Elsevier

Public Health

Volume 141, December 2016, Pages 126-129
Public Health

Short Communication
Are Canadian children and adolescents sleep deprived?

https://doi.org/10.1016/j.puhe.2016.09.009Get rights and content

Highlights

  • Twenty percent of children and 30% of adolescents sleep less than recommended for optimal health.

  • Thirty-two percent of children and 42% of adolescents report trouble going to sleep or staying asleep.

  • Eleven percent of children and 32% of adolescents report difficulty staying awake during waking hours.

  • Differences between boys and girls are minimal.

Introduction

Sleep is essential to human health and healthy sleep requires adequate duration, good quality, appropriate timing and regularity and the absence of sleep disturbances or disorders. However, insufficient sleep has become common in modern societies with studies showing declines in sleep duration and more sleep problems and tiredness now compared with decades ago in children and adolescents.1, 2 An accumulating body of evidence shows that insufficient sleep is associated with adverse physical and mental health outcomes. For example, a recent systematic review that examined the relationships between sleep duration and various health outcomes in children and adolescents from 40 different countries found that longer sleep duration was associated with lower adiposity, better emotional regulation, better academic achievement and better quality of life/well-being.3

The National Sleep Foundation in the USA recommends that children aged 6–13 years sleep 9–11 h/night and adolescents aged 14–17 years sleep 8–10 h/night.4 These sleep duration recommendations have recently been supported and adopted in Canada.5 Although the ideal amount of sleep may vary from one person to another, sleep duration recommendations are important for surveillance and help to inform public policies, interventions, and the population of healthy sleep behaviours.

There is no doubt that sleep is increasingly recognized as an important component for optimal health; however, studies reporting on sleep using a representative sample of Canadian children and adolescents are lacking. Knowing the proportion of children and adolescents getting insufficient sleep is important given that sleep is critical for healthy growth and development and will allow to determine the extent of the problem. This information will also help to better tailor and target future interventions aimed at improving sleep habits in this paediatric population. Therefore, the objective of this study was to provide recent sleep duration and quality estimates of Canadian children and adolescents, and to determine the proportion of them adhering to current sleep duration guidelines.

Data used in this study were from the Canadian Health Measures Survey (CHMS), an ongoing cross-sectional survey that collects data from a representative sample of the population living in Canada. Cycle 1 (2007–2009), cycle 2 (2009–2011) and cycle 3 (2012–2013) were used for the present analyses. Health Canada's Research Ethics Board approved the conduct of CHMS and written informed consent and assent were obtained.

In the present study, 6–17 years old participants from CHMS' Cycles 1–3 were included. For descriptive and comparative purposes, participants were grouped into the following age categories: school-aged children (6–13 years old; n = 2043 boys, 1980 girls) and adolescents (14–17 years old; n = 829 boys, 778 girls). Comparisons were also made across genders (n = 2872 boys, 2758 girls). Responses to the questionnaire were provided by the parent or legal guardian for 80.1% of children and 1.9% of adolescents.

Sleep duration and quality were either parent-reported (ages 6–11 years) or self-reported (ages 12–17 years). CHMS assessed the amount of sleep using the following question in the household questionnaire: ‘How many hours do you usually spend sleeping in a 24-hour period, excluding time spent resting?’ Responses were rounded to the closest half hour by the interviewer. In addition to sleep duration, sleep quality was assessed using the following questions: (1) ‘how often do you have trouble going to sleep or staying asleep?’ and (2) ‘how often do you find it difficult to stay awake during your normal waking hours when you want to?’ For both questions, response options were ‘never’, ‘rarely’, ‘sometimes’, ‘most of the time’ and ‘all of the time’. Participants who responded ‘don't know’ or who did not answer the question were removed from the analyses (n = 3). Finally, participants were classified as meeting the recommended range of sleep duration (9–11 h/night for 6–13 years old or 8–10 h/night for 14–17 years old), sleeping less than the recommended range or sleeping longer than the recommended range.4, 5

To account for the survey design, the means and percentages were estimated using survey weights and their variances were estimated using the survey bootstrap technique. Then, 95% confidence intervals were calculated and small percentage confidence intervals were used by SUDAAN version 11 for estimated percentages ≤5%. t-Tests were performed to compare means and proportions between different domains. P-values were adjusted for multiple comparisons using the false discovery rate (FDR) adjustment method and differences between estimates were tested for statistical significance at a FDR adjusted P-value <0.05. All analyses were conducted with SAS version 9.3 and SUDAAN version 11.

Section snippets

Proportion of children and adolescents meeting the sleep duration recommendations

Overall, with the three cycles combined (n = 5625), mean self-reported sleep duration was 9.43 h/night (95% CI 9.37–9.48) for 6–13 years old and 8.07 h/night (95% CI 7.96–8.19) for 14–17 years old. Adolescents slept significantly less than children (by ∼1.4 h on average) and sleep duration was not significantly different between boys and girls. Trends over time revealed no significant differences in sleep duration.

With regard to sleep quality, 32.4% (95% CI 29.4–35.4) of 6–13 years old and

Public health implications of these findings

Short sleep duration and poor sleep quality are highly prevalent in Canadian youth, especially in adolescents. The finding that about one-third of adolescents sleep less than the recommended amount may be concerning given the well-documented adverse effects of insufficient sleep on physical and mental health. However, one needs to remember that sleeping less than the recommended amount does not necessarily imply that it will adversely impact health (our sleep needs are largely explained by our

Acknowledgements

The authors would like to thank the participants of the Canadian Health Measures Survey as well as all staff at Statistics Canada involved in the operations of the survey.

Ethical approval

Health Canada's Research Ethics Board approved the conduct of this study.

Funding

None.

Competing interests

None declared.

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