decision to include all these as control variables because the conventions set out by previous epidemiological studies have already established these factors as necessary control variables in studies on sleep (Hale and Do 2007;Krueger and Friedman 2009;Bottino et al. 2012). This is arguably a more conservative approach since we are controlling for risk factors that may theoretically be in the pathway linking land use and sleep, and thus, the true size of the association between the two may be understated. ...
Urban densification and mixed-use development may have unintended consequences and should be accompanied by research that anticipates its varied outcomes to ameliorate its negative impacts. The purpose of this study is to understand the association between different land use types and sleep duration/problems, and to further explore the role of traffic and noise as potential mechanisms for how land use may impact sleep. Our study is based on a cross-sectional survey of 2411 participants from across 443 dissemination areas in Toronto, Canada.
We found a positive association between sleep duration/problems and 1) commercial density, 2) residential density, and 3) industrial land use. Density of green space is not independently associated with sleep duration/problems. The association between different land use types and sleep are fully attenuated once we control for traffic levels and self-rated noise, which suggests that these land uses are associated with elevated levels of noise and traffic, which in turn negatively impact sleep duration and quality. Given the importance of noise and traffic as mediators between land use and sleep duration/sleep problems, further research should evaluate whether site-planning and architectural solutions to reduce exterior noise and exposure to traffic can ameliorate these potentially negative effects of intensive land use.
... Studies consistently show that living in a disadvantaged neighborhood that is characterized by poverty, social disorganization, and disorder is associated with a range of adverse sleep outcomes [1][2][3][4][5][6][7][8][9][10][11][12][13]. This growing body of work is impressive because it is remarkably stable across studies of younger and older populations, objective (census indicators of neighborhood socioeconomic disadvantage) and perceived (fear of crime in the neighborhood) neighborhood characteristics, and clinical (obstructive sleep apnea) and selfreported (sleep duration and sleep problems) sleep outcomes. ...
... Taken together, the results of our multivariate regression analyses show that respondents who feel safe from crime and violence in their neighborhoods tend to exhibit more favorable sleep outcomes than respondents who feel less safe in their neighborhoods. This general pattern, observed across several sleep outcomes and across several countries, is largely consistent with previous studies conducted in the USA, Canada, England, and Germany [1][2][3][4][5][6][7][8][9][10][11][12][13]. Our findings are especially close to the work of Steptoe and colleagues [13]. ...
Objective:
Building on previous North American and European studies of neighborhood context and sleep quality, we tested whether several self-reported sleep outcomes (sleep duration, insomnia symptoms, sleepiness, lethargy, and overall sleep quality) vary according to the level of perceived neighborhood safety in six countries: Mexico, Ghana, South Africa, India, China, and Russia.
Methods:
Using data (n = 39,590) from Wave I of the World Health Organization's Longitudinal Study on Global Ageing and Adult Health (2007–2010), we estimated a series of multinomial and binary logistic regression equations to model each sleep outcome within each country.
Results:
Taken together, our results show that respondents who feel safe from crime and violence in their neighborhoods tend to exhibit more favorable sleep outcomes than respondents who feel less safe. This general pattern is especially pronounced in China and Russia, moderately evident in Mexico, Ghana, and South Africa, and sporadic in India. Perceptions of neighborhood safety are strongly associated with insomnia symptoms and poor sleep quality (past 30 days), moderately associated with sleepiness, lethargy, and poor sleep quality (past 2 days), and inconsistently associated with sleep duration (past two days).
Conclusions:
We show that perceived neighborhood safety is associated with more favorable self-reported sleep outcomes in six understudied countries. Additional research is needed to replicate our findings using longitudinal data, more reliable neighborhood measures, and more direct measures of sleep quality in these and other regions of the world.
Keywords:
Neighborhood, Sleep, Mexico, Africa, Asia
... Understanding the link between BE and sleep is especially important given recent policies promoting high density development for health and sustainability (11). To date, there has been limited investigation of the relationships between BE and sleep, with existing work that broadly examines access to recreational facilities (12), green space (13), and urbanization (10,14,15). Using objectively measured BE and sleep data, we investigated the associations of BE with sleep duration and efficiency in the Multi-Ethnic Study of Atherosclerosis (MESA). ...
... Although previous work has not directly examined associations of neighborhood BE features with objectively measured sleep-wake patterns among adults, our findings are consistent with existing literature that show that residence in urban environments is associated with shorter sleep duration for both adults (10) and infants (14). Despite evidence that neighborhood social environment or physical disorder influences other sleep outcomes such as insomnia and daytime sleepiness (36,37), we found no statistically significant associations between BE and wake after sleep onset, sleep latency, insomnia, and daytime sleepiness. ...
Although dense neighborhood built environments support increased physical activity and lower obesity, these features may also disturb sleep. Therefore, we sought to understand the association between the built environment and objectively measured sleep. From 2010 to 2013, we analyzed data from examination 5 of the Multi-Ethnic Study of Atherosclerosis, a diverse population from 6 US cities. We fit multilevel models that assessed the association between the built environment (Street Smart Walk Score, social engagement destinations, street intersections, and population density) and sleep duration or efficiency from 1-week wrist actigraphy in 1,889 individuals. After adjustment for covariates, a 1-standard-deviation increase in Street Smart Walk Score was associated with 23% higher odds of short sleep duration (≤6 hours; odds ratio = 1.2, 95% confidence interval: 1.0, 1.4), as well as shorter average sleep duration (mean difference = -8.1 minutes, 95% confidence interval: -12.1, -4.2). Results were consistent across other built environment measures. Associations were attenuated after adjustment for survey-based measure of neighborhood noise. Dense neighborhood development may have multiple health consequence. In promoting denser neighborhoods to increase walkability, it is important to also implement strategies that reduce the adverse impacts of this development on sleep, such as noise reductions efforts.
... Urban environments are also associated with shorter sleeping duration for infants. (Bottino et al., 2012) These studies used the degree of urbanicity around residence to represent integrated environmental exposures that are prevalent in urban environments such as noise, traffic emission, and other factors. In general, urbanicity and greenness show negative correlations, and several researchers focused on greenness rather than urbanicity. ...
... Ebisu et al., 2014) Ideally research would include complete information on all potential risk factors, but such studies are difficult due to cost and intense data sampling. Land-use around residence has been used to represent integrated environmental exposures, (Bottino et al., 2012;Cyril et al., 2013;Ebisu et al., 2011) reflecting a suite of exposures including noise, air pollution, and other factors. ...
Background:
More than half of the world's population lives in urban environments. Due to urban related factors (e.g. higher air pollution), urban residents may face higher risk of adverse health outcomes, while access to green space could benefit health.
Purpose:
We explored associations between urban and green land-use and birth weight.
Methods:
Connecticut, U.S., birth certificate data (2000-2006) were acquired (n=239,811), and land-use data were obtained from the National Land Cover Database. We focused on three land-uses; urban space, urban open space, and green space (i.e. forest, shrub, herbaceous, and cultivated land). We estimated fractions of greenness and urbanicity within 250m from residence. A linear mixed effects model was conducted for birth weight and a logistic mixed effects model for low birth weight (LBW) and small for gestational age (SGA).
Results:
An interquartile range (IQR) increment in the fraction of green space within 250m of residence was associated with 3.2g (95% Confidence Interval [0.4, 6.0]) higher birth weight. Similarly, an IQR increase in green space was associated with 7.6% [2.6, 12.4] decreased risk of LBW. Exposure to urban space was negatively correlated with green space (Pearson correlation=-0.88), and it showed negative association with birth outcomes. Results were generally robust with different buffer sizes and controlling for fine particles (PM2.5) and traffic.
Conclusions:
We found protective associations by green space on birth outcomes. Increasing green space and/or reducing urban space (e.g. the greening of city environments) may reduce the risk of adverse birth outcomes such as LBW and SGA. Populations living in urban environments will grow in the next half century, and allocation of green space among urban areas may play a critical role for public health in urban planning.
... While the title of our article draws attention to the use of tertiles, somewhat akin to the "disappointing dichotomies" raised in the clinical context [9], we could equally have entitled this piece "quarrels with quartiles" or "quandaries with quintiles"; all of these approaches of exposure categorisation have been adopted in analyses of built environment effects on health. Recent literature provides examples examining binary splits (at the median or upper quartile) [10][11][12], tertiles [13][14][15], quartiles [16,17], quintiles [18][19][20], or some other data-dependent categories [21,22]. ...
... In one case, after finding no departure from linearity, quartiles were used to test for threshold effects but no justification as to why quartiles were adopted for this purpose was provided [16]. Elsewhere, categorisation was used to examine linearity in associations [18], while another study used dichotomisation when a bivariate distribution was apparent and a median split where this was not [10]. ...
In the analysis of the effect of built environment features on health, it is common for researchers to categorise built environment exposure variables based on arbitrary percentile cut-points, such as median or tertile splits. This arbitrary categorisation leads to a loss of information and a lack of comparability between studies since the choice of cut-point is based on the sample distribution. In this paper, we highlight the various drawbacks of adopting percentile categorisation of exposure variables. Using data from the SocioEconomic Status and Activity in Women (SESAW) study from Melbourne, Australia, we highlight alternative approaches which may be used instead of percentile categorisation in order to assess built environment effects on health. We discuss these approaches using an example which examines the association between the number of accessible supermarkets and body mass index. We show that alternative approaches to percentile categorisation, such as transformations of the exposure variable or factorial polynomials, can be implemented easily using standard statistical software packages. These procedures utilise all of the available information available in the data, avoiding a loss of power as experienced when categorisation is adopted.We argue that researchers should retain all available information by using the continuous exposure, adopting transformations where necessary.
http://www.ijbnpa.org/content/12/1/19/abstract
... Studies consistently show that living in a disadvantaged neighborhood that is characterized by poverty, social disorganization, and disorder is associated with a range of adverse sleep outcomes [1][2][3][4][5][6][7][8][9][10][11][12][13]. This growing body of work is impressive because it is remarkably stable across studies of younger and older populations, objective (census indicators of neighborhood socioeconomic disadvantage) and perceived (fear of crime in the neighborhood) neighborhood characteristics, and clinical (obstructive sleep apnea) and selfreported (sleep duration and sleep problems) sleep outcomes. ...
... Taken together, the results of our multivariate regression analyses show that respondents who feel safe from crime and violence in their neighborhoods tend to exhibit more favorable sleep outcomes than respondents who feel less safe in their neighborhoods. This general pattern, observed across several sleep outcomes and across several countries, is largely consistent with previous studies conducted in the USA, Canada, England, and Germany [1][2][3][4][5][6][7][8][9][10][11][12][13]. Our findings are especially close to the work of Steptoe and colleagues [13]. ...
... The covariates adjusted in the regression models were infant sex, small for gestational age (<10 th percentile of birth weight standards by gestational age 40 ), breastfeeding status at 1 month after birth, maternal age at delivery, maternal smoking habits, maternal alcohol consumption, gestational age at birth, parity, educational background, household income, and postpartum depressive symptoms (Edinburgh Postnatal Depression Scale score 41-43 ≥ 9). We selected the covariates based on previous studies [44][45][46][47][48][49] . ...
Sleep problems and irritable temperaments are common among infants with autism spectrum disorders (ASDs). The prospective association between such sleep problems and irritable temperaments and ASDs needs to be determined for elucidating the mechanism and exploring the future intervention study. Thus, in this study, we investigated whether sleep quality and temperament in 1-month-old infants are associated with the onset of ASDs in 3-year-old children. We also assessed its sex-stratified associations. We conducted a longitudinal study using data from 69,751 mothers and infants from a large-cohort study, the Japan Environment and Children’s Study. We examined the prospective association between infant sleep quality and temperament at 1 month of age and ASD diagnosis by 3 years of age. Infants with longer daytime sleep had a higher risk of later ASD than those with shorter daytime sleep (risk ratio [RR]: 1.33, 95% confidence interval [CI]: 1.01–1.75). Infants who experienced intense crying had a higher risk of ASD than those who did not (RR: 1.31, 95% CI: 1.00–1.72). There was a difference in sex in the association between a bad mood and later ASD. In particular, female infants experiencing bad moods had a higher risk of ASD than others (RR: 3.59, 95% CI: 1.91–6.75). The study findings provide important information for future intervention to reduce the risk of future ASD.
