Objective: This study aimed to examine the sleep arrangements and soothing methods and to assess their associations with sleep problems among children aged < 3 years in China. Methods: A cross-sectional survey was conducted in 2019 from six provinces in China. A total of 1,195 caregivers of children aged 0-35 months were included in the study. Data on sleep arrangements, soothing methods, and sleep problems (i.e., frequent night awakenings and difficulty falling asleep) were assessed using the Brief Infant Sleep Questionnaire. The reasons for bed-sharing in sleep arrangements were recorded using a self-designed questionnaire. Results: The bed-sharing practice was very prevalent at any age, which ranged from 69.9% to 78.3%. Most infants fell asleep while feeding or being rocked/held before age 12 months. By age 35 months, 62.4% of the children fell asleep in bed near parents. The most common reasons for bed-sharing were breastfeeding/feeding and convenience. Parental involvement when falling asleep was significantly related with frequent night awakenings and difficulty falling asleep. No association was found between bed-sharing and sleep. Conclusion Bed-sharing and parental involvement were very common among Chinese children aged < 3 years. Children who fall asleep with parental involvement were more likely to have sleep problems.
Asians ; Beds ; Child, Preschool ; China ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Infant Behavior ; Infant, Newborn ; Male ; Sleep/physiology* ; Sleep Hygiene ; Sleep Wake Disorders ; Surveys and Questionnaires

BACKGROUND: School closure is one of the main policies of global health care strategies performed worldwide. Despite all benefits, there might be some threats for younger groups spending their time in quarantine. This study aims to determine the impacts of lockdown and school closure on children's major lifestyle aspects, especially their leisure and sleep pattern during the COVID-19 pandemic. METHODS: For the purpose of this study, an online questionnaire was distributed from 14th to 31st of March 2020 among the schools and students from the first grade to the 12th grade (before university) in Fars province, southern Iran. The questionnaire consisted of five sections which included data regarding the students' general information, activity priorities, adherence to quarantine, attitude toward school closure, and sleep patterns. RESULTS: In our study, 20,697 filled questionnaires were received from the participants with an average age of 13.76 years; 29.7% of them were male, 80.6% were from urban areas, and 83.3% were from public schools. The overall first preference of students during school closure was mobile and computer games (30.1%), followed by studying (26.6%) and watching television (13.8%). Our results demonstrated that the majority of students adhered to social distancing and there was also a significant correlation among education levels and desire for schools to be closed till the end of the semester (P = 0.015). Also, regarding sleep patterns, the majority (53.5%) had above 12 h of sleep throughout the day. CONCLUSION It seems that lockdown following COVID-19 pandemic has changed various aspects of the students' lifestyle remarkably, especially by increasing screen time and even sleep duration and pattern. We believe that certain strategies should be implemented by the Health and Educational Ministry to control not only the visible side effects of the quarantine period, but also the collateral consequences on their psychological and mental health.
Adolescent ; COVID-19/psychology* ; Child ; Female ; Humans ; Iran/epidemiology* ; Life Style ; Male ; Quarantine/statistics & numerical data* ; SARS-CoV-2 ; Schools ; Sleep Hygiene ; Students/statistics & numerical data* ; Surveys and Questionnaires

OBJECTIVES: To investigate the therapeutic effect of cranial electrotherapy stimulation (CES) with sleep hygiene in patients with chronic insomnia. METHODS: This study was designed as a prospective, double-blinded, and randomized controlled trial. Twenty-seven patients with chronic insomnia were recruited and randomly allocated to two groups; cranial microcurrent therapy (MC) group and sham group. All patients received sleep hygiene education. Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were measured at baseline (pre-treatment), and 2 weeks and 4 weeks of treatment. RESULTS: In MC group, the PSQI and ISI showed a tendency to decrease consistently until 4 weeks of treatment. In sham group, PSQI and ISI initially decreased during the first 2 weeks, but it increased after 2 weeks of treatment. CONCLUSIONS: This study showed that combination treatment of CES and sleep hygiene is more effective in treating chronic insomnia than sleep hygiene only as demonstrated by improvement and maintenance of sleep score for 1 month.
Education ; Electric Stimulation Therapy ; Humans ; Hygiene ; Prospective Studies ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: Insomnia is one of the major concerns in the elderly population. Cognitive behavioral treatment for insomnia is the first line treatment option, but there are some limitations including time and cost burdens and the requirement for sufficient cognitive resources to obtain a proper treatment effect. The Brief intervention for insomnia (BII) is a treatment that focuses on behavioral aspects of insomnia in primary care practices. The purpose of this study was to evaluate the effects of BII in community-dwelling older adults. METHODS: A total of 47 older adults with insomnia were enrolled from community centers between May 2016 and January 2018. They participated in the BII program for three weeks. We gathered sleep-related participant information with using the Pittsburgh sleep quality index (PSQI), the Sleep hygiene index, and a sleep diary. Clinical efficacy was evaluated by comparing total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) before and after the treatment. RESULTS: There was significant improvement in sleep-related features after BII. Global score and sleep quality from the PSQI, freshness, and WASO from the sleep diary showed statistically significant improvement. CONCLUSION: We found BII showed positive clinical efficacy in community dwelling older adults, especially from the perspective of subjective sleep quality and WASO. This finding implies that BII can be effectively applied for the managment of elderly insomnia patients in a community setting.
Adult ; Aged ; Humans ; Hygiene ; Independent Living ; Primary Health Care ; Sleep Initiation and Maintenance Disorders ; Treatment Outcome

