Jianghong Liu1, Xianchen Liu2, Victoria Pak1, Yingjie Wang1, Chonghuai Yan3, Jennifer Pinto-Martin1, David Dinges4. 1. School of Nursing, University of Pennsylvania, Philadelphia, PA. 2. Shandong University School of Public Health, Jinan, China. 3. Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiaotong University School of Medicine, China. 4. Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Abstract
STUDY OBJECTIVES: Little is known about the effect of lead exposure on children's sleep. This study examined the association between blood lead levels (BLL) and sleep problems in a longitudinal study of children. SETTING: Four community-based elementary schools in Jintan City, China. PARTICIPANTS: 1,419 Chinese children. MEASUREMENT AND RESULTS: BLL were measured when children were aged 3-5 y, and sleep was assessed at ages 9-13 y. Sleep was assessed by both parents' report, using the Children's Sleep Habits Questionnaire (CSHQ), and children's report, using an adolescent sleep questionnaire. A total of 665 children with complete data on BLL and sleep at both ages were included in the current study. Mean age of the sample at BLL assessment was 4.74 y (standard deviation [SD] = 0.89) and at sleep assessment was 11.05 y (SD = 0.88). Mean BLL was 6.26 μg/dL (SD = 2.54). There were significant positive correlations between BLL and 3 CSHQ subscales: Sleep onset delay (r = 0.113, P < 0.01), sleep duration (r = 0.139, P < 0.001), and night waking (r = 0.089, P < 0.05). Excessive daytime sleepiness (EDS) (26.1% versus 9.0%, P < 0.001) and use of sleeping pills (6.5% versus 1.8%, P = 0.03) were more prevalent in children BLL ≥ 10.0 μg/dL than in those children BLL < 10.0 μg/dL. After adjusting for demographics, BLL ≥ 10.0 μg/dL was significantly associated with increased risk for insomnia symptoms (odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.03-3.95) and EDS (OR = 2.90, 95% CI = 1.27-6.61). CONCLUSION: The findings indicate that elevated blood lead levels in early childhood are associated with increased risk for sleep problems and excessive daytime sleepiness in later childhood.
STUDY OBJECTIVES: Little is known about the effect of lead exposure on children's sleep. This study examined the association between blood lead levels (BLL) and sleep problems in a longitudinal study of children. SETTING: Four community-based elementary schools in Jintan City, China. PARTICIPANTS: 1,419 Chinese children. MEASUREMENT AND RESULTS:BLL were measured when children were aged 3-5 y, and sleep was assessed at ages 9-13 y. Sleep was assessed by both parents' report, using the Children's Sleep Habits Questionnaire (CSHQ), and children's report, using an adolescent sleep questionnaire. A total of 665 children with complete data on BLL and sleep at both ages were included in the current study. Mean age of the sample at BLL assessment was 4.74 y (standard deviation [SD] = 0.89) and at sleep assessment was 11.05 y (SD = 0.88). Mean BLL was 6.26 μg/dL (SD = 2.54). There were significant positive correlations between BLL and 3 CSHQ subscales: Sleep onset delay (r = 0.113, P < 0.01), sleep duration (r = 0.139, P < 0.001), and night waking (r = 0.089, P < 0.05). Excessive daytime sleepiness (EDS) (26.1% versus 9.0%, P < 0.001) and use of sleeping pills (6.5% versus 1.8%, P = 0.03) were more prevalent in childrenBLL ≥ 10.0 μg/dL than in those childrenBLL < 10.0 μg/dL. After adjusting for demographics, BLL ≥ 10.0 μg/dL was significantly associated with increased risk for insomnia symptoms (odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.03-3.95) and EDS (OR = 2.90, 95% CI = 1.27-6.61). CONCLUSION: The findings indicate that elevated blood lead levels in early childhood are associated with increased risk for sleep problems and excessive daytime sleepiness in later childhood.
Authors: Maryse F Bouchard; David C Bellinger; Jennifer Weuve; Julia Matthews-Bellinger; Stephen E Gilman; Robert O Wright; Joel Schwartz; Marc G Weisskopf Journal: Arch Gen Psychiatry Date: 2009-12
Authors: Lisa J Meltzer; Sarah Biggs; Amy Reynolds; Kristin T Avis; Valerie McLaughlin Crabtree; Katherine B Bevans Journal: Sleep Med Date: 2012-02-10 Impact factor: 3.492
Authors: Erica C Jansen; Galit Levi Dunietz; Aleena Dababneh; Karen E Peterson; Ronald D Chervin; Jonggyu Baek; Louise O'Brien; Peter X K Song; Alejandra Cantoral; Howard Hu; Martha M Téllez-Rojo Journal: J Clin Sleep Med Date: 2019-10-15 Impact factor: 4.062
Authors: Jianghong Liu; Siyuan Cao; Zehang Chen; Adrian Raine; Alexandra Hanlon; Yuexian Ai; Guoping Zhou; Chonghuai Yan; Patrick W Leung; Linda McCauley; Jennifer Pinto-Martin Journal: Int J Epidemiol Date: 2015-08-31 Impact factor: 7.196
Authors: Jianghong Liu; Ying Cui; Linda Li; Lezhou Wu; Alexandra Hanlon; Jennifer Pinto-Martin; Adrian Raine; Joseph R Hibbeln Journal: Sci Rep Date: 2017-12-21 Impact factor: 4.379