Short or Irregular Sleep Duration in Early Childhood Increases Risk of Injury for Primary School-Age Children: A Nationwide Longitudinal Birth Cohort in Japan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Sleep Duration (SD) and Irregular Sleep
2.3. Injury (Outcomes)
2.4. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Sleep Duration (SD) and Injury
3.3. Sleep Duration and Problematic Behavior (Stratified Analysis)
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Included (n = 32,044) | Lost to Follow-Up (n = 5665) | |
---|---|---|
Sleep Duration, n (%) | ||
6 h | 1191 (3.7) | 269 (4.7) |
7 h | 6773 (21.1) | 1224 (21.6) |
8 h | 11,249 (35.1) | 1926 (34.0) |
9 h | 7280 (22.7) | 1182 (20.9) |
10 or 11 h | 2921 (9.1) | 423 (7.5) |
>12 h | 52 (0.2) | 10 (0.2) |
Irregular | 2578 (8.0) | 631 (11.1) |
Gender, n (%) | ||
Male | 16,682 (52.1) | 2911 (51.4) |
Female | 15,362 (47.9) | 2754 (48.6) |
Term or preterm birth, n (%) | ||
Term | 30,515 (95.2) | 5360 (94.6) |
Preterm | 1529 (4.8) | 305 (5.4) |
Singleton or multiple birth, n (%) | ||
Singleton | 31,418 (98.0) | 5532 (97.7) |
Multiple | 626 (2.0) | 133 (2.3) |
Parity, n (%) | ||
1 (no older siblings) | 15,650 (48.8) | 2707 (47.8) |
2 | 11,883 (37.1) | 2033 (35.9) |
3 | 4511 (14.1) | 925 (16.3) |
Daycare Attendance, n (%) * | ||
Nursery | 26,733 (83.4) | 4450 (78.6) |
Home | 4944 (15.4) | 961 (17.0) |
Missing Data | 367 (1.1) | 254(4.5) |
Maternal Age at Delivery, n (%) | ||
<25 (years old) | 3029 (9.5) | 934 (16.5) |
25–30 | 12,153 (37.9) | 2192 (38.7) |
30–35 | 12,240 (38.2) | 1853 (32.7) |
>35 | 4622 (14.4) | 686 (12.1) |
Maternal Smoking, n (%) | ||
None | 27,753 (86.6) | 4354 (76.9) |
Yes | 4163 (13.0) | 1272 (22.5) |
Missing Data | 128 (0.4) | 39 (0.7) |
Maternal Education, n (%) | ||
University or Higher | 4873 (15.2) | 551 (9.7) |
Junior College | 13,711 (42.8) | 2051 (36.2) |
High School or Other | 12,975 (40.5) | 2800 (49.4) |
Missing Data | 485 (1.5) | 263 (4.6) |
Family income at Seven Years Old, n (%) | ||
<400 (million Yen) | 4042 (12.6) | 489 (8.6) |
400–700 | 13,533 (42.2) | 1145 (20.2) |
700–1000 | 6768 (21.1) | 434 (7.7) |
>1000 | 3626 (11.3) | 242 (4.3) |
Missing Data | 4075 (12.7) | 3355 (59.2) |
Residential Area, n (%) | ||
Wards (Districts) | 7088 (22.1) | 1187 (21.0) |
Cities | 18,876 (58.9) | 3355 (59.2) |
Towns or Villages | 6080 (19.0) | 1123 (19.8) |
Problematic Behavior, n (%) ** | ||
No | 12,214 (38.1) | 888 (15.7) |
Yes | 18,408 (57.4) | 1556 (27.5) |
Missing Data | 1422 (4.4) | 3221 (56.9) |
Injury (n = 6369) | No Injury (n = 25,675) | |
---|---|---|
Gender, n (%) | ||
Male | 3907 (61.3) | 12,775 (49.8) |
Female | 2462 (38.7) | 12,900 (50.2) |
Term or Preterm Birth, n (%) | ||
Term | 6036 (94.8) | 24,479 (95.3) |
Preterm | 333 (5.2) | 1196 (4.7) |
Singleton or Multiple Birth, n (%) | ||
Singleton | 6271 (98.5) | 25,147 (97.9) |
Multiple | 98 (1.5) | 528 (2.1) |
Parity, n (%) | ||
1 (no older siblings) | 3035 (47.7) | 12,615 (49.1) |
2 | 2466 (38.7) | 9417 (36.7) |
3 | 868 (13.6) | 3643 (14.2) |
Daycare Attendance, n (%) * | ||
Nursery | 5292 (83.1) | 21,441 (83.5) |
Home | 1014 (15.9) | 3930 (15.3) |
Missing Data | 63 (1.0) | 304 (1.2) |
Maternal Age at Delivery, n (%) | ||
<25 (years old) | 536 (8.4) | 2493 (9.7) |
25–30 | 2453 (38.5) | 9700 (37.8) |