OBJECTIVES: To determine urinary mercury levels in e-waste workers in Southern Thailand and the airborne mercury levels in the e-waste shops where they worked, to describe the associations between urinary and airborne mercury levels, and to evaluate the prevalence of mercury exposure-related health effects among e-waste workers. METHODS: A cross-sectional study was conducted by interviewing 79 workers in 25 e-waste shops who lived in Nakhon Si Thammarat Province, Thailand. Information on general and occupational characteristics, personal protective equipment use, and personal hygiene was collected by questionnaire. Urine samples were collected to determine mercury levels using a cold-vapor atomic absorption spectrometer mercury analyzer. RESULTS: The e-waste workers’ urinary mercury levels were 11.60±5.23 μg/g creatinine (range, 2.00 to 26.00 μg/g creatinine) and the mean airborne mercury levels were 17.00±0.50 μg/m3 (range, 3.00 to 29.00 μg/m3). The urinary and airborne mercury levels were significantly correlated (r=0.552, p < 0.001). The prevalence of self-reported symptoms was 46.8% for insomnia, 36.7% for muscle atrophy, 24.1% for weakness, and 20.3% for headaches. CONCLUSIONS: Personal hygiene was found to be an important protective factor, and should therefore be stressed in educational programs. Employers should implement engineering measures to reduce urinary mercury levels and the prevalence of associated health symptoms among e-waste workers.
Absorption ; Creatinine ; Cross-Sectional Studies ; Headache ; Humans ; Hygiene ; Muscular Atrophy ; Personal Protective Equipment ; Prevalence ; Protective Factors ; Sleep Initiation and Maintenance Disorders ; Thailand*

PURPOSE: This study aimed to develop and test a structural model for sleep quality in female shift work nurses. The hypothetical model was constructed on the basis of Spielman's 3P model of insomnia and previous research related to the sleep quality of shift nurses. METHODS: This cross-sectional study used structural equation modeling and recruited 285 female shift work nurses from four general and university hospitals with over 300 beds located in C and J cities in Gyeongsangnamdo. Data were collected from September 27 to October 20, 2016, and then analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling. The study used SPSS/Win 18.0 and AMOS 18.0 in processing the data. RESULTS: The final model showed good fit to the empirical data: χ2/df=2.19, SRMR=.07, RMSEA=.07, AGFI=.85, TLI=.91, GFI=.93, GFI=.89, NFI=.87. The factors that influenced sleep quality were sleep hygiene (β=.32), perceived shift work status (β=−.16), stress response (β=.16), shift work experience (β=.15), perceived health status (β=−.14), and circadian rhythm (β=−.13) explaining 36.0% of the variance. CONCLUSION: The model of sleep quality of the shift work nurses constructed in this study is recommended as a model to understand and predict the sleep quality of shift work nurses. The results suggest that strategies for improving the sleep quality of shift work nurses should focus on sleep hygiene, perceived health status, stress response, circadian rhythm, perceived shift work status, and shift work experience.
Circadian Rhythm ; Cross-Sectional Studies ; Female* ; Gyeongsangnam-do ; Hospitals, University ; Humans ; Hygiene ; Models, Structural ; Sleep Initiation and Maintenance Disorders ; Stress, Psychological

This study aimed to investigate the relationship between sleep duration and periodontitis in adult Korean women. This cross-sectional study was based on the 2014 Korea National Health and Nutrition Examination Survey (KNHNES). We selected the data from 3,292 women (over 19 years of age) out of 7,550 participants for analysis, after excluding data from men. Complex logistic regression analysis was performed to determine the effect of sleep duration on the risk of periodontitis; the crude and adjusted odds ratios (ORs) were calculated. The risk of periodontitis was higher in participants who had a sleep duration of 7 hours or more, than in those with less than 7 hours (crude OR) by 1.37 times (95% confidence interval [CI], 1.13∼1.65). The adjusted OR of the participants after adjusting for the sample characteristics of the participants (age, education level, income level, diabetes, hypertension, obesity) was 1.04 times (95% CI, 0.82∼1.32), but the risk for periodontitis was slightly higher, though not statistically significant. This study confirmed the relationship between sleep duration and the risk of periodontitis in Korean women. Therefore, it is necessary to develop and implement a comprehensive health promotion program that can improve the proper sleeping habits of adult women in Korea and to combine oral hygiene management programs to prevent periodontal disease.
Adult* ; Cross-Sectional Studies ; Education ; Female ; Health Promotion ; Humans ; Hypertension ; Korea* ; Logistic Models ; Male ; Nutrition Surveys* ; Odds Ratio ; Oral Health ; Oral Hygiene ; Periodontal Diseases ; Periodontitis* ; Sleep Deprivation

