Sleep disturbances in children newly enrolled in elementary school are associated with parenting stress in China

Amaerjiang, Nubiya; Xiao, Huidi; Zunong, Jiawulan; Shu, Wen; Li, Menglong; Pérez‐Escamilla, Rafael; Hu, Yanyan

doi:10.1016/j.sleep.2021.10.033

Cited by 9 publications

(10 citation statements)

References 48 publications

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“…Second, we did not include data related to children's lifestyle and curricula patterns during the study period. We speculate that, due to the social and cultural environment, children attending primary schools in Beijing are under substantial academic pressures [9] and the opportunities for physical activity do not meet the recommended standard during the school week. Our findings underscore the necessity in encouraging more water intake for the children in the long sedentary time periods of their school weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that elementary school children often start the school day in a status of mild dehydration [8]. In China, high academic pressures [9] often lead to students to having short inter-curriculum rest periods; children may not drink enough fluids in order to reduce the micturition frequency. Weekly activity patterns from Monday to Friday include periodic insufficient water intake and long periods of sedentary behavior.…”

Section: Introductionmentioning

confidence: 99%

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Dehydration Status Aggravates Early Renal Impairment in Children: A Longitudinal Study

Amaerjiang

Xiao

et al. 2022

Nutrients

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Dehydration is common in children for physiological and behavioral reasons. The objective of this study was to assess changes in hydration status and renal impairment across school weekdays. We conducted a longitudinal study of three repeated measures of urinalysis within one week in November 2019 in a child cohort in Beijing, China. We measured urine specific gravity (USG) to determine the dehydration status, and the concentration of β2-microglobulin (β2-MG) and microalbumin (MA) to assess renal function impairment among 1885 children with a mean age of 7.7 years old. The prevalence of dehydration was 61.9%, which was significantly higher in boys (64.3%). Using chi-square tests and linear mixed-effects regression models, we documented the trends of the renal indicators’ change over time among different hydration statuses. Compared to Mondays, there were apparent increases of β2-MG concentrations on Wednesdays (β = 0.029, p < 0.001) and Fridays (β = 0.035, p < 0.001) in the dehydrated group, but not in the euhydrated group. As for the MA concentrations, only the decrease on Fridays (β = −1.822, p = 0.01) was significant in the euhydrated group. An increased trend of elevated β2-MG concentration was shown in both the euhydrated group (Z = −3.33, p < 0.001) and the dehydrated group (Z = −8.82, p < 0.001). By contrast, there was a decreased trend of elevated MA concentrations in the euhydrated group (Z = 3.59, p < 0.001) but not in the dehydrated group. A new indicator ratio, β2-MG/MA, validated the consistent trends of renal function impairment in children with dehydration. Renal impairment trends worsened as a function of school days during the week and the dehydration status aggravated renal impairment during childhood across school weekdays, especially tubular abnormalities in children.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dehydration Status Aggravates Early Renal Impairment in Children: A Longitudinal Study

Amaerjiang

Xiao

et al. 2022

Nutrients

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“…Z-scores of height, weight, and body mass index (BMI) were calculated using 2007 WHO standards and standardized SBP was calculated by age and sex group. Lifestyle information were reported by parents using self-administrated questionnaires, including sleep duration (Children's Sleep Habits Questionnaire [CSHQ]) ( 26 , 27 ), fruit and vegetable intake (FVI; 16-item Mediterranean Diet Quality Index in children and adolescents [KIDMED]) ( 23 , 28 ), and computer/cell phone screen time and PA time (self-administrated questionnaire, including 17 activities indoor and outdoor lasting at least 15 min, based on Children's Leisure Activities Study Survey Chinese version [CLASS-C]) ( 29 ). Short sleep for children was defined as sleep duration <10 h/day.…”

Section: Methodsmentioning

confidence: 99%

Interaction of Hydration Status and Physical Activity Level on Early Renal Damage in Children: A Longitudinal Study

Shu

Amaerjiang

et al. 2022

Front. Nutr.

