Brambilla Paolo, Giussani Marco, Pasinato Angela, Venturelli Leonello, Privitera Francesco, Miraglia Del Giudice Emanuele, Sollai Sara, Picca Marina, Di Mauro Giuseppe, Bruni Oliviero, Chiappini Elena
Family Pediatrician, Azienda Tutela della Salute (ATS) Città Metropolitana di Milano, Via Parada 32, 20854, Vedano al Lambro, MB, Italy.
Family Pediatrician, ULSS 6 Vicenza, Vicenza, Italy.
Ital J Pediatr. 2017 Jan 13;43(1):7. doi: 10.1186/s13052-016-0324-x.
Sleep in childhood and adolescence is crucial for mental and physical health; however several researches reported an increasing trend towards a sleep deprivation in this age. Due to the lack of recent epidemiological studies in Italy, the aim of our study was to depict sleep habits and patterns in Italian children aged 1-14 years and to evaluate their relationships with video devices use (TV, tablet, smartphone, PC) and evening/night child activities.
A structured interview was conducted during 2015 by 72 Family Pediatricians in 2030 healthy children aged 1-14 years by a cross-sectional survey named "Ci piace sognare". Total sleep duration was calculated, 2015 National Sleep Foundation Recommendations were used as reference. Optimal sleepers were defined children sleeping in own bed all night without awakenings. Multivariable median regression was performed to identify predictors of sleep duration and multivariable logistic regression for predictors of optimal sleep.
Total sleep duration and numbers of awakenings decreased with age. Only 66.9% of children had sleep duration in agreement with Recommendations (50% in 10-14 years group). Before sleeping 63.5% of children used video devices (39.6% at 1-3 years), 39.1% read, 27.5% drank and 19.5% ate. Bottle users at bedtime were 30.8% at 1-3 years, 16.6% at 3-5 years and 4.9% at 5-7 years. Overall, 23.4% of children changed sleeping place during the night, 22.4% referred sleeping problems in the first year of life. Video devices use was negative predictor of sleep duration (-0.25 h [95%CI:-0.35,-0.14], p < 0.001). Optimal sleep was inversely related with bedroom TV (OR 0.63 [0.50,0.79], p < 0.001), with sleeping disorders in the first year (OR 0.62 [0.48,0.80], p < 0.001)), with bottle use (OR 0.64 [0.44,0.94], p < 0.05) and posivively related with high mother's education level (OR 1.44 [1.11,1.88], p < 0.01).
About one third of 1 to 14 year Italian children sleep less than recommended, one half in teenage. Modifiable risk factors for sleep abnormalities such as video devices use, bedroom TV and bottle use should be target of preventive strategies for a correct sleep. Pediatricians should give priority to the identification of sleep disorders early in life.
儿童和青少年时期的睡眠对身心健康至关重要；然而，多项研究报告称，这个年龄段的睡眠剥夺现象呈上升趋势。由于意大利近期缺乏流行病学研究，我们研究的目的是描述1至14岁意大利儿童的睡眠习惯和模式，并评估其与视频设备使用（电视、平板电脑、智能手机、个人电脑）以及儿童夜间活动的关系。
2015年，72名家庭儿科医生通过一项名为“我们喜欢做梦”的横断面调查，对2030名1至14岁的健康儿童进行了结构化访谈。计算总睡眠时间，以2015年美国国家睡眠基金会的建议为参考。最佳睡眠者定义为整夜都睡在自己床上且无觉醒的儿童。进行多变量中位数回归以确定睡眠时间的预测因素，并进行多变量逻辑回归以确定最佳睡眠的预测因素。
总睡眠时间和觉醒次数随年龄增长而减少。只有66.9%的儿童睡眠时间符合建议（10至14岁组为50%）。睡前，63.5%的儿童使用视频设备（1至3岁组为39.6%），39.1%的儿童阅读，27.5%的儿童喝东西，19.5%的儿童吃东西。1至3岁儿童睡前使用奶瓶的比例为30.8%，3至5岁为16.6%，5至7岁为4.9%。总体而言，23.4%的儿童夜间更换睡眠地点，22.4%的儿童表示在生命的第一年有睡眠问题。视频设备的使用是睡眠时间的负向预测因素（-0.25小时[95%置信区间：-0.35，-0.14]，p<0.001）。最佳睡眠与卧室电视呈负相关（比值比0.63[0.50，0.79]，p<0.001），与第一年的睡眠障碍呈负相关（比值比0.62[0.48，0.80]，p<0.001），与使用奶瓶呈负相关（比值比0.64[0.44，0.94]，p<0.05），与母亲的高教育水平呈正相关（比值比1.44[1.11，1.88]，p<0.01）。
1至14岁的意大利儿童中约有三分之一睡眠不足，青少年中这一比例为一半。视频设备使用、卧室电视和奶瓶使用等可改变的睡眠异常风险因素应成为正确睡眠预防策略的目标。儿科医生应优先在生命早期识别睡眠障碍。
