Sleep duration, schedule and quality among urban Chinese children and adolescents: associations with routine after-school activities

• Published in: PloS one Vol. 10; no. 1; p. e0115326
• Main Authors: Jiang, Xiaoxiao, Hardy, Louise L, Baur, Louise A, Ding, Ding, Wang, Ling, Shi, Huijing
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 22.01.2015; Public Library of Science (PLoS)
• Subjects: Activity programs (Education); Adolescent; Adolescents; Cell phones; Child; Children; China; Commuting; Daytime; Electronic devices; Elementary school students; Female; Gender aspects; Girls; Health aspects; Humans; Hygiene; Insomnia; Male; Metropolitan areas; Motor Activity; Physical activity; Quality; Recreation; Sex; Sex Characteristics; Sex differences; Sleep; Students; Studies; Teenagers; Urban Population; Urbanization; Work; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0115326

With rapid urbanization accompanied by lifestyle changes, children and adolescents living in metropolitan areas are faced with many time use choices that compete with sleep. This study reports on the sleep hygiene of urban Chinese school students, and investigates the relationship between habitual after-school activities and sleep duration, schedule and quality on a regular school day. Cross-sectional, school-based survey of school children (Grades 4-8) living in Shanghai, China, conducted in 2011. Self-reported data were collected on students' sleep duration and timing, sleep quality, habitual after-school activities (i.e. homework, leisure-time physical activity, recreational screen time and school commuting time), and potential correlates. Mean sleep duration of this sample (mean age: 11.5-years; 48.6% girls) was 9 hours. Nearly 30% of students reported daytime tiredness. On school nights, girls slept less (p<0.001) and went to bed later (p<0.001), a sex difference that was more pronounced in older students. Age by sex interactions were observed for both sleep duration (p=0.005) and bedtime (p=0.002). Prolonged time spent on homework and mobile phone playing was related to shorter sleep duration and later bedtime. Adjusting for all other factors, with each additional hour of mobile phone playing, the odds of daytime tiredness and having difficulty maintaining sleep increased by 30% and 27% among secondary students, respectively. There are sex differences in sleep duration, schedule and quality. Habitual activities had small but significant associations with sleep hygiene outcomes especially among secondary school students. Intervention strategies such as limiting children's use of electronic screen devices after school are implicated.