Bonuck Karen A, Schwartz Barbara, Schechter Clyde
Department of Family and Social Medicine, Albert Einstein College of Medicine.
Steinhardt School of Culture, Education, and Human Development, New York University.
Sleep Health. 2016 Mar;2(1):19-24. doi: 10.1016/j.sleh.2015.12.002.
Healthy child development requires sufficient, quality sleep. Sleep problems in early childhood impair social-emotional and cognitive function and increase obesity risk. From a health literacy framework, "sleep health literacy" denotes the knowledge, motivation, and competencies to promote healthy sleep and to recognize a sleep problem.
To explore the untapped potential of early childhood education (ECE) programs to promote sleep health literacy, we surveyed staff (n=63) and parents (n=196) in Head Start about sleep-related knowledge, attitudes/beliefs, sleep hygiene, and sleep problems. Head Start is the largest ECE program in the United States.
Most parents believed that their child had healthy sleep habits (81%); few believed that he or she had a sleep problem (10%). Yet, unhealthy bedtime practices and insufficient sleep for age were reported in 50% and 33% of children, respectively. Between 10% and 12% of children had 1 or more sleep onset or awakening problems. Every unhealthy bedtime practice but one was associated with a sleep problem; parental presence at bedtime was associated with the most problems. Insufficient sleep was significantly associated with unhealthy sleep practices. More children with late vs early bedtimes (48% vs14%, < .01) and frequent vs less frequent parental presence at bedtime (50% vs 26%-30%, < .02) failed to obtain sufficient sleep. Staff members are more comfortable healthy sleep with parents (87%) than them (45%).
Among parents, there is a "disconnect" between actual and perceived sleep hygiene. Similarly, staff perceived a gap between their competencies to promote healthy sleep in families and their capacity to address sleep problems. US health literacy goals include the need to embed accurate, accessible, and actionable health information in ECE programs. Study findings strongly support the need to work toward sleep health literacy in ECE programs.
儿童的健康发展需要充足的优质睡眠。幼儿期的睡眠问题会损害社会情感和认知功能，并增加肥胖风险。从健康素养框架来看，“睡眠健康素养”指的是促进健康睡眠和识别睡眠问题的知识、动机和能力。
为了探索幼儿教育（ECE）项目在促进睡眠健康素养方面尚未开发的潜力，我们对美国最大的幼儿教育项目“启智计划”中的工作人员（n = 63）和家长（n = 196）进行了关于睡眠相关知识、态度/信念、睡眠卫生和睡眠问题的调查。
大多数家长认为他们的孩子有健康的睡眠习惯（81%）；很少有人认为孩子有睡眠问题（10%）。然而，分别有50%和33%的儿童存在不健康的就寝习惯和睡眠不足的情况。10%至12%的儿童有1种或更多入睡或觉醒问题。除了一种情况外，每一种不健康的就寝习惯都与睡眠问题有关；就寝时父母陪伴出现的问题最多。睡眠不足与不健康的睡眠习惯显著相关。就寝时间晚的儿童比就寝时间早的儿童（48%对14%，P <.01）以及就寝时父母陪伴频繁的儿童比陪伴不频繁的儿童（50%对26% - 30%，P <.02）更难以获得充足睡眠。工作人员与家长讨论健康睡眠问题时（87%）比直接讨论孩子的睡眠问题时（45%）更自在。
在家长中，实际的睡眠卫生状况与认知之间存在“脱节”。同样，工作人员意识到他们在促进家庭健康睡眠的能力与解决睡眠问题的能力之间存在差距。美国的健康素养目标包括需要将准确、易懂且可行的健康信息融入幼儿教育项目。研究结果有力地支持了在幼儿教育项目中致力于提高睡眠健康素养的必要性。