... Covariates. In addition to infant sleep and temperament data, other covariates were included in the analyses following previous studies that assessed factors associated with infant sleep [20][21][22][23][24][25]. Maternal data included maternal age at delivery, parity or any previous childbirth experience, sleep duration of the mother during pregnancy, smoking habits during pregnancy, marital status, maternal educational background, household income, and postnatal depressive symptoms (Edinburgh Postnatal Depression Scale [26,27]: a score of �9 out of 30 was defined as having depressive symptoms in Japan [28]). ...
This study aimed to examine the association between infant sleep quality and temperament in one-month-old infants using a large cohort study data. We used data from the Japan Environment and Children’s Study, a cohort study which follows around 100,000 women from pregnancy until their children’s development. The mothers were asked about their infants’ sleep and temperament using a structured questionnaire. Frequent crying (adjusted odds ratio [AOR]: 1.05, 95% confidence interval [CI]: 1.00–1.10) and intense crying (AOR: 1.19, 95% CI: 1.13–1.25) were positively associated with longer sleep periods during the day than at night. Female infants with longer daytime sleep periods than that at nighttime were more likely to cry frequently (AOR: 1.11, 95% CI: 1.04–1.20). Parous women with infants who had frequent night awakening believed their infants cried more intensely (AOR: 1.17, 95% CI: 1.03–1.31). The study demonstrated a specific association between sleep quality and temperament in one-month-old infants. Based on the results of this study, further sleep intervention studies are required to improve infant temperament.
... race/ethnic compositions) or geographic characteristics (e.g., sunlight patterns; Grandner et al., 2012). While sleep has also been found to vary across other contextual levels such as regions, counties, or neighborhoods (Bottino et al., 2012;Grandner et al., 2012;Hill et al., 2009;Liu et al., 2016;Troxel et al., 2017), states are a particularly important geographic unit due to unique geographies, behavioral patterns, cultural practices, policies, increasing polarization, and differing social and economic opportunity structures that may have significant consequences for sleep. ...
Demographers have consistently documented the importance of educational attainment for population-health. However, it is becoming increasingly clear that the relationship between educational attainment and health varies considerably across contexts. This study examines how the education-sleep association varies across U.S. states to glean insights into whether and how states may shape the importance of education for sleep and for which education level(s) there is the most state-level variation. Using data from the 2014, 2016, and 2018 Behavioral Risk Factor Surveillance System survey (n = 798,242), we fit multinomial regression models predicting self-reported sleep duration (normal-sleep of seven to eight hours as base, short-sleep of six or fewer hours, and long-sleep of nine or more hours) from education and state of residence, before and after adjusting for demographic, socioeconomic, behavior-related, and health covariates. We find that the education-sleep association varies considerably across states. This variation is driven primarily by the low-educated; those with high levels of education have similarly advantaged sleep durations across states. We show that adjusting for socioeconomic, behavioral and health covariates explained most of the state level education-sleep variation and that health factors were especially important for short-sleep while socioeconomic factors were especially important for long-sleep, suggesting that policies that minimize health and socioeconomic disparities across states could minimize educational inequality in sleep and educational variation across states. Our findings thus document variation across states in the education-sleep association and suggest that those with lower levels of education may be most vulnerable to state characteristics.
... Time-invariant covariates accounted for in the analysis included mother's characteristics: age at enrollment (years; continuous), maternal intelligence quotient (IQ; Kaufman Brief Intelligence Test, KBIT-2; continuous), smoking during pregnancy (self-reported as former or during pregnancy vs. never), college education (yes/no), marital status (married or cohabiting yes/no); and child's characteristics: age at the time of assessment, sex (male, female), race/ethnicity (Black, Hispanic, Asian, White, Other), season of birth (winter, spring, summer, fall). We considered the following time-varying covariates: household income (>$ 70,000/year vs not), median census tract income (continuous), population density (based on the National Land Cover Data; continuous) at the census block-group level as a proxy for urbanicity (Bottino et al., 2012), derived at each visit except in early adolescence, for which only household income data was available (Table 1, Figure 1). We selected these covariates based on prior publications linking green space and executive function and behavioral development ( Figure 1) (Amoly et al., 2014;Bijnens et al., 2020). ...
Increasingly, studies suggest benefits of natural environments or greenness on children's health. However, little is known about cumulative exposure or windows of susceptibility to greenness exposure. Using inverse probability weighting of marginal structural models (IPW/MSM), we estimated effects of greenness exposure from birth through adolescence on executive function and behavior. We analyzed data of 908 children from Project Viva enrolled at birth in 1999–2002 and followed up until early adolescence. In mid-childhood (median 7.7 years) and early adolescence (13.1 years), executive function and behavior were assessed using the Behavior Rating Inventory of Executive Function and the Strengths and Difficulties Questionnaire (SDQ). Greenness was measured at birth, early childhood, mid-childhood, and early adolescence, using the Normalized Difference Vegetation Index. We used inverse probability weighting of marginal structural models to estimate effects of interventions that ensure maximum greenness exposure versus minimum through all intervals; and that ensure maximum greenness only in early childhood (vs. minimum through all intervals). Results of the effects of “maximum (vs. minimum) greenness at all timepoints” did not suggest associations with mid-childhood outcomes. Estimates of “maximum greenness only in early childhood (vs. minimum)” suggested a beneficial association with mid-childhood SDQ (−3.21, 99 %CI: −6.71,0.29 mother-rated; −4.02, 99 %CI: −7.87,-0.17 teacher-rated). No associations were observed with early adolescent outcomes. Our results for “persistent” maximum greenness exposure on behavior, were not conclusive with confidence intervals containing the null. The results for maximum greenness “only in early childhood” may shed light on sensitive periods of greenness exposure for behavior regulation.
... Covariates included characteristics of the child (sex, race (White vs. non-White), and age at cognitive testing), mother's intelligence, parents' education (high-school degree, some college, or at least a college graduate), annual household income at enrollment (in $, <40,000, 40,000-70,000, >70,000), and neighborhood median annual income (at Census-tract level at birth). Neighborhood population density, used as a proxy for urbanicity, was assessed from residential address at birth using nationwide land-use data derived from satellite images with approximately 30-m resolution (24). Mothers' intelligence was assessed using the KBIT-2 (22) (at the mid-childhood visit), which is a valid and reliable measure for ages 4-90, standardized using a representative US sample. ...
The association between early life greenness and child cognition is not well understood. Using prospective data from Project Viva (n=857) from 1999 to 2010, we examined associations of early life greenness exposure with mid-childhood cognition. We estimated residential greenness at birth, early childhood (median age 3.1y), and mid-childhood (7.8y) using 30m resolution Landsat satellite imagery [Normalized Difference Vegetation Index]. In early childhood and mid-childhood, we administered standardized assessments of verbal and nonverbal intelligence, visual-motor abilities, and visual memory. We used natural splines to examine associations of early life-course greenness with mid-childhood cognition, adjusting for age, sex, race, income, neighborhood socioeconomic status, maternal intelligence, and parental education. At lower levels of greenness (greenness<0.6), greenness exposure at early childhood was associated with a 0.48% increase in non-verbal intelligence and 2.64% increase in visual memory in mid-childhood. The association between early childhood greenness and mid-childhood visual memory was observed after further adjusting for early childhood cognition and across different methodologies, while the association with non-verbal intelligence was not. No other associations between early life-course greenness and mid-childhood cognition were found.
Early childhood greenness was nonlinearly associated with higher mid-childhood visual memory. Our findings highlight the importance of nonlinear associations between greenness and cognition.
... For the remaining neighborhood physical environment exposures, the number of studies reporting associations between any particular exposure-outcome pair was small. Among seven studies assessing the built environment, those that assessed sleep duration subjectively were more likely to report associations (two out of two studies [16,72]) compared to studies assessing duration objectively (one out of four studies [62]). A poorer built environment was also associated with later sleep timing [44,62], increased variability [44], and OSA symptoms [31]. ...
Understanding salient environmental determinants of pediatric sleep is essential for informing interventions and public health initiatives. Emerging evidence suggests that the neighborhood environment can impact pediatric sleep, but this evidence has not yet been systematically reviewed. We conducted a systematic review of the scientific literature on associations between neighborhood environments and sleep in young children (0-5 years), school-aged children (6-12 years) and adolescents (13-18 years). We reviewed 85 articles published between 2003 and 2020. The most commonly examined neighborhood exposure was low socioeconomic status (40 studies), which was associated with sleep outcomes in 58% of studies (primarily shorter sleep duration, later sleep timing, or obstructive sleep apnea). Evidence was stronger for neighborhood safety/crime/violence (21 studies), with 86% of studies reporting associations with sleep outcomes (primarily self- or caregiver-reported sleep problems). Fewer studies examined associations of neighborhood physical environment exposures, including noise (15 studies), the built environment (seven studies), and air pollution (six studies). Limitations of the current body of evidence include 1) limited examination of neighborhood exposures other than socioeconomic status or safety, 2) use of primarily cross-sectional observational study designs, 3) lack of objective sleep outcome assessment, and 4) limits of current exposure assessment methods.
... In that study, self-reported neighborhood-level noise partially explained these associations, suggesting higher noise in denser, more walkable neighborhoods as a potential mechanism for these built environment features to impair sleep. Similarly, greater urban land use was associated with shorter parentreported infant sleep duration among a cohort of infants in Massachusetts, although no associations were observed for population density or proximity of a major roadway [53]. More dense, walkable neighborhoods may expose residents to greater levels of noise, traffic, light, and air pollution, which may disrupt sleep [9]. ...
Study Objectives
Over 75% of US high school students obtain insufficient sleep, placing them at risk for adverse health outcomes. Identification of modifiable determinants of adolescent sleep is needed to inform prevention strategies, yet little is known about the influence of the built environment on adolescent sleep.
Methods
In this prospective study, actigraphy was used to assess sleep outcomes among 110 adolescents for 14 days each in eighth and ninth grades: duration (hours/night), onset and offset, and sleeping ≥8 hours. Home addresses were linked to built environment exposures: sound levels, tree canopy cover, street density, intersection density, population density, and housing density. Mixed-effects regression estimated associations of built environment measures with sleep outcomes, adjusting for sex, race, parent education, household income, household size, grade, weeknight status, and neighborhood poverty.
Results
A 1-standard deviation (SD) increase in neighborhood sound was associated with 16 minutes later sleep onset (β = 0.28; 95% confidence interval (CI): 0.06, 0.49) and 25% lower odds of sleeping for ≥8 hours (odds ratio (OR) = 0.75, 95% CI: 0.59, 0.96). A 1-SD increase in neighborhood tree canopy was associated with 18 minutes earlier sleep onset (β = −0.31, 95% CI: −0.49, −0.13) and 10 minutes earlier sleep offset (β= −0.17, 95% CI: −0.28, −0.05). No associations were observed for density-based exposures.
Conclusions
Higher neighborhood sound level was associated with lower odds of sufficient sleep, while higher tree canopy cover was associated with more favorable sleep timing. Neighborhood sound levels and tree canopy cover are potential targets for policies and interventions to support healthier sleep among adolescents.
... To date, only two studies have examined the role of neighborhood factors in infant sleep. One larger birth cohort study observed maternal report of shorter sleep duration of 12-month-old infants among those living in high urbanicity areas, but no relation to population density or closeness to major roadways (Bottino et al., 2012). However, this study did not examine neighborhood socioeconomic conditions or safety. ...
Background
Sleep health is important for development and improves overall health. There are large socioeconomic gradients in sleep health, from childhood through adulthood. Recent findings suggest that children from neighborhoods with poorer socioeconomic conditions have more sleep problems. The current study aimed to investigate the associations between neighborhood factors and infant sleep health.
Participants and Methods
Secondary data analysis using Multilevel Modeling (MLM) was conducted for a subsample of 2445 women from the All our Families longitudinal cohort study, for whom early pregnancy neighborhood data could be geocoded. The Vancouver Area Neighborhood Deprivation Index (VANDIX) was calculated using census data to assess neighborhood SES. Neighborhood disorder was measured using community crime reports from police services. Mothers rated the perceived safety of their neighborhood and reported on their infants’ nighttime sleep consolidation, awakenings, and onset latency at 12 months postpartum.
Results
MLM indicated that neighborhood disorder and maternal perceptions of unsafety predicted less consolidated sleep after accounting for individual and family-level factors including maternal ethnicity, household income, breastfeeding duration, and co-sleeping. Neighborhood deprivation was indirectly related to less consolidated sleep among 12-month-old infants through more reports of disorder and maternal perceptions of less safety.
Conclusions
Consistent with the socio-ecological model of sleep, neighborhood-level, family, and individual factors influence infant sleep health. Policy efforts to increase neighborhood safety and public health initiatives to increase awareness of the importance of sleep could help improve infant sleep health.
