The Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA; The Possibilities Project, Children's Hospital of Philadelphia, Philadelphia, USA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, USA.
Sleep Med Rev. 2021 Jun;57:101465. doi: 10.1016/j.smrv.2021.101465. Epub 2021 Mar 17.
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 y), school-aged children (6-12 y) and adolescents (13-18 y). 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.
了解儿童睡眠的显著环境决定因素对于告知干预措施和公共卫生举措至关重要。新出现的证据表明，邻里环境会影响儿童睡眠，但这方面的证据尚未得到系统审查。我们对 2003 年至 2020 年期间发表的关于邻里环境与幼儿（0-5 岁）、学龄儿童（6-12 岁）和青少年（13-18 岁）睡眠之间关联的科学文献进行了系统审查。我们共审查了 85 篇文章。最常被研究的邻里环境暴露因素是低社会经济地位（40 项研究），其中 58%的研究（主要是睡眠时间更短、入睡时间更晚或阻塞性睡眠呼吸暂停）表明其与睡眠结果有关。邻里安全/犯罪/暴力（21 项研究）的证据更强，其中 86%的研究报告了与睡眠结果的关联（主要是自我报告或护理人员报告的睡眠问题）。较少的研究调查了邻里物理环境暴露因素与睡眠之间的关联，包括噪声（15 项研究）、建筑环境（7 项研究）和空气污染（6 项研究）。目前这方面证据的局限性包括：1）除社会经济地位或安全因素外，对邻里环境暴露因素的研究有限；2）主要使用横断面观察性研究设计；3）缺乏客观的睡眠结果评估；4）目前暴露评估方法的局限性。
