Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
Folkhälsan Research Center, Helsinki, Finland.
J Sleep Res. 2024 Feb;33(1):e13960. doi: 10.1111/jsr.13960. Epub 2023 Jun 7.
This study compared weekday and weekend actigraphy-measured and parent-reported sleep in relation to weight status among preschool-aged children. Participants were 3-6 years old preschoolers from the cross-sectional DAGIS-study with sleep data for ≥2 weekday and ≥2 weekend nights. Parents-reported sleep onset and wake-up times were gathered alongside 24 h hip-worn actigraphy. An unsupervised Hidden-Markov Model algorithm provided actigraphy-measured night time sleep without the guidance of reported sleep times. Waist-to-height ratio and age-and-sex-specific body mass index characterised weight status. Comparison of methods were assessed with consistency in quintile divisions and Spearman correlations. Associations between sleep and weight status were assessed with adjusted regression models. Participants included 638 children (49% girls) with a mean ± SD age of 4.76 ± 0.89. On weekdays, 98%-99% of actigraphy-measured and parent-reported sleep estimates were classified in the same or adjacent quintile and were strongly correlated (r = 0.79-0.85, p < 0.001). On weekends, 84%-98% of actigraphy-measured and parent-reported sleep estimates were respectively classified and correlations were moderate to strong (r = 0.62-0.86, p < 0.001). Compared with actigraphy-measured sleep, parent-reported sleep had consistently earlier onset, later wake-up, and greater duration. Earlier actigraphy-measured weekday sleep onset and midpoint were associated with a higher body mass index (respective β-estimates: -0.63, p < 0.01 and -0.75, p < 0.01) and waist-to-height ratio (-0.004, p = 0.03 and -0.01, p = 0.02). Though the sleep estimation methods were consistent and correlated, actigraphy measures should be favoured as they are more objective and sensitive to identifying associations between sleep timing and weight status compared with parent reports.
本研究比较了学龄前儿童工作日和周末的活动计测和家长报告的睡眠与体重状况的关系。参与者为来自横断面 DAGIS 研究的 3-6 岁学龄前儿童，他们有≥2 个工作日和≥2 个周末夜晚的睡眠数据。家长报告了睡眠起始和醒来时间，同时进行了 24 小时臀部佩戴活动计测。无监督的隐马尔可夫模型算法提供了无需报告睡眠时间指导的活动计测夜间睡眠时间。腰围身高比和年龄及性别特异性体重指数用于描述体重状况。使用五分位划分一致性和斯皮尔曼相关性评估方法间的比较。使用调整后的回归模型评估睡眠与体重状况之间的关联。研究纳入了 638 名儿童（49%为女孩），平均年龄为 4.76±0.89 岁。在工作日，98%-99%的活动计测和家长报告的睡眠估计值被分类在相同或相邻的五分位区间内，且相关性很强（r=0.79-0.85，p<0.001）。在周末，84%-98%的活动计测和家长报告的睡眠估计值分别被分类，相关性为中等至强（r=0.62-0.86，p<0.001）。与活动计测睡眠相比，家长报告的睡眠通常起始更早，醒来更晚，且持续时间更长。工作日活动计测睡眠起始和中点较早与体重指数较高（分别的β估计值：-0.63，p<0.01 和-0.75，p<0.01）和腰围身高比较高（0.004，p=0.03 和-0.01，p=0.02）相关。尽管睡眠估计方法是一致且相关的，但与家长报告相比，活动计测法更客观，更能敏感地识别睡眠时间与体重状况之间的关联，因此应优先选择。