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BackgroundOptimal water intake positively affects various aspects of human physiology, especially renal function. Physical activity (PA) may have an impact on hydration status and renal health, but the interaction of hydration status and PA level on renal function is not well-studied in children.MethodsWe conducted four waves of urine assays in our child cohort (PROC) study from October 2018 to November 2019 in Beijing, China. We measured urinary specific gravity, β2-microglobulin (β2-MG), and microalbumin (MA) excretion to assess hydration status and renal damage in the context of PA level and other covariates among 1,914 primary school children. We determined the associations of renal damage with the interaction of hydration status and PA level using generalized linear mixed-effects models.ResultsThe prevalence of dehydration was 35.0%, 62.1%, 63.9%, and 63.3%, and the prevalence of insufficient PA was 86.2%, 44.9%, 90.4%, and 90.2% from wave 1 to wave 4 among 1,914 primary school children. From wave 1 to wave 4, the prevalence of renal tubular damage had a significant increasing trend of 8.8%, 15.9%, 25.7%, and 29.0% (Z = 16.9, P < 0.001), while the prevalence of glomerular damage revealed a declining trend of 5.6%, 5.5%, 4.4%, and 4.1% (Z = −2.4, P = 0.016). There were stable longitudinal associations of renal tubular and glomerular damage with hydration status (euhydration: OR = 0.50 and 0.33, respectively) but not with PA level. In multivariate analysis, significant interactions of hydration status and PA level were noted with renal tubular damage (β = 0.43, P = 0.014) and glomerular damage (β = 0.60, P = 0.047). Children with euhydration and insufficient PA were less likely to have renal tubular damage (OR = 0.46, 95% CI: 0.39, 0.53) or glomerular damage (OR = 0.28, 95% CI: 0.20, 0.39); children with euhydration and sufficient PA were also less likely to have renal tubular damage (OR = 0.57, 95% CI: 0.44, 0.75) or glomerular damage (OR = 0.47, 95% CI: 0.30, 0.74), adjusting for age, sex, BMI z-score, standardized SBP, sleep duration, computer/cell phone screen time, and fruit and vegetable intake.ConclusionChildren with euhydration and either sufficient or insufficient PA were less likely to have early renal damage. Adequate daily water intake for children is important, especially after PA.

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“…First grade is a transition from preschool to school age. A study in Asia also revealed that more than two‐thirds of first graders had sleep disturbances (Amaerjiang et al., 2021). It is unknown whether sleep is associated with children's myopia and dental caries during this transition period.…”

Section: Introductionmentioning

confidence: 99%

“…First grade is a transition from preschool to school age. A study in Asia also revealed that more than two-thirds of first graders had sleep disturbances (Amaerjiang et al, 2021). It is unknown…”

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confidence: 98%

Sleep and its association with dental caries or myopia in first graders

Tsai,

Wang

et al. 2023

Nursing Open

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AimFirst grade is a transition from pre‐school to school‐age. The change in lifestyle behaviours such as sleep may have a physiological response, which contributes to the presence or absence of two highly incident diseases: dental caries or myopia. The aim of the study was to examine the association between sleep and myopia as well as sleep and dental caries in first graders.DesignIt is a cross‐sectional study.MethodsThis was a recruitment phase of an interventional study. A total of 338 children whose caregivers completed a Children's Sleep Habits Questionnaire. Caregivers also provided information regarding myopia and caries status of children and their parents. Binary logistic regression was applied to analyse the potential risk factors.ResultsDental caries and myopia rates were 45.9% and 9.5%, respectively. After adjusting for children's gender, children's age, fathers with caries and mothers with caries, the odds ratio for dental caries in children who slept less than 9 h when compared to those who slept for nine and more hours was 1.94. Mothers with caries were 3.37 times more likely to have children with caries than mothers without caries. However, sleep was not associated with myopia in first graders.ConclusionSleeping less than 9 h and maternal caries were risk factors of children developing dental caries. Future sleep and myopia studies can be conducted on higher graders who may present prolonged exposure and accumulations of myopic risk factors.ImplicationsScreening of children with insufficient sleep is needed for nurses to enable the early identification of high‐risk groups for dental caries in school settings. Family nurses are encouraged to work with family members to implement tailored sleep interventions, in order to facilitate better sleep and oral health practices in both school and home settings.RegistrationThis study protocol was registered on ClinicalTrials.gov (Registration number: Redacted).

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Sleep disturbances in children newly enrolled in elementary school are associated with parenting stress in China

Cited by 9 publications

References 48 publications

Dehydration Status Aggravates Early Renal Impairment in Children: A Longitudinal Study

Dehydration Status Aggravates Early Renal Impairment in Children: A Longitudinal Study

Interaction of Hydration Status and Physical Activity Level on Early Renal Damage in Children: A Longitudinal Study

Sleep and its association with dental caries or myopia in first graders

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