... We have previously found an association between residential urbanicity and infant sleep duration in this cohort. 20 We assessed smoking during pregnancy by asking mothers at both first and second trimester visits about their cigarette smoking habits before and during pregnancy. At 6 months and 1 year postpartum, mothers reported the average number of hours of sleep they obtained during a 24-hour period in the last month. ...
Objective
To examine the association of maternal lifetime experiences of racial discrimination with infant sleep duration over the first 2 years of life.
Design
Prebirth cohort study.
Setting
Massachusetts, USA (baseline: 1999-2002).
Participants
552 mother-infant dyads in Project Viva, for whom the mother self-identified as being a woman of color.
Measurements
During pregnancy, mothers completed the Experiences of Discrimination survey that measured lifetime experiences of racial discrimination in eight domains. The main outcome was a weighted average of their infants’ 24-hour sleep duration from 6 months to 2 years.
Results
30% reported 0 domains of racial discrimination, 35% 1–2 domains, and 34% ≥3 domains. Any racial discrimination (≥1 vs. 0 domains) was higher among black (80%) versus Hispanic (58%) or Asian (53%) mothers and the United States versus foreign-born mothers (79% vs. 58%) and was associated with higher mean prepregnancy BMI (26.8 vs. 24.5 kg/m²). Children whose mothers reported ≥3 domains versus 0 domains had shorter sleep duration from 6 months to 2 years in unadjusted analysis (β –18.6 min/d; 95% CI –37.3, 0.0), which was attenuated after adjusting for maternal race/ethnicity and nativity (–13.6 min/d; –33.7, 6.5). We found stronger associations of racial discrimination with offspring sleep at 6 months (–49.3 min/d; –85.3, -13.2) than for sleep at 1 year (–13.5 min/d; –47.2, 20.3) or 2 years (4.2 min/d; –21.5, 29.9).
Conclusions
Maternal lifetime experiences of racial discrimination was associated with shorter offspring sleep duration at 6 months, but not with infant’s sleep at 1 and 2 years of age.
... A further Canadian study found elevated risk of shortened sleep and sleep problems associated with living in dense commercial, residential areas, and living near industrial sites with subjective noise measures (Chum et al. 2015). A related study also found that the level of urbanicity was negatively associated with infant sleep duration (Bottino et al. 2012). Another study found that living in green spaces reduces the risk of short sleep duration (Astell-Burt et al. 2013)-but noise levels were not investigated. ...
It is a one-sided preconception that living in a city is necessarily associated with unbearable noise exposure. The observed variation of noise exposure in cities is quite large and you can find quiet residential areas as well. However, in megacities, the background sound level—“the city hum”—is usually louder due to the multitude of city sound sources. The large variation in noise levels is determined by the cumulative effect of unfavorable or thoughtful city design elements at several scales of a city’s general and neighborhood layout. This comprises several scales of planning: the transportation system, the city and building structure, population density, the design of street and building façades, the amount of green space, and the quality of the dwellings with respect to sound and vibration features. The favorable and unfavorable features differ between European, Asian, North and South American and African cities of any size and contribute to more or less health.
... little was known about the mechanism by which air pollutants may affect sleep. Some studies pointed out harmful effects of air pollution on the sleep in school-age children [14,15,16]. It was demonstrated that air pollution exposure had a negative impact on children's sleep with a significant association between PM 10 levels and sleep disturbance [17,18]. ...
https://www.cabdirect.org/globalhealth/abstract/20193484929
... For example, 1-year-old infants in Eastern Massachusetts who lived in more urban areas were found to have shorter daily sleep duration than those who lived in less urban areas. 42 These differences in early childhood sleep duration and patterns among children from different geographic locations and cultures have been noticed throughout childhood. 35 Parent-child relationships and parenting factors, specifically parental affect (depression and anxiety) influences infant and child sleep. ...
Sleep problems are common, reported by a quarter of parents with children under the age of 5 years, and have been associated with poor behavior, worse school performance, and obesity, in addition to negative secondary effects on maternal and family well-being. Yet, it has been shown that pediatricians do not adequately address sleep in routine well-child visits, and underdiagnose sleep issues. Pediatricians receive little formal training in medical school or in residency regarding sleep medicine. An understanding of the physiology of sleep is critical to a pediatrician׳s ability to effectively and confidently counsel patients about sleep. The biological rhythm of sleep and waking is regulated through both circadian and homeostatic processes. Sleep also has an internal rhythmic organization, or sleep architecture, which includes sleep cycles of REM and NREM sleep. Arousal and sleep (REM and NREM) are active and complex neurophysiologic processes, involving both neural pathway activation and suppression. These physiologic processes change over the life course, especially in the first 5 years. Adequate sleep is often difficult to achieve, yet is considered very important to optimal daily function and behavior in children; thus, understanding optimal sleep duration and patterns is critical for pediatricians. There is little experimental evidence that guides sleep recommendations, rather normative data and expert recommendations. Effective counseling on child sleep must account for the child and parent factors (child temperament, parent-child interaction, and parental affect) and the environmental factors (cultural, geographic, and home environment, especially media exposure) that influence sleep. To promote health and to prevent and manage sleep problems, the American Academy of Pediatrics (AAP) recommends that parents start promoting good sleep hygiene, with a sleep-promoting environment and a bedtime routine in infancy, and throughout childhood. Thus, counseling families on sleep requires an understanding of sleep regulation, physiology, developmental patterns, optimal sleep duration recommendations, and the many factors that influence sleep and sleep hygiene.
... It has already been shown that contextual factors that affect health are highly interrelated with a child's residence and its associated level of urbanicity [20]. Studies have found that the rapid urbanization of the world's population over the past few decades, and the consequent increase in the concentration of urban and suburban populations, has created a characteristic termed urbanicity, defined as living in urban areas, that can have strong adverse or beneficial effects on the health and behavior of children [17,20,21]. As demonstrated by Vlahov and Galea [20], the most common topics of concern that emerge from the urban health literature can be summarized in three principal themes: features of the social environment, features of the physical environment, and the provision of health and social services. ...
To determine the association of urbanicity, defined as living in an urban area, with cognitive development at five years of age in preterm children who were free of any disabilities or neurodevelopmental delays.
Prospective population-based cohort.
French regional Loire Infant Follow-up Team (LIFT) network.
Included in the study were 1738 surviving infants born between March 2003 and December 2008 before 35 weeks of gestational age. At two years of age, the children were free of any disabilities and neurodevelopmental delays and were living in the Pays de la Loire region from their birth to five years of age.
The cognitive development at five years of age was evaluated with the Global School Adaptation score (GSA). The urbanicity of the residence for each child was classified into three groups: urban, quasi-rural, and rural area.
Quantile regression approaches were used to identify a significant association between urbanicity and the GSA score at five years of age (adjusting for child and family characteristics). We found that the negative impact of urbanicity on the GSA score was more important for the lower quantile of the GSA scores.
Urbanicity was significantly associated with cognitive neurodevelopment at five years of age in preterm children born before 35 weeks of gestation. Complementary results additionally suggest that this relation could be mediated at the residence level by a high socioeconomic deprivation level. If these results are confirmed, more personalized follow-ups could be developed for preterm children. Further studies are needed to finely identify the contextual characteristics of urbanicity that underlie this association.
... Urbanization has been linked with reduced infant sleep [161] and experimental research demonstrates long-term consequences of dim light at night in early life, on subsequent anxiety and other neuropsychiatric disorders [162]. In adults, sleep debt is known to compromise emotional empathy [163]. ...
Famed microbiologist René J. Dubos (1901¿1982) was an early pioneer in the developmental origins of health and disease (DOHaD) construct. In the 1960s, he conducted groundbreaking experimental research concerning the ways in which early-life experience with nutrition, microbiota, stress, and other environmental variables could influence later-life health outcomes. He also wrote extensively on potential health consequences of a progressive loss of contact with natural environments (now referred to as green or blue space), arguing that Paleolithic experiences have created needs, particularly in the mental realm, that might not be met in the context of rapid global urbanization. He posited that humans would certainly adapt to modern urban landscapes and high technology, but there might be a toll to be paid in the form of higher psychological distress (symptoms of anxiety and depression) and diminished quality of life. In particular, there might be an erosion of humanness, exemplified by declines in altruism/empathy. Here in the first of a two-part review, we examine contemporary research related to natural environments and question to what extent Dubos might have been correct in some of his 50-year-old assertions.
... The multi-level approach integrates a range of strategies to address the problem of childhood obesity in the context of a complex set of societal, family, and individual factors that contribute to the obesity epidemic [15]. This trial builds on successes from the field of pediatric obesity treatment, considering parents as agents of change, and implementing a family-based behavioral intervention that focuses on healthy nutrition, physical activity, and behavioral modifications [5,10,[16][17][18][19][20]. Finally, GROW is based in local community centers in order to maximize the use of the built environment [21]. ...
Growing Right Onto Wellness (GROW) is a randomized controlled trial that tests the efficacy of a family-centered, community-based, behavioral intervention to prevent childhood obesity among preschool-aged children. Focusing on parent-child pairs, GROW utilizes a multi-level framework, which accounts for macro (i.e., built-environment) and micro (i.e., genetics) level systems that contribute to the childhood obesity epidemic. Six hundred parent-child pairs will be randomized to a 3-year healthy lifestyle intervention or a 3-year school readiness program. Eligible children are enrolled between ages 3 and 5, are from minority communities, and are not obese. The principal site for the GROW intervention is local community recreation centers and libraries. The primary outcome is childhood Body Mass Index (BMI) trajectory at the end of the three-year study period. In addition to other anthropometric measurements, mediators and moderators of growth are considered, including genetics, accelerometry, and diet recall. GROW is a staged intensity intervention, consisting of intensive, maintenance, and sustainability phases. Throughout the study, parents build skills in nutrition, physical activity, and parenting, concurrently forming new social networks. Participants are taught goal-setting, self-monitoring, and problem solving techniques to facilitate sustainable behavior change. The GROW curriculum uses low health literacy communication and social media to communicate key health messages. The control arm is administered to both control and intervention participants. By conducting this trial in public community centers, and by implementing a family-centered approach to sustainable healthy childhood growth, we aim to develop an exportable community-based intervention to address the expanding public health crisis of pediatric obesity.
Background: Findings on the associations between prenatal PFAS exposures and offspring adiposity are inconsistent. Whether such associations may extend to adolescence is especially understudied.
Objectives: We investigated associations of prenatal PFAS exposures with offspring adiposity and body composition at 16-20 years of age.
Methods: We studied 545 mother-child pairs in the prospective prebirth cohort Project Viva (Boston, Massachusetts). We measured six PFAS (PFOA, PFOS, PFNA, PFHxS, EtFOSAA, and MeFOSAA) in maternal early pregnancy (median age=9.6 wk, range: 5.7-19.6 wk) plasma samples. At the late adolescence visit (median age=17.4y, range: 15.9-20.0 y), we obtained anthropometric measures and assessed body composition using bioelectrical impedance analysis and dual-energy X-ray absorptiometry. We examined associations of individual PFAS with obesity [i.e., age- and sex-specific body mass index (BMI) ≥95th percentile] and adiposity and body composition using multivariable Poisson and linear regression models, respectively. We assessed PFAS mixture effects using Bayesian kernel machine regression (BKMR) and quantile g-computation. We used fractional-polynomial models to assess BMI trajectories (at 3-20 years of age) by prenatal PFAS levels.
Results: Thirteen percent (n=73) of the children had obesity in late adolescence. After multivariable adjustment, higher prenatal PFAS concentrations were associated with higher obesity risk [e.g., 1.59 (95% CI: 1.19, 2.12), 1.24 (95% CI: 0.98, 1.57), and 1.49 (95% CI: 1.11, 1.99) times the obesity risk per doubling of PFOS, PFOA, and PFNA, respectively]. BKMR showed an interaction between PFOA and PFOS, where the positive association between PFOS and obesity was stronger when PFOA levels were lower. Each quartile increment of the PFAS mixture was associated with 1.52 (95% CI: 1.03, 2.25) times the obesity risk and 0.52 (95% CI: −
0.02, 1.06) kg/m2 higher BMI. Children with higher prenatal PFOS, EtFOSAA, and MeFOSAA concentrations had higher rates of BMI increase starting from 9-11 years of age.
Discussion: Prenatal PFAS exposures may have obesogenic effects into late adolescence.