30–35 | 2473 (38.8) | 9767 (37.8) |
>35 | 907 (14.2) | 3715 (14.5) |
Maternal Smoking, n (%) | ||
None | 5553 (87.2) | 22,200 (86.5) |
Yes | 794 (12.5) | 3369 (13.1) |
Missing Data | 22 (0.3) | 106 (0.4) |
Maternal Education, n (%) | ||
University or Higher | 1014 (15.9) | 3859 (15.0) |
Junior College | 2871 (45.1) | 10,840 (42.2) |
High School or Other | 2392 (37.6) | 10,583 (41.2) |
Missing Data | 92 (1.4) | 393 (1.5) |
Family income at Seven Years Old, n (%) | ||
<400 (million Yen) | 750 (11.8) | 3292 (12.8) |
400–700 | 2731 (42.9) | 10,802 (42.1) |
700–1000 | 1418 (22.3) | 5350 (20.8) |
>1000 | 714 (11.2) | 2912 (11.3) |
Missing Data | 756 (12.0) | 3319 (12.9) |
Residential Area, n (%) | ||
Wards (Districts) | 1490 (23.4) | 5598 (21.8) |
Cities | 3745 (58.8) | 15,131 (58.9) |
Towns or Villages | 1134 (17.8) | 4946 (19.3) |
Case/n (%) | Crude OR (95% CI) | Adjusted OR * (95% CI) | |
---|---|---|---|
Sleep Duration | |||
6 h | 282/1191 (23.7) | 1.39 (1.18–1.64) | 1.40 (1.19–1.66) |
7 h | 1334/6773 (19.7) | 1.10 (0.98–1.23) | 1.10 (0.98–1.23) |
8 h | 2260/11,249 (20.1) | 1.13 (1.01–1.25) | 1.13 (1.02–1.26) |
9 h | 1388/7280 (19.1) | 1.06 (0.94–1.18) | 1.06 (0.95–1.19) |
10 or 11 h | 533/2921 (18.2) | 1 (Reference) | 1 (Reference) |
>12 h | 11/52 (21.2) | 1.20 (0.61–2.35) | 1.23 (0.62–2.41) |
Irregular | 561/2578 (21.8) | 1.25 (1.09–1.42) | 1.26 (1.10–1.43) |
No Problematic Behavior (n = 12,214) | Problematic Behavior (n = 18,408) | |||
---|---|---|---|---|
Case/n (%) | Adjusted OR * (95% CI) | Case/n (%) | Adjusted OR * (95% CI) | |
Sleep Duration | ||||
6 h | 98/464 (20.0) | 1.39 (1.04–1.84) | 170/673 (25.3) | 1.38 (1.12–1.71) |
7 h | 497/2640 (18.8) | 1.25 (1.03–1.52) | 778/3829 (20.3) | 1.04 (0.90–1.21) |
8 h | 795/4383 (18.1) | 1.20 (1.00–1.44) | 1388/6417 (21.6) | 1.14 (1.00–1.30) |
9 h | 443/2711 (16.3) | 1.06 (0.87–1.29) | 864/4226 (20.4) | 1.06 (0.92–1.22) |
10 or 11 h | 171/1.087 (15.7) | 1 (Reference) | 330/1683 (19.6) | 1 (Reference) |
>12 h | 5/23 (21.7) | 1.63 (0.59–4.48) | 6/26 (23.1) | 1.18 (0.47–2.99) |
Irregular | 194/906 (21.4) | 1.49 (1.18–1.87) | 349/1554 (22.5) | 1.20 (1.01–1.42) |
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Obara, T.; Naito, H.; Tsukahara, K.; Matsumoto, N.; Yamamoto, H.; Yorifuji, T.; Nakao, A. Short or Irregular Sleep Duration in Early Childhood Increases Risk of Injury for Primary School-Age Children: A Nationwide Longitudinal Birth Cohort in Japan. Int. J. Environ. Res. Public Health 2021, 18, 9512. https://doi.org/10.3390/ijerph18189512
Obara T, Naito H, Tsukahara K, Matsumoto N, Yamamoto H, Yorifuji T, Nakao A. Short or Irregular Sleep Duration in Early Childhood Increases Risk of Injury for Primary School-Age Children: A Nationwide Longitudinal Birth Cohort in Japan. International Journal of Environmental Research and Public Health. 2021; 18(18):9512. https://doi.org/10.3390/ijerph18189512
Chicago/Turabian StyleObara, Takafumi, Hiromichi Naito, Kohei Tsukahara, Naomi Matsumoto, Hirotsugu Yamamoto, Takashi Yorifuji, and Atsunori Nakao. 2021. "Short or Irregular Sleep Duration in Early Childhood Increases Risk of Injury for Primary School-Age Children: A Nationwide Longitudinal Birth Cohort in Japan" International Journal of Environmental Research and Public Health 18, no. 18: 9512. https://doi.org/10.3390/ijerph18189512