Sleep, School Performance, and a School-Based Intervention among School-Aged Children: A Sleep Series Study in China

Abstract

BackgroundSufficient sleep during childhood is essential to ensure a transition into a healthy adulthood. However, chronic sleep loss continues to increase worldwide. In this context, it is imperative to make sleep a high-priority and take action to promote sleep health among children. The present series of studies aimed to shed light on sleep patterns, on the longitudinal association of sleep with school performance, and on practical intervention strategy for Chinese school-aged children.Methods and FindingsA serial sleep researches, including a national cross-sectional survey, a prospective cohort study, and a school-based sleep intervention, were conducted in China from November 2005 through December 2009. The national cross-sectional survey was conducted in 8 cities and a random sample of 20,778 children aged 9.0±1.61 years participated in the survey. The five-year prospective cohort study included 612 children aged 6.8±0.31 years. The comparative cross-sectional study (baseline: n = 525, aged 10.80±0.41; post-intervention follow-up: n = 553, aged 10.81±0.33) was undertaken in 6 primary schools in Shanghai. A battery of parent and teacher reported questionnaires were used to collect information on children’s sleep behaviors, school performance, and sociodemographic characteristics. The mean sleep duration was 9.35±0.77 hours. The prevalence of daytime sleepiness was 64.4% (sometimes: 37.50%; frequently: 26.94%). Daytime sleepiness was significantly associated with impaired attention, learning motivation, and particularly, academic achievement. By contrast, short sleep duration only related to impaired academic achievement. After delaying school start time 30 minutes and 60 minutes, respectively, sleep duration correspondingly increased by 15.6 minutes and 22.8 minutes, respectively. Moreover, intervention significantly improved the sleep duration and daytime sleepiness.ConclusionsInsufficient sleep and daytime sleepiness commonly existed and positively associated with the impairment of school performance, especially academic achievement, among Chinese school-aged children. The effectiveness of delaying school staring time emphasized the benefits of optimal school schedule regulation to children’s sleep health.

Associations of self-reported sleep disturbance and duration with academic failure in community-dwelling Swedish adolescents: Sleep and academic performance at school

“…As a consequence, adolescents with sleep problems may perform poorly in school. Supporting this assumption, previous studies have demonstrated that adolescents with insufficient sleep are at an increased risk for academic failure [3,5,[7][8][9]. For instance, in a study involving 713 adolescents, self-reported sleep complaints were associated with overall impaired performance at school [10].…”

“…Surveys in both Asian and European cohorts have recently shown that a significant proportion of school-aged children perceive the quality of their regular sleep to be insufficient [1][2][3]. This is alarming, as adolescents with sleep problems exhibit deficits in attention, a lack of concentration, reduced cognitive functioning, and signs of reduced capacity to cope with emotional stress [1,[4][5][6].…”

Relationship between Sleep Habits and Daytime Sleepiness, Inattention, and Aggressive Behavior among Taiwanese Kindergarten Children

“…A shorter sleep duration yielded greater daytime sleepiness. Li et al [26] reported similar findings.…”

Public health activities for ensuring adequate sleep among school-age children: current status and future directions

“…The previous study reported that children's sleep phases were not delayed, their sleep durations were longer, and their daytime functioning was better with later school start times as compared to children with early start times [48]. Several studies verified the effectiveness of delaying school start times, and all reported improved sleep durations and daytime functioning [8,49,50]. Thus, delayed start times should be adopted at schools in Japan, but several problems need to be addressed first.…”

“…'Good sleep' contributes to memory consolidation [1], executive function development [2], and improved metabolic health [3]. Conversely, 'sleep problems' among children might cause physical or mental health problems [4][5][6], reduce school life quality [7][8][9], or facilitate a mood disorder, anxiety disorder, or physical complaints during or after adolescence [10,11].…”