Objective:
A growing evidence base suggests home and neighborhood environmental exposures may influence adolescent sleep, but few studies have assessed these relationships using methods that account for time-varying, location-specific exposures, or multiple neighborhood contexts. This study aimed to assess the feasibility and acceptability of using smartphone global positioning system (GPS) tracking and ecological momentary assessment (EMA) to assess time-varying home and neighborhood environmental exposures hypothesized to be associated with adolescent sleep.
Methods:
Adolescents aged 15-17 years in Philadelphia completed 7 days of continuous smartphone GPS tracking, which was used to identify daily levels of exposure to geocoded neighborhood factors (eg, crime, green space). Four daily EMA surveys assessed home sleep environment (eg, noise, light), stress, health behaviors, and neighborhood perceptions. Feasibility and acceptability of GPS tracking and EMA were assessed, and distributions of daily environmental exposures were examined.
Results:
Among 25 teens (mean age 16, 56% male), there was a high level of GPS location data captured (median daily follow-up: 24 hours). Seventy-eight percent of EMA surveys were completed overall. Most participants (96%) reported no privacy concerns related to GPS tracking and minimal burden from EMA surveys. Exposures differed between participants' home neighborhoods and locations visited outside the home neighborhood (eg, higher crime away from home). Sleep environment disruptions were present on 29% of nights (most common: uncomfortable temperature) and were reported by 52% of adolescents.
Conclusions:
Results demonstrate the feasibility and acceptability of mobile methods for assessing time-varying home and neighborhood exposures relevant to adolescent sleep for up to 1 week.
Poor infant sleep quality is associated with negative maternal and infant health outcomes. This study measures socioeconomic disparities in infant sleep quality, and assesses whether child sleep location and maternal stress mediate associations between socioeconomic status (SES) and infant sleep quality. The study includes 86 socioeconomically diverse, mother-infant dyads living in an urban area with infants aged 6–12 months. Mothers reported socioeconomic demographics, infant sleep quality (Brief Infant Sleep Questionnaire) and maternal subjective stress (Perceived Stress Scale). Maternal objective stress was measured via hair cortisol concentration (HCC). The associations among SES, infant sleep quality, infant co-rooming, and maternal stress were assessed. Infants from families with lower income-to-needs (ITN) ratios had poorer infant sleep quality. The association between familial ITN and infant sleep quality was mediated by whether the child co-rooms with parents. Maternal perceived stress was independently associated with infant sleep quality, but HCC was not associated with infant sleep quality.
Objective
To characterize family and environmental correlates of sleep patterns that may contribute to differences in infant sleep.
Methods
We studied 313 infants in the Rise & SHINE (Sleep Health in Infancy & Early Childhood study) cohort. Our main exposures were the parent-reported sleep environment, feeding method and sleep parenting strategies at infant age one month. The main outcomes were nighttime sleep duration, longest nighttime sleep and number of awakenings measured by actigraphy at age six months. We used multivariable linear regression models to examine associations, and secondarily also explored the role of sleep-related environmental exposures in mediating previously observed associations of racial/ethnicity and parental education with infant sleep characteristics.
Results
In adjusted models, a non-dark sleep environment (versus an always dark sleep location) and taking the baby to parent’s bed when awake at night (versus no co-sleeping) were associated with 28 (95% CI, -45, -11) and 18 (95% CI, -33, -4) minutes less sleep at night, respectively. Bottle feeding at bedtime was associated with 62 (95% CI, 21, 103) minutes additional longest nighttime sleep period. Exploratory mediation analyses suggested a modest mediating role of a non-dark sleep environment on racial/ethnic and educational differences in sleep duration.
Conclusions
Infant sleep duration was positively associated with a dark sleep environment and a focal feed at bedtime while taking the baby to the parent’s bed was associated with reduced infant sleep. Modifying the sleep environment and practices may improve infant sleep and reduce sleep health disparities.
In this chapter, we describe the main hypothesized pathways by which the built environment affects sleep health. These pathways can be grouped into three broad categories: ambient hazards and physical exposures; psychosocial pathways; health and behavior. These pathways by which the built environment can affect sleep can occur at three different levels: home, neighborhood, and society. Efforts to improve population sleep health through the built environment should incorporate principles of social justice by seeking to improve the extent to which all society members can access comfortable housing, parks, public transit, healthy food stores, and pollution-free sources of energy and transportation.
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
Objectives
To examine whether increased socioeconomic disadvantage, indexed using a measure of community distress, was associated with variation in caregiver-reported early childhood sleep patterns and problems in a large US sample using a mobile health application (app).
Design
Cross-sectional.
Setting
Data were collected using the free, publicly available Johnson's Bedtime© baby sleep app.
Participants
A total of 14,980 caregivers (85.1% mothers) of children ages 6-35.9 months (M = 13.88 months; 52.6% boys) participated in this study.
Measures
Caregivers reported on child sleep using the Brief Infant Sleep Questionnaire-Revised. Socioeconomic disadvantage was indexed by zip code using the Distressed Communities Index (DCI), which combines seven US census indicators of socioeconomic disadvantage. DCI scores range from prosperous (lowest quintile) to distressed (highest quintile).
Results
Socioeconomic disadvantage was significantly associated with later bedtimes, longer sleep onset latency, and shorter nighttime and 24-hour (total) sleep duration, with children living in distressed communities showing the poorest sleep. However, caregivers living in distressed communities reported a significantly lower prevalence of overall child sleep problems (43% vs 58% in prosperous communities), and more confidence in managing child sleep (42% vs 34% in prosperous communities).
Conclusions
Children living in the most distressed communities have the poorest reported sleep patterns and bedtime behaviors; however, their caregivers are less likely to report problematic child sleep. These findings highlight the need for community-level sleep health promotion interventions, as well as further investigation of caregiver perceptions about child sleep and sleep health promotion among families living in socioeconomically disadvantaged contexts.
Purpose
Latinx children have the highest prevalence of obesity in the US. Physical activity (PA) and sleep are important risk factors for this health disparity, yet limited evidence exists examining objectively measured data among this population. We aim to identify correlates of sleep and PA, as well as the association between sleep and PA, among a sample of Latinx children.
Design and methods
A cross-sectional study was conducted with thirty Latinx 3-to-5-year old children who wore GT3X+ triaxial accelerometers for five consecutive days, from which we examined sleep and PA constructs. Linear regression and ANOVA were used to examine study constructs.
Results
Sedentary behavior, light PA, and MVPA (moderate-to-vigorous PA) were 51.7, 5.6, and 2.6 min/h respectively. Total sleep duration averaged 9.6 h, sleep efficiency averaged 80.0%, and sleep variability averaged 1.30 h/night. Higher household income was associated with sleep variability (F = 7.240, p = .012) and lower sedentary behavior (F = 5.481, p = .027), and higher sleepiness was associated with lower MVPA (β = −0.503, p = .005) and higher child BMI (β = 0.531, p = .033). MVPA was associated with higher sleep efficiency (β = 0.441, p = .016).
Conclusions
Household income emerged as a correlate of sleep variability and sedentary behavior in our study. In addition, we found that MVPA levels were associated with sleep efficiency.
Practice implications
Our results signal an impetus for further research (particularly with larger, multi-site study designs) examining study constructs among Latinx children.
In 2014, Buysse published a novel definition of sleep health, raising awareness for the importance of this construct for individuals, populations, clinical care, and research. However, the original definition focused on adults, with the recommendation that it should be adapted for children and adolescents. As children live within a complex and dynamic system, and may not always have control over their own sleep, this theoretical review will examine and apply Buysse’s five dimensions of sleep health within the context of pediatrics. In addition, using examples from the pediatric sleep literature we introduce a modified definition that takes into consideration the influence of the socio-ecological system within which children live, and the sleep-related behaviors that are critical in supporting or hindering sleep health. Finally, we discuss how the proposed theoretical framework, Peds B-SATED, can be applied to clinical practice, research, and training in the field of pediatric sleep.
Introduction:
We sought to examine the associations among parent-level constructs, sleep-related parenting practices, and child sleep in Latinx families.
Method:
A quantitative study was conducted with 101 Latinx parents of children aged 2-5 years. Key variables that were examined included parental stress, coparenting quality, bedtime routine consistency, parent-child sleep interactions, and child's sleep duration.
Results:
Path analysis results indicated that (1) parent stress had a direct effect on child sleep duration (p =.005) and was mediated by parent-child sleep interactions (p =.021); (2) coparenting quality had a direct effect on child sleep duration (p =.001) and was mediated by bedtime routine consistency (p =.010); and (3) bedtime routine consistency had an indirect effect on child body mass index percentile and was mediated by sleep duration (p =.049).
Discussion:
Coparenting quality and parental stress may be important constructs to consider when designing interventions to improve Latinx child sleep duration.
Purpose
Poor sleep quality is associated with childhood obesity, and Latinx children have the highest prevalence of obesity in the United States. Parents are key agents to ensuring good sleep quality among children, but limited research has examined sleep parenting among Latinx working parents who may have added responsibilities.
Design and methods
Working Latinx parents of 2-to-5-year old children participated in in-depth interviews exploring parenting and familial contexts of child sleep. Main topics in the interview guide included sleep-related parenting practices, social support, cultural influences, and intervention service delivery and content preferences. Thematic analysis was used to analyze data.
Results
Twenty parents completed the interview. The following themes emerged: Sleep parenting, sleep knowledge, impact of familial structures, family commitments, child temperament, and broader contextual factors on sleep, and intervention content and design ideas. Across participants, employment was reported to be a barrier to effective sleep parenting. Parents also reported engaging in practices that may interfere with sleep quality such as using screen time as a distraction and reducing naptime during the weekends to increase the amount of family time. Family-level factors such as co-parenting and spousal support were reported to facilitate sleep parenting. Participants also indicated the need for more sleep parenting knowledge and a preference for mobile platforms and social media to deliver information.
Conclusions
Results not only fill critical gaps in the literature, but also highlight the variability in parents' approaches to sleep parenting and an urgent need for intervention/programming efforts to target Latinx parent's sleep knowledge and parenting.
Objective
This systematic review aimed to summarize correlates of sleep duration in children under 5 years of age.
Methods
Six electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, SPORTDiscus, and Scopus) were searched from inception to May 2019. Observational studies and intervention studies reporting cross-sectional results from baseline data were considered. Data were extracted using a predesigned form and potential correlates were categorized following a sociological framework.
Results
One-hundred and sixteen studies, representing 329,166 children, met the inclusion criteria, with a high risk of bias in 62 included studies. A total of 83 correlates of sleep duration were identified. Among the associations studied four or more times, correlates of nap duration were child’s age and nighttime sleep onset/bedtime; correlates of nighttime sleep duration were household income, parent marital status, parental adiposity level, nighttime sleep duration at younger age, nighttime sleep onset/bedtime, nighttime sleep wakeup time, and frequency of current bedtime routine; correlate of total sleep duration was screen time.
Conclusions
Young children from low-income households, single families, or having overweight parents may be at risk for short sleep duration. Promoting healthy sleep duration from an early age appears essential. Effective practices may include encouraging an earlier bedtime, limiting screen time, and establishing a regular bedtime routine. The absence of consistent evidence in the psychological, cognitive, and emotional domain as well as the physical environmental domain warrants further research.
Sleep health is a multidimensional construct that includes adequate duration, quality and appropriately timed sleep, that may be influenced by environmental factors. In this review, we focus on how an individual's living and sleeping environment, both the surrounding neighborhood physical and social features and the atmosphere around them, may impact their sleep health. We explore the associations of the physical environment (urban density, recreational facilities, green space, mixed land use, healthy food stores), neighborhood deprivation (disadvantage, disorder), and the social environment (social cohesion, safety, stigma) with sleep in both adult and pediatric populations. We investigate how physical and social environmental features may lead to alterations in the timing, duration and quality of sleep and contribute to the most prevalent sleep disorders: insomnia, sleep apnea and circadian rhythm disorders. We also review how ambient factors such as artificial light, environmental noise, and air pollution may contribute to sleep pathology. We have included key studies and recent emerging data regarding how the differential distribution of environmental factors that may affect sleep health may contribute to sleep health disparities.
The American Academy of Pediatrics recommends infants' exposure to electronic screen-based media be minimized; however, more research is needed to understand effects of viewing screen-based media. Here, we examine relations between media use and sleep. Data were collected from mothers when their infants (N = 429) were four months of age. Mothers answered questions about the time their infants spent watching electronic screen-based media. Exposure to electronic screen-based media was negatively associated with nighttime sleep (but not daytime sleep), such that an hour of screen time was associated with nearly 13 min less sleep on a typical night.
