Karen Thorpe1, Sally Staton1, Emily Sawyer2, Cassandra Pattinson1, Catherine Haden3, Simon Smith4. 1. School of Psychology and Counselling, Institute for Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia. 2. School of Medicine and Dentistry, James Cook University, Queensland, Australia. 3. Department of Library, Queensland University of Technology, Queensland, Australia. 4. Centre for Accident Research & Road Safety-Queensland, Institute for Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
Abstract
BACKGROUND: Duration and quality of sleep affect child development and health. Encouragement of napping in preschool children has been suggested as a health-promoting strategy. OBJECTIVES: The aim of this study is to assess evidence regarding the effects of napping on measures of child development and health. DESIGN: This study is a systematic review of published, original research articles of any design. SUBJECTS: Children aged 0-5 years. METHOD: Electronic database search was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessment of research quality was carried out following a Grading of Recommendations, Assessment, Development and Evaluations (GRADE) protocol. RESULTS: Twenty-six articles met inclusion criteria. These were of heterogeneous quality; all had observational designs (GRADE-low). Development and health outcomes included salivary cortisol, night sleep, cognition, behaviour, obesity and accidents. The findings regarding cognition, behaviour and health impacts were inconsistent, probably because of variation in age and habitual napping status of the samples. The most consistent finding was an association between napping and later onset, shorter duration and poorer quality of night sleep, with evidence strongest beyond the age of 2 years. LIMITATIONS: Studies were not randomised. Most did not obtain data on the children's habitual napping status or the context of napping. Many were reliant on parent report rather than direct observation or physiological measurement of sleep behaviour. CONCLUSIONS: The evidence indicates that beyond the age of 2 years napping is associated with later night sleep onset and both reduced sleep quality and duration. The evidence regarding behaviour, health and cognition is less certain. There is a need for more systematic studies that use stronger designs. In preschool children presenting with sleep problems clinicians should investigate napping patterns. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Duration and quality of sleep affect child development and health. Encouragement of napping in preschool children has been suggested as a health-promoting strategy. OBJECTIVES: The aim of this study is to assess evidence regarding the effects of napping on measures of child development and health. DESIGN: This study is a systematic review of published, original research articles of any design. SUBJECTS:Children aged 0-5 years. METHOD: Electronic database search was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessment of research quality was carried out following a Grading of Recommendations, Assessment, Development and Evaluations (GRADE) protocol. RESULTS: Twenty-six articles met inclusion criteria. These were of heterogeneous quality; all had observational designs (GRADE-low). Development and health outcomes included salivary cortisol, night sleep, cognition, behaviour, obesity and accidents. The findings regarding cognition, behaviour and health impacts were inconsistent, probably because of variation in age and habitual napping status of the samples. The most consistent finding was an association between napping and later onset, shorter duration and poorer quality of night sleep, with evidence strongest beyond the age of 2 years. LIMITATIONS: Studies were not randomised. Most did not obtain data on the children's habitual napping status or the context of napping. Many were reliant on parent report rather than direct observation or physiological measurement of sleep behaviour. CONCLUSIONS: The evidence indicates that beyond the age of 2 years napping is associated with later night sleep onset and both reduced sleep quality and duration. The evidence regarding behaviour, health and cognition is less certain. There is a need for more systematic studies that use stronger designs. In preschool children presenting with sleep problems clinicians should investigate napping patterns. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Child Psychology; Comm Child Health; Sleep
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