Michels N, De Henauw S, Eiben G, Hadjigeorgiou C, Hense S, Hunsberger M, Konstabel K, Molnár D, Moreno L A, Siani A, De Bourdeaudhuij I, Pigeot I
Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Health Sciences, Vesalius, University College Ghent, Ghent, Belgium.
Obes Rev. 2015 Dec;16 Suppl 2:68-77. doi: 10.1111/obr.12327.
According to recent findings, short sleep duration is associated with overweight in children. However, primary prevention efforts aimed at achieving adequate sleep among children are scarce. Therefore, the 'Identification and prevention of Dietary-induced and lifestyle-induced health EFfects In Children and infantS' (IDEFICS) study implemented a multilevel intervention that included sleep duration as a key behavioural target. The aim of this study is to evaluate sleep duration among children participating in the IDEFICS study.
The IDEFICS nocturnal sleep intervention was included as part of stress reduction educational messages aimed at parents and children. Sleep was assessed by a parental 24-h recall (only weekdays; n = 8,543) and by a diary (weekdays and weekends separately; n = 4,150). Mixed linear models tested the intervention effect on sleep duration change between baseline when children were 2-9.9 years of age (2007/2008) and follow-up (2009/2010). Logistic mix models were used to study the intervention effect on the presence of TV in the children's bedroom (one of the intervention messages; n = 8,668). Additionally, parents provided qualitative data regarding exposure to the intervention.
About 51.1% of the parents in the intervention regions reported awareness of the sleep intervention. A small intervention effect was seen on weeknight sleep duration in that the decrease in sleep duration over 2 years was smaller in the intervention (15 min) as compared with control regions (19 min) (p = 0.044). There was no overall intervention effect on weekend sleep duration or on the presence of a TV in the bedroom. A small significant time effect between baseline and follow-up was found on bedroom TV presence depending on self-reported intervention exposure (3% increase in TV presence in exposed versus 6.6% increase in non-exposed). Children without a TV in the bedroom had longer nocturnal sleep duration.
The sleep component of the intervention did not lead to clinically relevant changes in sleep duration. Future interventions aimed at young children's sleep duration could benefit from more specific and intense messaging than that found in the IDEFICS intervention. Future research should use objective measures of sleep duration as well as intermediate outcomes (sleep knowledge, sleep environment and sleep practices).
根据最近的研究结果，睡眠时间短与儿童超重有关。然而，旨在让儿童获得充足睡眠的一级预防措施却很少。因此，“儿童和婴儿饮食与生活方式所致健康影响的识别与预防”（IDEFICS）研究实施了一项多级干预措施，将睡眠时间作为关键行为目标。本研究的目的是评估参与IDEFICS研究的儿童的睡眠时间。
IDEFICS夜间睡眠干预作为针对家长和儿童的减压教育信息的一部分。通过家长24小时回忆法（仅工作日；n = 8543）和日记法（工作日和周末分别记录；n = 4150）评估睡眠情况。混合线性模型测试了干预对2至9.9岁儿童（2007/2008年）基线时与随访（2009/2010年）之间睡眠时间变化的影响。逻辑混合模型用于研究干预对儿童卧室中电视存在情况（干预信息之一；n = 8668）的影响。此外，家长提供了关于接触干预措施的定性数据。
干预地区约51.1%的家长报告知晓睡眠干预措施。观察到对工作日夜间睡眠时间有较小的干预效果，即与对照地区（19分钟）相比，干预地区2年内睡眠时间的减少量较小（15分钟）（p = 0.044）。对周末睡眠时间或卧室中电视的存在情况没有总体干预效果。根据自我报告的干预接触情况，发现基线与随访之间在卧室电视存在情况上有较小的显著时间效应（接触干预的儿童电视存在情况增加3%，未接触干预的儿童增加6.6%）。卧室中没有电视的儿童夜间睡眠时间更长。
干预措施中的睡眠部分并未导致睡眠时间出现具有临床意义的变化。未来针对幼儿睡眠时间的干预措施可能会从比IDEFICS干预措施更具体、更强烈且更有针对性的信息传递中受益。未来的研究应使用睡眠时间的客观测量方法以及中间结果（睡眠知识、睡眠环境和睡眠习惯）。