This paper aims to provide a systematic review of the literature on the associated factors with infant sleep-wake behaviour during the first 12 months of life, namely (1) the factors positively and negatively associated with sleep-wake behaviour and (2) the factors positively and negatively affected by sleep-wake behaviour. This systematic review was based on a standard protocol constructed according with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and included 146 papers. Two typologies of factors were found in the literature: factors positively and negatively associated with infant sleep-wake behaviour and effects of sleep-wake behaviour. Different factors were identified as being positively and negatively associated with the different sleep-wake behaviours and positively and negatively affected by the different sleep-wake behaviours during the first 12 months of life. Some inconsistent results could be explained by methodological differences between the studies.
Purpose of review:
Sleep is important for overall health and well-being. Insufficient sleep and sleep disorders are highly prevalent among adults and children and therefore a public health burden, particularly because poor sleep is associated with adverse health outcomes. Emerging evidence has demonstrated that environmental factors at the household- and neighborhood-level can alter healthy sleep. This paper will (1) review recent literature on the environmental determinants of sleep among adults as well as children and adolescents; and (2) discuss the opportunities and challenges for advancing research on the environment and sleep.
Recent findings:
Epidemiologic research has shown that social features of environments, family, social cohesion, safety, noise, and neighborhood disorder can shape and/or impact sleep patterns; and physical features such as light, noise, traffic, pollution, and walkability can also influence sleep and is related to sleep disorders among adults and children. Prior research has mainly measured one aspect of the environment, relied on self-reported sleep, which does not correlate well with objective measures, and investigated cross-sectional associations. Although most studies are conducted among non-Hispanic white populations, there is growing evidence that indicates that minority populations are particularly vulnerable to the effects of the environment on insufficient sleep and sleep disorders.
Summary:
There is clear evidence that environmental factors are associated with insufficient sleep and sleep disorders. However, more research is warranted to evaluate how and which environmental factors contribute to sleep health. Interventions that target changes in the environment to promote healthy sleep should be developed, tested, and evaluated as a possible pathway for ameliorating sleep health disparities and subsequently health disparities.
Over the past decade, clinical, epidemiological and biological research has provided strong evidence for the role of sleep health as a fundamental component of health and well-being (Jackson et al., Annu Rev Public Health 36:417–440, 2015). Emerging research has identified the influences of personal and social stress, family relationships, and neighborhood environmental and social characteristics on sleep. Sleep typically occurs in the context of family behaviors and family schedules. For family scholars, there are valuable opportunities to incorporate consideration of social, psychological, and environmental/contextual factors into sleep study models, and to explicitly assess individual, family, and larger contextual mediators and moderators. Family scholars are especially well positioned to advance understanding of and develop new models that elucidate risk factors and outcomes related to sleep health and that address contextual factors, family relationships, and life course issues.
Objectives:
The establishment of organized sleep patterns is an important developmental process during infancy. Little is known about the role of nutrition in sleep maturation. This review focuses on exploring the link between infant sleep and nutrition with the aim to provide an overview of existing literature on the impact of diet and specific nutrients on sleep modulation in infants.
Methods:
An exploratory literature search was performed on the topic in Medline, Scopus and Cochrane Library databases, with a focus on publications in English.
Results:
Both the type of nutrients consumed and the timing at which they were consumed, relative to sleeping time, have been reported to influence infant sleep. Some nutrients have been shown to naturally fluctuate in maternal breast milk with circadian rhythm, and nutrients such as tryptophan, nucleotides, essential fatty acids and Omega-3 long-chain fatty acids have been suggested to impact infant sleep.
Discussion:
In summary, little is known about the nutritional impact on infant sleep and sleep maturation, particularly with regard to specific nutrients. While nutrients like tryptophan and nucleotides seem to impact sleep at the level of brain activity, some fatty acids may affect sleep as a result of their role in supporting the maturity of the central nervous system. In our view, the existing literature indicates that the link between nutrition and infant sleep may be a promising concept to support this crucial phase of early development.
The diurnal cycle of light and dark is one of the strongest environmental factors for life on Earth. Many species in both terrestrial and aquatic ecosystems use the level of ambient light to regulate their metabolism, growth, and behavior. The sky glow caused by artificial lighting from urban areas disrupts this natural cycle, and has been shown to impact the behavior of organisms, even many kilometers away from the light sources. It could be hypothesized that factors that increase the luminance of the sky amplify the degree of this "ecological light pollution". We show that cloud coverage dramatically amplifies the sky luminance, by a factor of 10.1 for one location inside of Berlin and by a factor of 2.8 at 32 km from the city center. We also show that inside of the city overcast nights are brighter than clear rural moonlit nights, by a factor of 4.1. These results have important implications for choronobiological and chronoecological studies in urban areas, where this amplification effect has previously not been considered.
Identifying a stressor paradigm that elicits mean increases in salivary cortisol in young children has proven elusive, possibly due to characteristics of the paradigms used and how and when cortisol is sampled. We therefore examined the validity of a standardized task (adapted from Lewis and Ramsay, 2002) and procedures developed to assess cortisol reactivity in 215 preschool-aged children. Children participated in a standardized stress task during a home visit, which was videorecorded for future coding. Salivary cortisol samples were obtained at baseline and 10, 20, 30, 40, and 50 min post-stress. In support of the validity of the task, significant increases in cortisol levels from baseline were found, followed by a significant decline, and a quadratic function provided a good fit to the data. Children also showed a significant increase in negative emotions and a decrease in positive emotions over the course of the stress task. Results indicate that the task successfully elicited the hypothesized cortisol response in 3-year-old children.
Smart growth is an approach to urban planning that provides a framework for making community development decisions. Despite its growing use, it is not known whether smart growth can impact physical activity. This review utilizes existing built environment research on factors that have been used in smart growth planning to determine whether they are associated with physical activity or body mass. Searching the MEDLINE, Psycinfo and Web-of-Knowledge databases, 204 articles were identified for descriptive review, and 44 for a more in-depth review of studies that evaluated four or more smart growth planning principles. Five smart growth factors (diverse housing types, mixed land use, housing density, compact development patterns and levels of open space) were associated with increased levels of physical activity, primarily walking. Associations with other forms of physical activity were less common. Results varied by gender and method of environmental assessment. Body mass was largely unaffected. This review suggests that several features of the built environment associated with smart growth planning may promote important forms of physical activity. Future smart growth community planning could focus more directly on health, and future research should explore whether combinations or a critical mass of smart growth features is associated with better population health outcomes.
Little is known about the social determinants of sleep attainment. This study examines the relationship of race/ethnicity, socio-economic status (SES) and other factors upon sleep quality.
A cross-sectional survey of 9,714 randomly selected subjects was used to explore sleep quality obtained by self-report, in relation to socioeconomic factors including poverty, employment status, and education level. The primary outcome was poor sleep quality. Data were collected by the Philadelphia Health Management Corporation.
Significant differences were observed in the outcome for race/ethnicity (African-American and Latino versus White: unadjusted OR = 1.59, 95% CI 1.24-2.05 and OR = 1.65, 95% CI 1.37-1.98, respectively) and income (below poverty threshold, unadjusted OR = 2.84, 95%CI 2.41-3.35). In multivariable modeling, health indicators significantly influenced sleep quality most prominently in poor individuals. After adjusting for socioeconomic factors (education, employment) and health indicators, the association of income and poor sleep quality diminished, but still persisted in poor Whites while it was no longer significant in poor African-Americans (adjusted OR = 1.95, 95% CI 1.47-2.58 versus OR = 1.16, 95% CI 0.87-1.54, respectively). Post-college education (adjusted OR = 0.47, 95% CI 0.31-0.71) protected against poor sleep.
A "sleep disparity" exists in the study population: poor sleep quality is strongly associated with poverty and race. Factors such as employment, education and health status, amongst others, significantly mediated this effect only in poor subjects, suggesting a differential vulnerability to these factors in poor relative to non-poor individuals in the context of sleep quality. Consideration of this could help optimize targeted interventions in certain groups and subsequently reduce the adverse societal effects of poor sleep.
Sleep-disordered breathing (SDB), the recurrent episodic disruption of normal breathing during sleep, affects as much as 17% of U.S. adults, and may be more prevalent in poor urban environments. SDB and air pollution have been linked to increased cardiovascular diseases and mortality, but the association between pollution and SDB is poorly understood.
We used data from the Sleep Heart Health Study (SHHS), a U.S. multicenter cohort study assessing cardiovascular and other consequences of SDB, to examine whether particulate air matter less than 10 μm in aerodynamic diameter (PM(10)) was associated with SDB among persons 39 years of age and older.
Using baseline data from SHHS urban sites, outcomes included the following: the respiratory disturbance index (RDI); percentage of sleep time at less than 90% O(2) saturation; and sleep efficiency, measured by overnight in-home polysomnography. We applied a fixed-effect model containing a city effect, controlling for potential predictors. In all models we included both the 365-day moving averages of PM(10) and temperature (long-term effects) and the differences between the daily measures of these two predictors and their 365-day average (short-term effects).
In summer, increases in RDI or percentage of sleep time at less than 90% O(2) saturation, and decreases in sleep efficiency, were all associated with increases in short-term variation in PM(10). Over all seasons, we found that increased RDI was associated with an 11.5% (95% confidence interval: 1.96, 22.01) increase per interquartile range increase (25.5°F) in temperature.
Reduction in air pollution exposure may decrease the severity of SDB and nocturnal hypoxemia and may improve cardiac risk.
Inter-relationships among built and socioeconomic environmental characteristics may result in confounding of associations between environment exposure measures and health behaviors or outcomes, but traditional multivariate adjustment can be inappropriate due to collinearity.
We used principal factor analysis to describe inter-relationships between a large set of Geographic Information System-derived built and socioeconomic environment measures for adolescents in the National Longitudinal Study of Adolescent Health (Wave I, 1995-96, n = 17,294). Using resulting factors in sex-stratified multivariate negative binomial regression models, we tested for confounding of associations between built and socioeconomic environment characteristics and moderate to vigorous physical activity (MVPA). Finally, we used knowledge gained from factor analysis to construct replicable environmental measures that account for inter-relationships and avoid collinearity.
Using factor analysis, we identified three built environment constructs [(1) homogenous landscape; 2) development intensity with high pay facility count; 3) development intensity with high public facility count] and two socioeconomic environment constructs [1) advantageous economic environment, 2) disadvantageous social environment]. In regression analysis, confounding of built environment-MVPA associations by socioeconomic environment factors was stronger than among built environment factors. In fully adjusted models, MVPA was negatively associated with the highest (versus lowest) quartile of homogenous land cover in males [exp(coeff) (95% CI): 0.91 (0.86, 0.96)] and intensity (pay facilities) [exp(coeff) (95% CI): 0.92 (0.85, 0.99)] in females. Single proxy measures (Simpson's diversity index, count of pay facilities, count of public facilities, median household income, and crime rate) representing each environmental construct replicated associations with MVPA.
Environmental characteristics are inter-related. Both built and SES environments should be incorporated into analysis in order to minimize confounding. Single environmental measures may be useful proxies for environmental constructs in longitudinal analysis and replication in external populations, but more research is needed to better understand mechanisms of action, and ultimately identify policy-relevant environmental determinants of physical activity.
Exposure to traffic-related particulate matter (PM) has been associated with adverse respiratory health outcomes in children. Diesel exhaust particles (DEPs) are a local driver of urban fine PM [aerodynamic diameter < or = 2.5 microm (PM(2.5))]; however, evidence linking ambient DEP exposure to acute respiratory symptoms is relatively sparse, and susceptibilities of urban and asthmatic children are inadequately characterized.
We examined associations of daily ambient black carbon (BC) concentrations, a DEP indicator, with daily respiratory symptoms among asthmatic and nonasthmatic adolescents in New York City (NYC) and a nearby suburban community.
BC and PM(2.5) were monitored continuously outside three NYC high schools and one suburban high school for 4-6 weeks, and daily symptom data were obtained from 249 subjects (57 asthmatics, 192 nonasthmatics) using diaries. Associations between pollutants and symptoms were characterized using multilevel generalized linear mixed models, and modification by urban residence and asthma status were examined.
Increases in BC were associated with increased wheeze, shortness of breath, and chest tightness. Multiple lags of nitrogen dioxide (NO(2)) exposure were associated with symptoms. For several symptoms, associations with BC and NO(2) were significantly larger in magnitude among urban subjects and asthmatics compared with suburban subjects and nonasthmatics, respectively. PM(2.5) was not consistently associated with increases in symptoms.
