Marlenga Barbara, King Nathan, Pickett William, Lawson Joshua, Hagel Louise, Dosman James A
National Children's Center for Rural and Agricultural Health and Safety, Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA.
Department of Public Health Sciences, Queen's University, Kingston, Ontario.
Paediatr Child Health. 2017 Jul;22(4):211-216. doi: 10.1093/pch/pxx070. Epub 2017 May 31.
To examine sleep patterns in a large cohort of rural children and explore the association between sleep patterns and injury occurrence.
Cross-sectional analyses of the baseline survey from a prospective cohort study (2012 to 2017) was conducted with 46 rural schools in Saskatchewan, Canada who distributed surveys to parents of 2275 rural dwelling farm and nonfarm children aged 0 to 17 years. Parents reported child sleep characteristics and farm or nonfarm injury in the previous calendar year. Multivariable log-binomial regression examined associations between sleep characteristics and injury risk.
There was a significant trend of decreasing sleep duration with increasing age (P-trend < 0.001). Short sleep duration on weekdays (RR: 2.14; 95% CI: 1.25 to 3.66) and sleep debt (RR: 1.89; 95% CI: 1.21 to 2.95) increased injury risk in school-age children (7 to 12 years) but not in teens. A nearly fivefold increase in injury risk was identified among school-age children reporting all sleep problems (RR: 4.99; 95% CI: 1.99 to 12.50). Snoring in teens (13 to 17 years), often a symptom of obstructive sleep apnea, was associated with increased injury risk (RR: 1.98; 95% CI: 1.17 to 3.33). There were no statistically significant associations identified between sleep characteristics and injury risk in preschool children.
Injuries to rural children are an important public health concern. This study highlights the impact of sleep problems on risk for injury among rural children. These findings are discussed in light of the recent American Academy of Pediatrics Technical Report on Insufficient Sleep in Adolescents and Young Adults.
调查一大群农村儿童的睡眠模式，并探讨睡眠模式与受伤发生之间的关联。
对一项前瞻性队列研究（2012年至2017年）的基线调查进行横断面分析，研究对象为加拿大萨斯喀彻温省的46所农村学校，这些学校向2275名居住在农村的0至17岁农场和非农场儿童的家长发放了调查问卷。家长报告了孩子上一历年的睡眠特征以及农场或非农场受伤情况。多变量对数二项回归分析了睡眠特征与受伤风险之间的关联。
睡眠时长随年龄增长呈显著下降趋势（P趋势<0.001）。工作日睡眠时长较短（相对风险：2.14；95%置信区间：1.25至3.66）和睡眠债（相对风险：1.89；95%置信区间：1.21至2.95）会增加学龄儿童（7至12岁）的受伤风险，但对青少年则无此影响。报告存在所有睡眠问题的学龄儿童受伤风险增加近五倍（相对风险：4.99；95%置信区间：1.99至12.50）。青少年（13至17岁）打鼾通常是阻塞性睡眠呼吸暂停的症状，与受伤风险增加相关（相对风险：1.98；95%置信区间：1.17至3.33）。学龄前儿童的睡眠特征与受伤风险之间未发现具有统计学意义的关联。
农村儿童受伤是一个重要的公共卫生问题。本研究强调了睡眠问题对农村儿童受伤风险的影响。结合美国儿科学会最近关于青少年和青年睡眠不足的技术报告对这些发现进行了讨论。
