Sleep characteristics and health-related quality of life in 9- to 11-year-old children from 12 countries

Xiao, Qian and Chaput, Jean Philippe and Olds, Timothy and Fogelholm, Mikael and Hu, Gang and Lambert, Estelle V. and Maher, Carol and Maia, Jose and Onywera, Vincent and Sarmiento, Olga L. and Standage, Martyn and Tremblay, Mark S. and Tudor-Locke, Catrine and Katzmarzyk, Peter T. and Church, Timothy S. and Lambert, Denise G. and Barreira, Tiago and Broyles, Stephanie and Butitta, Ben and Champagne, Catherine and Cocreham, Shannon and Denstel, Kara D. and Drazba, Katy and Harrington, Deirdre and Johnson, William and Milauskas, Dione and Mire, Emily and Tohme, Allison and Rodarte, Ruben and Amoroso, Bobby and Luopa, John and Neiberg, Rebecca and Rushing, Scott and Timothy Olds, Olds and Lewis, Lucy and Ferrar, Katia and Georgiadis, Effie and Stanley, Rebecca and Rodrigues Matsudo, Victor Keihan and Matsudo, Sandra and Araujo, Timoteo and Carlos de Oliveira, Luis and Fabiano, Luis and Bezerra, Diogo and Ferrari, Gerson and Bélanger, Priscilla and Borghese, Mike and Boyer, Charles and LeBlanc, Allana and Wang, Yue, ISCOLE Research Group (2020) Sleep characteristics and health-related quality of life in 9- to 11-year-old children from 12 countries. Sleep Health, 6 (1). pp. 4-14. (

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Introduction: Previous studies have linked short sleep duration, poor sleep quality, and late sleep timing with lower health-related quality of life (HRQoL) in children. However, almost all studies relied solely on self-reported sleep information, and most studies were conducted in high-income countries. To address these gaps, we studied both device-measured and self-reported sleep characteristics in relation to HRQoL in a sample of children from 12 countries that vary widely in terms of economic and human development. Methods: The study sample included 6,626 children aged 9-11 years from Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. Waist-worn actigraphy was used to measure total sleep time, bedtime, wake-up time, and sleep efficiency on both weekdays and weekends. Children also reported ratings of sleep quantity and quality. HRQoL was measured by the KIDSCREEN-10 survey. Multilevel regression models were used to determine the relationships between sleep characteristics and HRQoL. Results: Results showed considerable variation in sleep characteristics, particularly duration and timing, across study sites. Overall, we found no association between device-measured total sleep time, sleep timing or sleep efficiency, and HRQoL. In contrast, self-reported ratings of poor sleep quantity and quality were associated with HRQoL. Conclusions: Self-reported, rather than device-based, measures of sleep are related to HRQoL in children. The discrepancy related to sleep assessment methods highlights the importance of considering both device-measured and self-reported measures of sleep in understanding its health effects.


Xiao, Qian, Chaput, Jean Philippe, Olds, Timothy, Fogelholm, Mikael, Hu, Gang, Lambert, Estelle V., Maher, Carol, Maia, Jose, Onywera, Vincent, Sarmiento, Olga L., Standage, Martyn, Tremblay, Mark S., Tudor-Locke, Catrine, Katzmarzyk, Peter T., Church, Timothy S., Lambert, Denise G., Barreira, Tiago, Broyles, Stephanie, Butitta, Ben, Champagne, Catherine, Cocreham, Shannon, Denstel, Kara D., Drazba, Katy, Harrington, Deirdre ORCID logoORCID:, Johnson, William, Milauskas, Dione, Mire, Emily, Tohme, Allison, Rodarte, Ruben, Amoroso, Bobby, Luopa, John, Neiberg, Rebecca, Rushing, Scott, Timothy Olds, Olds, Lewis, Lucy, Ferrar, Katia, Georgiadis, Effie, Stanley, Rebecca, Rodrigues Matsudo, Victor Keihan, Matsudo, Sandra, Araujo, Timoteo, Carlos de Oliveira, Luis, Fabiano, Luis, Bezerra, Diogo, Ferrari, Gerson, Bélanger, Priscilla, Borghese, Mike, Boyer, Charles, LeBlanc, Allana and Wang, Yue;