Acute exposures to traffic-related pollutants such as DEPs and/or NO(2) may contribute to increased respiratory morbidity among adolescents, and urban residents and asthmatics may be at increased risk. The findings provide support for developing additional strategies to reduce diesel emissions further, especially in populations susceptible because of environment or underlying respiratory disease.
Health researchers have explored how different aspects of neighborhood characteristics contribute to health and well-being, but current understanding of built environment factors is limited.
This study explores whether the association between stress and health varies by residential neighborhood, and if yes, whether built and social neighborhood environment characteristics act as moderators.
This study uses multilevel modeling and variables derived from geospatial data to explore the role of neighborhood environment in moderating the association of stress with health. Individual-level data (N = 4,093) were drawn from residents of 45 neighborhoods within Philadelphia County, PA, collected as part of the 2006 Philadelphia Health Management Corporation's Household Health Survey.
We find that the negative influence of high stress varied by neighborhood, that residential stability and affluence (social characteristics) attenuated the association of high stress with health, and that the presence of hazardous waste facilities (built environment characteristics) moderated health by enhancing the association with stress.
Our findings suggest that neighborhood environment has both direct and moderating associations with health, after adjusting for individual characteristics. The use of geospatial data could broaden the scope of stress-health research and advance knowledge by untangling the intertwined relationship between built and social environments, stress, and health. In particular, future studies should integrate built environment characteristics in health-related research; these characteristics are modifiable and can facilitate health promotion policies.
Infant sleep undergoes dramatic evolution during the first year of life. This process is driven by underlying biological forces but is highly dependent on environmental cues including parental influences. In this review the links between infant sleep and parental behaviors, cognitions, emotions and relationships as well as psychopathology are examined within the context of a transactional model. Parental behaviors, particularly those related to bedtime interactions and soothing routines, are closely related to infant sleep. Increased parental involvement is associated with more fragmented sleep. Intervention based on modifying parental behaviors and cognitions have direct effect on infant sleep. It appears that parental personality, psychopathology and related cognitions and emotions contribute to parental sleep-related behaviors and ultimately influence infant sleep. However, the links are bidirectional and dynamic so that poor infant sleep may influence parental behaviors and poor infant sleep appears to be a family stressor and a risk factor for maternal depression.
Air pollution and social characteristics have been shown to affect indicators of health. While use of spatial methods to estimate exposure to air pollution has increased the power to detect effects, questions have been raised about potential for confounding by social factors.
A study of singleton births in Eastern Massachusetts was conducted between 1996 and 2002 to examine the association between indicators of traffic, land use, individual and area-based socioeconomic measures (SEM), and birth outcomes (birth weight, small for gestational age and preterm births), in a two-level hierarchical model.
We found effects of both individual (education, race, prenatal care index) and area-based (median household income) SEM with all birth outcomes. The associations for traffic and land use variables were mainly seen with birth weight, with an exception for an effect of cumulative traffic density on small for gestational age. Race/ethnicity of mother was an important predictor of birth outcomes and a strong confounder for both area-based SEM and indices of physical environment. The effects of traffic and land use differed by level of education and median household income.
Overall, the findings of the study suggested greater likelihood of reduced birth weight and preterm births among the more socially disadvantaged, and a greater risk of reduced birth weight associated with traffic exposures. Results revealed the importance of controlling simultaneously for SEM and environmental exposures as the way to better understand determinants of health.
Although accumulating evidence over the past two decades points towards noise as an ambient stressor for children, all of the data emanate from studies in high-intensity, noise impact zones around airports or major roads. Extremely little is known about the nonauditory consequences of typical, day-to-day noise exposure among young children. The present study examined multimethodological indices of stress among children living under 50 dB or above 60 dB (A-weighted, day-night average sound levels) in small towns and villages in Austria. The major noise sources were local road and rail traffic. The two samples were comparable in parental education, housing characteristics, family size, marital status, and body mass index, and index of body fat. All of the children were prescreened for normal hearing acuity. Children in the noisier areas had elevated resting systolic blood pressure and 8-h, overnight urinary cortisol. The children from noisier neighborhoods also evidenced elevated heart rate reactivity to a discrete stressor (reading test) in the laboratory and rated themselves higher in perceived stress symptoms on a standardized index. Furthermore girls, but not boys, evidenced diminished motivation in a standardized behavioral protocol. All data except for the overnight urinary neuroendocrine indices were collected in the laboratory. The results are discussed in the context of prior airport noise and nonauditory health studies. More behavioral and health research is needed on children with typical, day-to-day noise exposure.
Fully understanding the determinants and sequelae of fetal growth requires a continuous measure of birth weight adjusted for gestational age. Published United States reference data, however, provide estimates only of the median and lowest and highest 5th and 10th percentiles for birth weight at each gestational age. The purpose of our analysis was to create more continuous reference measures of birth weight for gestational age for use in epidemiologic analyses.
We used data from the most recent nationwide United States Natality datasets to generate multiple reference percentiles of birth weight at each completed week of gestation from 22 through 44 weeks. Gestational age was determined from last menstrual period. We analyzed data from 6,690,717 singleton infants with recorded birth weight and sex born to United States resident mothers in 1999 and 2000.
Birth weight rose with greater gestational age, with increasing slopes during the third trimester and a leveling off beyond 40 weeks. Boys had higher birth weights than girls, later born children higher weights than firstborns, and infants born to non-Hispanic white mothers higher birth weights than those born to non-Hispanic black mothers. These results correspond well with previously published estimates reporting limited percentiles.
Our method provides comprehensive reference values of birth weight at 22 through 44 completed weeks of gestation, derived from broadly based nationwide data. Other approaches require assumptions of normality or of a functional relationship between gestational age and birth weight, which may not be appropriate. These data should prove useful for researchers investigating the predictors and outcomes of altered fetal growth.
Although sleep disturbances in children are common, little is known about the relationship between children's sleep disruptions and maternal sleep and daytime functioning. Forty-seven mothers completed measures of sleep, depression, parenting stress, fatigue, and sleepiness. Significant differences in maternal mood and parenting stress were found between mothers of children with and without significant sleep disturbances. Regression analyses showed that the quality of the children's sleep significantly predicted the quality of maternal sleep. In addition, maternal sleep quality was a significant predictor of maternal mood, stress, and fatigue. Results from this pilot study support the need for future research examining the relationship between child sleep disturbances and maternal daytime functioning, and they highlight the importance of screening for and treating pediatric sleep disruptions.
Obesity results from a complex interaction between diet, physical activity, and the environment. The built environment encompasses a range of physical and social elements that make up the structure of a community and may influence obesity. This review summarizes existing empirical research relating the built environment to obesity. The Medline, PsychInfo, and Web of Science databases were searched using the keywords "obesity" or "overweight" and "neighborhood" or "built environment" or "environment." The search was restricted to English-language articles conducted in human populations between 1966 and 2007. To meet inclusion criteria, articles had to 1) have a direct measure of body weight and 2) have an objective measure of the built environment. A total of 1,506 abstracts were obtained, and 20 articles met the inclusion criteria. Most articles (84%) reported a statistically significant positive association between some aspect of the built environment and obesity. Several methodological issues were of concern, including the inconsistency of measurements of the built environment across studies, the cross-sectional design of most investigations, and the focus on aspects of either diet or physical activity but not both. Given the importance of the physical and social contexts of individual behavior and the limited success of individual-based interventions in long-term obesity prevention, more research on the impact of the built environment on obesity is needed.
To examine the extent to which infant sleep duration is associated with overweight at age 3 years.
Longitudinal survey.
Multisite group practice in Massachusetts.
Nine hundred fifteen children in Project Viva, a prospective cohort. Main Exposure At children's ages 6 months, 1 year, and 2 years, mothers reported the number of hours their children slept in a 24-hour period, from which we calculated a weighted average of daily sleep.
We used multivariate regression analyses to predict the independent effects of sleep duration (< 12 h/d vs > or = 12 h/d) on body mass index (BMI) (calculated as the weight in kilograms divided by the height in meters squared) z score, the sum of subscapular and triceps skinfold thicknesses, and overweight (BMI for age and sex > or = 95th percentile) at age 3 years.
The children's mean (SD) duration of daily sleep was 12.3 (1.1) hours. At age 3 years, 83 children (9%) were overweight; the mean (SD) BMI z score and sum of subscapular and triceps skinfold thicknesses were 0.44 (1.03) and 16.66 (4.06) mm, respectively. After adjusting for maternal education, income, prepregnancy BMI, marital status, smoking history, and breastfeeding duration and child's race/ethnicity, birth weight, 6-month weight-for-length z score, daily television viewing, and daily participation in active play, we found that infant sleep of less than 12 h/d was associated with a higher BMI z score (beta, 0.16; 95% confidence interval, 0.02-0.29), higher sum of subscapular and triceps skinfold thicknesses (beta, 0.79 mm; 95% confidence interval, 0.18-1.40), and increased odds of overweight (odds ratio, 2.04; 95% confidence interval, 1.07-3.91).
Daily sleep duration of less than 12 hours during infancy appears to be a risk factor for overweight and adiposity in preschool-aged children.
To examine the associations of child and family sociodemographic characteristics with preschooler bedtime routines.
We use parent-report data of 3217 3-year-old children (48% black, 26% Hispanic, and 22% white) from the Fragile Families and Child Wellbeing Study to examine whether child and family characteristics are associated with the presence, time, and consistency of bedtime routines.
More than 80% of sample children have a bedtime yet only two thirds follow it. After extensive controls for maternal education, family structure, and other household characteristics, black and Hispanic children have later bedtimes than white children and reduced odds of using regular bedtimes (by 22% and 29%, respectively) and using bedtime routines (by 47% and 33%, respectively). Low maternal education, increased household size, and poverty are associated with decreased use of parent-child interactive and hygiene-related bedtime routines.
Children from disadvantaged households are less likely to have consistent bedtime routines than their more advantaged counterparts. This may contribute to later disparities in sleep quality, duration and timing, factors known to be associated with adverse behavioral, cognitive, and health outcomes.
My research examines challenges inherent in the design of mobile groupware systems. For my thesis work I am designing interfaces and interaction techniques that can be used to augment face-to-face communication within groups of collocated mobile users. In my initial research, which explored collocated mobile photo capture and sharing, I uncovered three fundamental challenges to designing mobile groupware. In this paper I discuss these challenges as well as my proposed research agenda to addresses the challenges.
Existing evidence linking residential proximity to food establishments with body mass index (BMI; weight (kg)/height (m)(2)) has been inconclusive. In this study, the authors assessed the relation between BMI and proximity to food establishments over a 30-year period among 3,113 subjects in the Framingham Heart Study Offspring Cohort living in 4 Massachusetts towns during 1971-2001. The authors used novel data that included repeated measures of BMI and accounted for residential mobility and the appearance and disappearance of food establishments. They calculated proximity to food establishments as the driving distance between each subject's residence and nearby food establishments, divided into 6 categories. The authors used cross-classified linear mixed models to account for time-varying attributes of individuals and residential neighborhoods. Each 1-km increase in distance to the closest fast-food restaurant was associated with a 0.11-unit decrease in BMI (95% credible interval: -0.20, -0.04). In sex-stratified analyses, this association was present only for women. Other aspects of the food environment were either inconsistently associated or not at all associated with BMI. Contrary to much prior research, the authors did not find a consistent relation between access to fast-food restaurants and individual BMI, necessitating a reevaluation of policy discussions on the anticipated impact of the food environment on weight gain.
Low socioeconomic status (SES) has been associated with higher levels of allostatic load (AL). Posited mechanisms for this association include stress, personality, psychosocial variables, coping, social networks, and health behaviors. This study examines whether these variables explain the SES-AL relationship in a population-based sample of 208 51- to 69-year-old White, Black, and Hispanic adults in the Chicago Health, Aging, and Social Relations Study. AL was based on nine markers of physiological dysregulation. SES was inversely associated with a composite measure of AL; hostility and poor sleep quality helped to explain the association between AL and SES. Factor analyses revealed four AL components corresponding to the bodily systems of interest. SES was significantly associated with two AL components, suggesting that the effects of SES on physiological dysregulation are specific to certain systems in a middle to early old-age population.
To test associations between daytime and nighttime sleep duration and subsequent obesity in children and adolescents.
Prospective cohort.
Panel Survey of Income Dynamics Child Development Supplements (1997 and 2002) from US children.