OBJECTIVES: The present study investigated current practices of insomnia treatment among Korean doctors in clinical settings. METHODS: A total of 100 doctors participated in the present study and filled out a series of survey questions regarding their treatment of insomnia patients. RESULTS: The results revealed that the primary type of insomnia treatment was pharmacological and that the most popular medication was zolpidem. The majority of doctors reported that they also utilized non-pharmacological treatments such as sleep hygiene education and cognitive-behavioral therapy. However, these treatments tended to result in low satisfaction. In addition, the doctors perceived that patients largely preferred pharmacological treatments to non-pharmacological ones and did not have sufficient knowledge of non-pharmacological treatments. CONCLUSION: Many doctors believed that non-pharmacological treatments for insomnia were important, but reported that they were difficult to implement in practice. The results of this study suggest that improved medical conditions for non-pharmacological treatments and education of physicians are necessary to appropriately treat insomnia.
Education ; Humans ; Hygiene ; Sleep Initiation and Maintenance Disorders*

: We examined the nighttime sleep habits associated with insufficient sleep quantity and poor sleep quality among healthy preschool-aged Taiwanese children.: The study population of this cross-sectional survey was a stratified random sample of 3 to 6-year-old preschool children from 19 cities and counties in Taiwan. A caregiver-administered questionnaire was used to collect information on preschooler sleep quantity (sleep duration and sleep latency) and sleep quality (sleep disturbances and disruption) and potentially related sleep habits.: Of the 1253 children for whom analysable survey data were collected (children's mean age: 5.03 ± 1.27 years), more than half (53.07%) engaged in bedtime television (TV)-viewing, 88.95% required a sleep reminder, 43.85% exhibited bedtime resistance, 93.6% engaged in co-sleeping (bed-sharing or room-sharing), and only 33.72% slept in a well darkened bedroom. Bedtime TV-viewing, co-sleeping, bedroom light exposure, and bedtime resistance were the primary predictors, without a bedtime TV-viewing habit was the strongest predictor analysed; it explained 15.2% and 19.9% of the variance in adequate sleep quantity and improved sleep quality in preschool children.: Sleep loss and poor sleep quality in preschool children could be alleviated, at least partly, by curtailing bedtime TV-viewing, limiting light exposure during sleeping, and reducing bed-sharing habit.
Child ; Child Behavior ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Lighting ; Male ; Sleep ; Sleep Deprivation ; Sleep Hygiene ; Surveys and Questionnaires ; Taiwan ; Television

INTRODUCTIONThis study aimed to determine the sleep patterns and dysfunctions in children with learning problems in comparison against a local population-based sample.

MATERIALS AND METHODSParents of 200 children with learning problems and 372 parents of a local population-based sample of typically developing (TD) children were recruited to complete a questionnaire on their child's sleep patterns and sleep problems. The Children's Sleep Habits Questionnaire (CSHQ) is a validated parent-reported sleep screening questionnaire that contains 54 items identifying sleep behaviours in children.

RESULTSThe mean age of the sample was 4.2 years (SD: 1.4; range, 2 to 6 years). Sleep duration was similar between the 2 groups. The difference in mean CSHQ subscale scores between children with learning problems and TD children was significant for sleep-disordered breathing (1.3 vs 1.2,= 0.001). Among children with learning problems, 36.5% snored (vs 26.6% of TD children), 30.5% had noisy breathing (vs 18.8%), and 9.0% (vs 4.6%) experienced difficulty breathing 2 or more times a week. Children with learning problems woke up in a more irritable mood (= 0.01), had more difficulty in getting out of bed (<0.001), and took a longer time to be alert (<0.001). They exhibited fewer behaviours of daytime drowsiness (= 0.009). Among this group of children, 15.0% of parents reported that their child had a sleep problem compared to 9.0% in the TD group.

CONCLUSIONSleep breathing disorders and symptoms of morning sleepiness are more prevalent in children with learning problems. Symptoms of daytime lethargy are similar between the 2 groups. We suggest that a simple outpatient screening targeted at these problems be instituted in the initial workup of any child with learning difficulties.

Case-Control Studies ; Child ; Child, Preschool ; Comorbidity ; Female ; Humans ; Irritable Mood ; Learning Disorders ; epidemiology ; Male ; Prevalence ; Singapore ; epidemiology ; Sleep ; Sleep Apnea Syndromes ; epidemiology ; Sleep Hygiene ; Sleep Wake Disorders ; epidemiology ; Snoring ; epidemiology