Sleep deprivation in children and adolescents in China: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LI Xingli ¹ , WANG Cheng ² , ZHANG Ting ² , WANG Jiabin ² ,  YANG Lan ^1,2

1. School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;
2. Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730000, P. R. China;

Corresponding author：

YANG Lan, Email: yanglan0608@126.com

Keywords：

Children; Adolescent; Sleep deprivation; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.202111056

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the rate of sleep deprivation in children and adolescents in China from 2004 to 2019. Methods PubMed, The Cochrane Library, EMbase, Web of Science, CBM, CNKI and WanFang Data databases were searched to collect cross-sectional studies on the sleep deprivation rate of children and adolescents in China from inception to July 15^th, 2021. Two researchers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed by using Stata 15.0 software. Results A total of 45 cross-sectional studies were included, with a total sample size of 769 918 participants, of whom 587 457 reported sleep deprivation. The results of meta-analysis showed that the sleep deprivation rate of Chinese children and adolescents was 61% (95%CI 55% to 68%). Subgroup analysis indicated that the sleep deprivation rates were 62% for female children and 59% for male children. The rate was 84% in junior high school, 80% in high school and 64% in primary school. The rates in south China, southwest China, northwest China, north China, east China and central China were 68%, 62%, 61%, 57%, 57% and 54%, respectively. The rate of sleep deficiency based on "health requirements for daily study time of primary and junior school students" was the highest at 74% (95% CI 70% to 79%). The cumulative meta-analysis by time showed that the sleep deprivation rate had gradually stabilized and approached 60% since 2011. Conclusion Current evidence shows that the sleep deprivation rate of Chinese children and adolescents is high. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.

Citation： LI Xingli, WANG Cheng, ZHANG Ting, WANG Jiabin, YANG Lan. Sleep deprivation in children and adolescents in China: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(3): 268-275. doi: 10.7507/1672-2531.202111056 Copy

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2. Davies SK, Ang JE, Revell VL, et al. Effect of sleep deprivation on the human metabolome. Proc Natl Acad Sci USA, 2014, 111(29): 10761-10766.
3. Wang Z, Chen WH, Li SX, et al. Gut microbiota modulates the inflammatory response and cognitive impairment induced by sleep deprivation. Mol Psychiatry, 2021. DOI: 10.1038/s41380-021-01113-1.
4. 汪倩玲, 张新东, 伍晓艳, 等. 睡眠状况与儿童青少年心理行为问题关联研究. 中华流行病学杂志, 2021, 42(5): 859-865.
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11. Ruppar T. Meta-analysis: how to quantify and explain heterogeneity. Eur J Cardiovasc Nurs, 2020, 19(7): 646-652.
12. Polanczyk GV, Salum GA, Sugaya LS, et al. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry, 2015, 56(3): 345-65.
13. Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health, 2017, 5(2): e147-e156.
14. Chen T, Wu Z, Shen Z, et al. Sleep duration in Chinese adolescents: biological, environmental, and behavioral predictors. Sleep Med, 2014, 15(11): 1345-1353.
15. 陈天麒, 董彬, 张文静, 等. 儿童青少年睡眠时间与速度和耐力成绩的相关性研究. 北京大学学报(医学版), 2018, 50(3): 429-435.
16. Gong QH, Li H, Zhang XH, et al. Associations between sleep duration and physical activity and dietary behaviors in Chinese adolescents: results from the youth behavioral risk factor surveys of 2015. Sleep Med, 2017, 37: 168-173.
17. Gong QH, Li SX, Li H, et al. 25-Hydroxyvitamin D status and its association with sleep duration in Chinese schoolchildren. Nutrients, 2018, 10(8): 1013.
18. Gong QH, Li SX, Li H, et al. Insufficient sleep duration and overweight/obesity among adolescents in a Chinese population. Int J Environ Res Public Health, 2018, 15(5): 997.
19. 李生慧, 沈晓明, 金星明, 等. 全国城市学龄儿童睡眠状况研究. 中华儿科杂志, 2008, 46(3): 185-189.
20. Lin YQ, Zhuang WJ, Zheng FH, et al. Weekday and weekend sleep deprivation are associated with recurrent nightmare in adolescents: a cross-sectional study. Sleep Med, 2020, 76: 36-42.
21. Tso W, Rao N, Jiang F, et al. Sleep duration and school readiness of Chinese preschool children. J Pediatr, 2016, 169: 266-271.
22. Wang H, Hu R, Du H, et al. The relationship between sleep duration and obesity risk among school students: a cross-sectional study in Zhejiang, China. Nutr Metab (Lond), 2018, 15: 48.
23. 王香云, 王香, 黄超全, 等. 长沙市学龄儿童睡眠不足对智力结构的影响. 中国当代儿科杂志, 2013, 15(10): 866-869.
24. 王香云, 钱燕飞, 龚省城, 等. 儿童睡眠质量对上课注意力和学习成绩影响的量化研究. 中国当代儿科杂志, 2011, 13(12): 973-976.
25. Zhang B, Hao Y, Zhou J, et al. The association between sleep patterns and overweight/obesity in Chinese children: a cross-sectional study. Neuropsychiatr Dis Treat, 2015, 11: 2209-2216.
26. 丁鹏, 耿梦龙, 伍晓艳, 等. 长江中下游三省学龄前儿童睡眠状况. 中国学校卫生, 2019, 40(8): 1173-1176,1181.
27. 龚清海, 李辉, 王锋, 等. 宁波市青少年睡眠与超重肥胖的相关性. 中国学校卫生, 2017, 38(10): 1493-1495,1499.
28. 郭海军, 袁帆, 栾德春, 等. 我国4城市中小学生身体活动及睡眠状况调查. 中国健康教育, 2016, 32(2): 107-110,115.
29. 洪忻, 梁亚琼, 王志勇, 等. 南京市初高中学生睡眠状况及与抑郁障碍关系. 中国公共卫生, 2007, 23(11): 1322-1324.
30. 黄婷, 周州, 韦琳, 等. 柳州市城区7~17岁儿童少年睡眠时间及其与高血压的关系. 中国儿童保健杂志, 2020, 28(9): 1044-1046, 1068.
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32. 金彦利, 蔡一飙, 赵凤敏, 等. 宁波市青少年睡眠与超重肥胖,血脂异常关系研究. 现代实用医学, 2018, 30(10): 1337-1339.
33. 李凯凯, 贾磊娜, 刘秀英, 等. 银川市学龄儿童青少年睡眠时间与血脂异常的关系. 现代预防医学, 2019, 46(11): 1965-1968, 1999.
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36. 龙鑫, 纪颖, 张洪伟, 等. 北京市中高年级小学生睡眠时间现状及影响因素分析. 中国卫生统计, 2020, 37(5): 704-707.
37. 吕艳莉, 尹国燕, 李志芳, 等. 长治市学龄儿童睡眠状况调查及影响因素分析. 长治医学院学报, 2020, 34(5): 329-333.
38. 马颖, 林穗方, 蒋琳, 等. 广东三城市青少年睡眠时间运动情况与超重肥胖的相关性. 中国学校卫生, 2017, 38(3): 338-340, 344.
39. 马颖, 邢艳菲, 蒋琳, 等. 就寝时间和睡眠持续时间对广州市学龄前儿童情绪和行为的影响. 医学与社会, 2019, 32(4): 98-102.
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Chinese Journal of Evidence-Based Medicine

Sleep deprivation in children and adolescents in China: a meta-analysis

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