Subjects aged 0 to 13 years (n = 1930) at baseline (1997).
Binary indicators of short daytime and nighttime sleep duration (<25th percentile of age-normalized sleep scores) at baseline.
Body mass index at follow-up (2002) was converted to age- and sex-specific z scores and trichotomized (normal weight, overweight, obese) using established cut points. Ordered logistic regression was used to model body mass index classification as a function of short daytime and nighttime sleep at baseline and follow-up, and important covariates included socioeconomic status, parents' body mass index, and, for children older than 4 years, body mass index at baseline.
For younger children (aged 0-4 years at baseline), short duration of nighttime sleep at baseline was strongly associated with increased risk of subsequent overweight or obesity (odds ratio = 1.80; 95% confidence interval, 1.16-2.80). For older children (aged 5-13 years), baseline sleep was not associated with subsequent weight status; however, contemporaneous sleep was inversely associated. Daytime sleep had little effect on subsequent obesity in either group.
Shortened sleep duration in early life is a modifiable risk factor with important implications for obesity prevention and treatment. Insufficient nighttime sleep among infants and preschool-aged children may be a lasting risk factor for subsequent obesity. Napping does not appear to be a substitute for nighttime sleep in terms of obesity prevention.
We examine the association between perceived neighborhood disorder and self-rated physical health. Building on previous research, we test whether this association is mediated by sleep quality.
We use data from the 2004 Survey of Texas Adults (n=1323) to estimate a series of ordinary least squares regression models. We formally assess mediation by testing for significant changes in the effect of neighborhood disorder before and after adjusting for sleep quality.
We find that residence in a neighborhood that is perceived as noisy, unclean, and crime-ridden is associated with poorer self-rated physical health, even with controls for irregular exercise, poor diet quality, smoking, binge drinking, obesity and a host of relevant sociodemographic factors. Our results also indicate that the relationship between neighborhood disorder and self-rated physical health is partially mediated by lower sleep quality.
Targeted interventions designed to promote sleep quality in disadvantaged neighborhoods may help to improve the physical health of residents in the short-term. Policies aimed at solving the problem of neighborhood disorder are needed to support sleep quality and physical health in the long-term.
Insufficient sleep in children is associated with adverse health effects. We examined the associations of early life risk factors with infant sleep duration.
We studied 1676 mother-infant pairs in a prebirth cohort study. Main outcomes were mothers' report of their infants' average 24-hour sleep duration at ages 6 months, 1 year, and 2 years.
Infants slept mean standard deviation [SD] durations of 12.2 (2.0) hours/day at age 6 months, 12.8 (1.6) hours/day at age 1 year, and 11.9 (1.3) hours/day at age 2 years. In multivariable regression models, maternal antenatal depression, introduction of solids at age <4 months, and infant TV/video viewing were associated with shorter sleep durations at both 1 and 2 years of age. Estimates were 0.36 fewer hours/day of sleep for maternal antenatal depression, 0.39 fewer hours/day of sleep if infant was introduced to solids at age <4 months, and 0.11 fewer hours/day of sleep for each 1 hour of TV viewed per week. Attendance at child care outside the home was associated with 0.18 fewer hours/day of sleep at age 2 years. At age 2 years, black, Hispanic, and Asian infants slept 0.40, 0.82, and 0.95, respectively, fewer hours per day than white infants.
Maternal depression during pregnancy, early introduction of solid foods, infant TV viewing, and attendance of child care were associated with shorter infant sleep duration. Racial/ethnic minority children slept fewer hours in the first 2 years of life than white children. Our results suggest that various risk factors, some potentially modifiable, are worthy of clinical consideration when addressing infant sleep duration.
The aim of this paper was to review the evidence for early-life (from conception to 5 years of age) determinants of obesity. The design is review of published systematic reviews. Data sources included Medline, Embase, Web of Science, Cochrane Library, CINAHL, PsycINFO. Identification of 22 eligible reviews from a database of 12,021 independent publications. Quality of selected reviews assessed using the Assessment of Multiple Systematic Reviews score. Articles published after the reviews were used to confirm results. No review was classified as high quality, 11 as moderate and 11 as low. Factors associated with later overweight and obesity: maternal diabetes, maternal smoking, rapid infant growth, no or short breastfeeding, obesity in infancy, short sleep duration, <30 min of daily physical activity, consumption of sugar-sweetened beverages. Other factors were identified as potentially relevant, although the size of their effect is difficult to estimate. Maternal smoking, breastfeeding, infant size and growth, short sleep duration and television viewing are supported by better-quality reviews. It is difficult to establish a causal association between possible determinants and obesity, and the relative importance of each determinant. Future research should focus on early-life interventions to confirm the role of protective and risk factors and to tackle the high burden obesity represents for present and future generations.
The aim of this study was to explore the relationships between infant sleep patterns and infant physical growth (weight for length ratio) using both objective and subjective sleep measures. Ninety-six first-born, healthy 6-month-old infants and their parents participated in the study. Infant sleep was assessed by actigraphy for four consecutive nights and by the Brief Infant Sleep Questionnaire (BISQ). In addition, parents were asked to complete background and developmental questionnaires. Questions about feeding methods were included in the developmental questionnaire. Infants' weight and length were assessed during a standard checkup at the infant-care clinic when the infants were 6 months old. Significant correlations were found between infant sleep and growth after controlling for potential infant and family confounding factors. Actigraphic sleep percentage and reported sleep duration were correlated negatively with the weight-to-length ratio measures. Sex-related differences in the associations between sleep and physical growth were found. Breast feeding at night was correlated with a more fragmented sleep, but not with physical growth. These findings suggest that sleep is related significantly to physical growth as early as in the first months of life. The study supports increasing evidence from recent studies demonstrating a link between short sleep duration and weight gain and obesity in young children.
Chronic epidemiological studies of airborne particulate matter (PM) have typically characterized the chronic PM exposures of their study populations using city- or countywide ambient concentrations, which limit the studies to areas where nearby monitoring data are available and which ignore within-city spatial gradients in ambient PM concentrations. To provide more spatially refined and precise chronic exposure measures, we used a Geographic Information System (GIS)-based spatial smoothing model to predict monthly outdoor PM(10) concentrations in the northeastern and midwestern United States. This model included monthly smooth spatial terms and smooth regression terms of GIS-derived and meteorological predictors. Using cross-validation and other pre-specified selection criteria, terms for distance to road by road class, urban land use, block group and county population density, point- and area-source PM(10) emissions, elevation, wind speed, and precipitation were found to be important determinants of PM(10) concentrations and were included in the final model. Final model performance was strong (cross-validation R(2)=0.62), with little bias (-0.4 mug m(-3)) and high precision (6.4 mug m(-3)). The final model (with monthly spatial terms) performed better than a model with seasonal spatial terms (cross-validation R(2)=0.54). The addition of GIS-derived and meteorological predictors improved predictive performance over spatial smoothing (cross-validation R(2)=0.51) or inverse distance weighted interpolation (cross-validation R(2)=0.29) methods alone and increased the spatial resolution of predictions. The model performed well in both rural and urban areas, across seasons, and across the entire time period. The strong model performance demonstrates its suitability as a means to estimate individual-specific chronic PM(10) exposures for large populations.
Infant sleep is a major source of concern for many parents. The aims of this longitudinal study were to assess: (a) the development of sleep patterns among infants, (b) the development of maternal cognitions regarding infant sleep, and (c) the relations between these domains during the 1st year of life. Eighty-five mothers were recruited during pregnancy and completed a questionnaire aimed at assessing maternal sleep-related cognitions. After delivery (at 1, 6, and 12 months) sleep was assessed using actigraphy and sleep logs, and maternal cognitions were reassessed. The findings demonstrated significant predictive and concomitant links between maternal cognitions and infant sleep. Maternal soothing behaviors mediated the relations between these domains.
Objective:
Few studies have examined interaction effects between person and environment, especially for cardiovascular disease (CVD) risk. The purpose of this study was to examine built environment characteristics and resident health behaviors as they relate to change in blood pressure, an important component of CVD.
Methods:
Participants (N=1145, aged 50-75 at baseline) were recruited from 120 neighborhoods in Portland, Oregon. Using a longitudinal design, we assessed changes in participants' systolic and diastolic blood pressure from baseline to 1-year follow-up (2006-2007 to 2007-2008). Independent variables included baseline neighborhood-level measures of GIS-constructed neighborhood walkability and density of fast-food restaurants, and resident-level measures of meeting physical activity recommendations and eating fruits and vegetables.
Results:
There was a small but significant resident-level increase in both systolic and diastolic blood pressure (P<0.001) over the 1-year observation period. A similar trend was also observed at the neighborhood level (P<0.001). Significant differences in change in blood pressure, by neighborhood walkability, were observed, with decreases in systolic and diastolic blood pressure for those living in high walkable neighborhoods (P<0.001). Neighborhoods of low walkability but with a high density of fast-food outlets and residents making visits to fast-food restaurants were significantly associated with increases in blood pressure measures over time. The negative effect of fast-food restaurants on blood pressure was diminished among high-walkable neighborhoods, with benefits observed among residents meeting guidelines for physical activity and eating fruits and vegetables.
Conclusions:
Neighborhoods with high walkability may ameliorate the risk of hypertension at the community level and promotion of neighborhood walkability could play a significant role in improving population health and reducing CVD risk.
The purpose of our study was to determine if common sleep disturbances in young children, such as night waking and bedtime struggle, tend to persist; if they are related to environmental stress factors and are accompanied by other behavior problems; and if their persistence is related to other factors. Sixty children aged 15 to 48 months (mean age 26.4 months) were studied by interviewing their mothers initially and after 3 years. Children with and without sleep disturbances were compared, with the latter serving as the control group. Twenty-five (42%: night waking, 22%; bedtime struggle, 13%; both night waking and bedtime struggle, 7%) of 60 children had sleep disturbances at the initial interview, and of these 25 children, 21 (84%) had persistence of sleep disturbances after 3 years, persistent sleep disturbances had a significant relationship with increased frequency of stress factors in the environment (P less than 0.01). Other generalized behavior difficulties were present in 30% of sleep-disturbed and 19% of non-sleep-disturbed children (P = NS). Co-sleeping (sleeping with a parent or sibling) was noted more frequently in sleep-disturbed (34%) than in non-sleep-disturbed (16%) children. Twenty percent of the mothers at initial interview and 30% at 3-year follow-up perceived their child's sleep disturbances as stressful to them and to their family life. Early identification of the child with sleep disturbances and timely intervention would help both the child and the family.
A longitudinal study, based on interviews with 308 middle-class, preponderantly white mothers, provided an opportunity to evaluate the continuity, predictive factors, and behavioral correlates of sleep problems in young children. When their children were 8 months old, 10% of the mothers reported that their babies woke three or more times per night, 8% reported that the babies took an hour or more to settle after waking, 5% complained that their own sleep was severely disrupted by the child, and 18% reported at least one of these problems. At 3 years of age, 29% of the children had difficulty getting to bed and/or falling asleep or staying asleep. Of children with a sleep problem at 8 months of age, 41% still had a problem at 3 years of age, whereas only 26% of children without a problem at 8 months of age had a problem at 3 years of age (P less than .001). Among children with sleep problems at 8 months of age, mothers' depressed feelings were the only measured demographic or psychosocial factor associated with persistent sleep problems (P = .02). A separate analysis indicated that these depressed feelings did not appear to be a consequence of the child's sleep problem. Future studies should evaluate how maternal depression interacts with other factors to result in persistent sleep problems. Children with persistent sleep problems were more likely to have behavior problems, especially tantrums (P less than .02) and behavior management problems (P less than .01), than were children without persistent sleep problems (P less than .02).(ABSTRACT TRUNCATED AT 250 WORDS)
To determine the range of sleep behaviour of normal children to age 38 months and to ascertain the level of parents' problems associated with their child's sleep behaviour.
A cross-sectional survey by questionnaire of parents presenting with their children for routine well-child checks at child health centres, mobile clinics, flying doctor clinics and home visits throughout Queensland. Of 3383 questionnaires distributed 3269 (96.5%) were returned.
1. Sleep frequency and duration, settling procedures, time taken to settle at night, age when child first slept through the night and number of night-time wakenings requiring parental intervention. 2. Parents' problems with their child's sleep behaviour.
There is a wide range of normal childhood sleep behaviour. Circadian rhythm is not well established until four months of age. Daytime sleep becomes less regular with increasing age. Frequent night-time wakening is common from four to 12 months. Night-time settling requires more parental input from 18 months. A large proportion of parents (28.6%) have a problem with their child's sleep behaviour.
Parents require information from health care providers about the wide range of normal childhood sleep patterns. This information can help prevent misdiagnosis, inappropriate medication use, child abuse and parental depression when children's sleep patterns are a problem.
A statistical study was made of reported night-waking in a national cohort of British 5-year-olds in order to explore long-term associations with physical, behavioural and mental development. After adjusting for the most likely confounders, reported night-waking at five was found to be linked at 10 years of age to certain chronic medical conditions and some symptoms of emotional distress. No convincing relationships existed between night-waking at five and selected measures of later physical development or intellectual ability.
The nocturnal excretion of catecholamines in urine was studied in 30-45-year-old women whose bedroom and/or living room were facing streets of varying traffic volume. The traffic volume of the streets was used as an indicator of noise exposure; adrenaline and noradrenaline concentrations were assessed as indicators of the outcome of the physiological stress. Significant associations between traffic volume and noradrenaline concentrations in urine were found with regard to the exposure of the bedroom (not the living room), indicating a higher chronic physiological arousal in noise-exposed subjects as compared to less exposed. Subjective measures of disturbance due to traffic noise were positively correlated with the noradrenaline level. However, this was only found in subjects where closing the window could not reduce the perceived disturbance, which points to the effectiveness of individual coping mechanisms. Stress hormones are useful indicators to study associations, mechanisms, and interactions between noise, health outcomes, and effect modifiers in epidemiological noise research.
To investigate perinatal predictors of newborn blood pressure.
Among 1059 mothers and their newborn infants participating in Project Viva, a US cohort study of pregnant women and their offspring, we obtained five systolic blood pressure readings on a single occasion in the first few days of life. Using multivariate linear regression models, we examined the extent to which maternal age and other pre- and perinatal factors predicted newborn blood pressure level.
Mean (SD) maternal age was 32.0 (5.2) years, and mean (SD) newborn systolic blood pressure was 72.6 (9.0) mm Hg. A multivariate model showed that for each 5-year increase in maternal age, newborn systolic blood pressure was 0.8 mm Hg higher (95% CI, 0.2, 1.4). In addition to maternal age, independent predictors of newborn blood pressure included maternal third trimester blood pressure (0.9 mm Hg [95% CI, 0.2, 1.6] for each increment in maternal blood pressure); infant age at which we measured blood pressure (2.4 mm Hg [95% CI 1.7, 3.0] for each additional day of life); and birth weight (2.9 mm Hg [95% CI, 1.6, 4.2] per kg).
Higher maternal age, maternal blood pressure, and birth weight were associated with higher newborn systolic blood pressure. Whereas blood pressure later in childhood predicts adult hypertension and its consequences, newborn blood pressure may represent different phenomena, such as pre- and perinatal influences on cardiac structure and function.
Low socioeconomic status (SES) is associated with a range of health outcomes. Our objective was to study the relationship between residence in a neighborhood of severe socioeconomic disadvantage and childhood obstructive sleep apnea (OSA).
Cross-sectional analysis of 843 (49% female, 36% African-American) children 8 to 11 years of age from a community-based cohort. Data on neighborhood conditions were obtained from the 2000 US Census. The main outcome measure was OSA, defined as an obstructive apnea hypopnea index >5 events per hour or an obstructive apnea index >1 event per hour.
Residence in a neighborhood of severe socioeconomic disadvantage was significantly associated with OSA after adjusting for effects of previously established risk factors: premature birth, obesity, and African-American ethnicity (OR = 3.44, 95% CI = 1.53-7.75). Secondary analyses showed that neighborhood disadvantage remained significantly associated with OSA: (1) in the African-American subgroup, after controlling for effects of prematurity and obesity; and (2) after controlling for indicators of household-level SES or other health characteristics.
Childhood OSA is associated with low SES as measured by an index describing severe neighborhood disadvantage, emphasizing the potential importance of environmental factors, particularly those associated with neighborhood distress, as risk factors for OSA.
This study establishes functions that specify self-reported sleep disturbance in relation to the exposure to nighttime transportation noise, by reanalyzing pooled data from previous studies. Results are based on data from 28 original datasets obtained from 24 field studies (4 studies collected data regarding 2 sources) including almost 23,000 participants exposed to nighttime levels ranging from 45 to 65 dB. Functions are presented that give the percentage highly sleep disturbed, sleep disturbed, and (at least) a little sleep disturbed people due to aircraft, road traffic, and railway noise in relation to the average nighttime outdoor exposure level at the facade most exposed to the source concerned. These functions show that at the same average nighttime noise-exposure level, aircraft noise is associated with more self-reported sleep disturbance than road traffic, and road traffic noise is associated with more sleep disturbance than railways. The association of noise-induced sleep disturbance with age has an inverse U-shape, with the strongest reaction found between 50 and 56 years of age.
In addition to being necessary for vision, light also plays a primary role in circadian physiology. Humans are diurnal animals and their biological clock synchronizes their physiological functions in such a way that functions associated with activity happen in the daytime while functions associated with rest occur at night. A misalignment between the endogenous circadian clock and the desired sleep schedule is the main cause of circadian sleep disorders; it may be involved in certain mood disorders as well. Since light is the main environmental cue used by the biological clock to set its own timing in relation to the day-night cycle, inappropriate light exposure can be involved in the physiopathology of circadian disorders. Conversely, when handled properly, controlled light exposure can be used to treat some mood and sleep disorders. While the earliest studies in the field focused solely on exposure to bright light, contemporary studies aim at understanding how the entire profile of light-dark exposure can influence the circadian clock and, consequently, mood, sleep, and vigilance quality. Following a brief summary of the main concepts underlying the non-visual effects of light, this paper presents some studies using ambulatory measurements of light exposure to illustrate how these concepts apply in real-life situations and discusses the clinical relevance of light exposure in the natural environment for mood, sleep, and circadian disorders.
In children, objective data carried out from sleep EEG monitoring are scarce. Furthermore, results associating the hypothalamic-pituitary-adrenocortical (HPA)-activity with sleep EEG measurements in children are missing. Therefore, our study aimed to investigate in preschool-children the association between sleep patterns and endocrine activity. Furthermore, children's behavioral/emotional difficulties and competences were assessed in order to correlate psychological strain with sleep measures.
Sixty-seven kindergarten children (35 boys and 32 girls) aged 5.34 underwent EEG-monitoring for one night. For baseline HPA-activity assessment, saliva samples were collected immediately after awakening, whereas saliva samples before, while and after a psychological challenge were used to assess the HPA-activity under stress conditions.
Compared to girls, boys showed significantly more REM sleep time. After cluster analysis, children labeled as 'poor' sleepers (n=27; 40,30%) showed significantly increased morning cortisol values, as compared to 'good' sleepers (n=22; 32,83%). Furthermore, increased cortisol AUC values under stress conditions were significantly associated with an elevated number of awakenings after sleep onset, and more sleep time in stages 1 and 2. In addition, an increased sleep efficiency was significantly correlated with self-reported emotional/behavioral difficulties, i.e. with low degrees of impulsivity (r=-.31; p<.05) and lower degrees of social inhibition and peer victimiziation (r=-.26, p<.05).
Our results underlined that already in preschool years, associations between objectively examined unfavorable sleep patterns, increased HPA-system activity and more difficult behavioral and psychosocial dimensions may be observed.
Night time noise exposure has very rarely been used in previous studies on the relationship between community noise and children's blood pressure, although children spend a larger part of their night time sleeping at home than adults. For this reason, we focused on night time noise exposure at children's residences and daytime noise at kindergartens. The aim of this study was to investigate the effects of urban road-traffic noise on children's blood pressure and heart rate. A cross-sectional study was performed on 328 preschool children (174 boys and 154 girls) aged 3-7 years, who attended 10 public kindergartens in Belgrade. Equivalent noise levels (Leq) were measured during night in front of children's residences and during day in front of kindergartens. A residence was regarded noisy if Leq exceeded 45 dB (A) during night and quiet if the Leq was < or =45 dB (A). Noisy and quiet kindergartens were those with daily Leq>60 dB (A) and < or =60 dB (A), respectively. Children's blood pressure was measured with mercury sphygmomanometer. Heart rate was counted by radial artery palpitation for 1 min. The prevalence of children with hypertensive values of blood pressure was 3.96% (13 children, including 8 boys and 5 girls) with higher prevalence in children from noisy residences (5.70%), compared to children from quiet residences (1.48%). The difference was borderline significant (p=0.054). Systolic pressure was significantly higher (5 mm Hg on average) among children from noisy residences and kindergartens, compared to children from both quiet environments (p<0.01). Heart rate was significantly higher (2 beats/min on average) in children from noisy residences, compared to children from quiet residences (p<0.05). Multiple regression, after allowing for possible confounders, showed a significant correlation between noise exposure and children's systolic pressure (B=1.056; p=0.009).
To examine the relationship between lung function and cognition among children in the Maternal-Infant Smoking Study of East Boston, a prospective cohort of women and children enrolled before 20 weeks of gestation. A number of studies have demonstrated a relationship between lung function and cognition among adults, but this relationship has not been studied among children.
At 6 years of age, children completed lung function tests. At 9 years of age, the Wide Range Assessment of Memory and Learning (WRAML) and Kaufman Brief Intelligence Test (K-BIT) were administered. Linear regression was used to assess the relationship between cognition and lung function.
The sample of 165 children included 53% girls and 52% Hispanic. Mean (+/- standard deviation) forced expiratory volume in 1 second (FEV (1)) was 1.26 +/- 0.2 L; mean forced vital capacity (FVC) was 1.37 +/- 0.2 L. In multivariate regression, a 1% increase from expected FEV(1) was associated with increases in the matrices and composite subscales of the K-BIT (p < .05), and in the verbal and learning subscales of the WRAML (p < .10). FVC was associated with increases in the composite and matrices subscale of the KBIT and in the visual and learning subscales of the WRAML (all p < .05).
Increased lung function was associated with increased cognitive development among children after adjusting for tobacco exposure, birthweight, and peak blood lead. Lung and cognitive function may operate under common regulatory processes and thus have shared vulnerabilities to a host of environmental factors during development.
Sleep disparity'' in the population: poor sleep quality is strongly associated with poverty and ethnicity Social and demo-graphic predictors of preschoolers' bedtime routines
- N P Patel
- M A Grandner
- D Xie
- C C Branas
- N Gooneratne
- L Hale
- L M Berger
- M K Lebourgeois
- J Brooks-Gunn
Patel, N.P., Grandner, M.A., Xie, D., Branas, C.C., Gooneratne, N., 2010. ''Sleep disparity'' in the population: poor sleep quality is strongly associated with poverty and ethnicity. BMC Public Health 10, 475. Hale, L., Berger, L.M., LeBourgeois, M.K., Brooks-Gunn, J., 2009. Social and demo-graphic predictors of preschoolers' bedtime routines. Journal of Developmen-tal & Behavioral Pediatrics 30 (5), 394–402.
A nearly continuous measure of birth weight for gestational age using a United States national reference
- E Oken
- K P Kleinman
- J W Rich-Edwards
- M W Gillman
Oken E, Kleinman KP, Rich-Edwards JW, Gillman MW. A nearly continuous measure of birth
weight for gestational age using a United States national reference. BMC Pediatr. 2003; 3:6.
[PubMed: 12848901]
Why care about sleep of infants and their parents? Sleep medicine reviews
- A Sadeh
- J A Mindell
- J Owens
Sadeh A, Mindell JA, Owens J. Why care about sleep of infants and their parents? Sleep medicine
reviews. Oct; 2011 15(5):335-337. [PubMed: 21612956]
Author manuscript; available in PMC (ref) 0.0 (ref) 0.0 (ref) 50 to < 100 meters 34 −9
- Health Place
Health Place. Author manuscript; available in PMC 2013 September 01.
0.0 (ref)
0.0 (ref)
0.0 (ref)
50 to < 100 meters
34
−9.18 (−52.4,33.98)
−15.9 (−58.1,26.27)
−24.4 (−66.3,17.37)
Built environment and changes in blood pressure in middle aged and older adults
- F Li
- P Harmer
- B J Cardinal
- N Vongjaturapat
Li F, Harmer P, Cardinal BJ, Vongjaturapat N. Built environment and changes in blood pressure in
middle aged and older adults. Prev Med. Mar; 2009 48(3):237-241. [PubMed: 19297686]
A nearly continuous measure of birth weight for gestational age using a United States national reference
- Oken