Association Between Adequate Sleep and Participation in Occupational Areas in School-Age Children

Abstract

Adequate sleep tailored to children’s age is important for their well-being. This study aimed to examine the association between adequate sleep and children’s participation in occupational areas. This study was a retrospective cross-sectional analysis of secondary data obtained from the 2020 National Survey of Children’s Health in the United States. This study included 6,818 children aged 6 to 11 years. The mean age was 8.48 years (standard deviation = 1.72). Multivariate regression models revealed that adequate sleep was significantly associated with increased participation in occupational areas (17% more in leisure, 95% confidence interval [CI]: 1.11–1.23; 15% more in play, 95% CI: 1.07–1.22; 11% more in education, 95% CI: 1.01–1.22) in school-age children, but not with participation in work and social participation. Adequate sleep is associated with increased participation of school-age children in occupational areas.

Plain Language Summary

Children’s Adequate Sleep and Occupational Areas: What You Need to Know

Occupation refers to an individual’s activities of daily living and all activities in which children participate. Occupational areas are divisions encompassing various activities in which children participate, such as leisure, play, education, social participation, or work. In this study, we analyzed the association between adequate sleep (age-appropriate sleep duration) and participation in various occupational areas among school-age children between 6 and 11 years old. Data from the 2020 National Survey of Children’s Health were analyzed. Adequate sleep in children was associated with increased participation in leisure, play, and education. Encouraging children’s participation in activities within occupational areas is associated to adequate sleep.

Keywords

children occupation participation pediatrics well-being

Get full access to this article

View all access options for this article.

References

Abraham

Scaria

(2015). Influence of sleep in academic performance – An integrated review of literature. Journal of Nursing and Health Sciences, 4(4), 78–81. https://doi.org/10.9790/1959-04477881

Accardo

J. A.

(Ed.). (2018). Sleep in children with neurodevelopmental disabilities: An evidence-based guide. Springer.

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001

Amiri

Kalantari

Gharebashloo

(2022). Association between leisure activities and sleep disturbances among children with and without cerebral palsy. International Journal of Therapy and Rehabilitation, 29(9), 1–16. https://doi.org/10.12968/ijtr.2021.0015

Backman

C. L.

(2004). Occupational balance: Exploring the relationships among daily occupations and their influence on well-being. Canadian Journal of Occupational Therapy/Revue Canadienne d’Ergotherapie, 71(4), 202–209. https://doi.org/10.1177/000841740407100404

Bedell

Coster

Law

Liljenquist

Kao

Y. C.

Teplicky

Anaby

Khetani

M. A.

(2013). Community participation, supports, and barriers of school-age children with and without disabilities. Archives of Physical Medicine and Rehabilitation, 94(2), 315–323. https://doi.org/10.1016/j.apmr.2012.09.024

Boergers

Hart

Owens

J. A.

Streisand

Spirito

(2007). Child sleep disorders: Associations with parental sleep duration and daytime sleepiness. Journal of Family Psychology, 21(1), 88–94. https://doi.org/10.1037/0893-3200.21.1.88

Brand

Beck

Gerber

Hatzinger

Holsboer-Trachsler

(2009). “Football is good for your sleep”: Favorable sleep patterns and psychological functioning of adolescent male intense football players compared to controls. Journal of Health Psychology, 14(8), 1144–1155. https://doi.org/10.1177/1359105309342602

Case-Smith

O’Brien

J. C.

(2014). Occupational therapy for children and adolescents. Elsevier Health Sciences.

10.

Chaput

J. P.

Dutil

Sampasa-Kanyinga

(2018). Sleeping hours: What is the ideal number and how does age impact this? Nature and Science of Sleep, 10, 421–430. https://doi.org/10.2147/NSS.S163071

11.

Chien

C. W.

Cheung

Chen

C. Y.

(2019). The relationship between sleep duration and participation in home, school, and community activities among school-aged children. Frontiers in Neuroscience, 13, Article 860. https://doi.org/10.3389/fnins.2019.00860

12.

Child and Adolescent Health Measurement Initiative. (2022). 2020 National Survey of Children’s Health: SAS dataset. Data Resource Center for Child and Adolescent Health Supported by Cooperative Agreement U59MC27866 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, & Maternal and Child Health Bureau. https://www.childhealthdata.org

13.

Dalene

K. E.

Anderssen

S. A.

Andersen

L. B.

Steene-Johannessen

Ekelund

Hansen

B. H.

Kolle

(2018). Cross-sectional and prospective associations between sleep, screen time, active school travel, sports/exercise participation and physical activity in children and adolescents. BMC Public Health, 18(1), Article 705. https://doi.org/10.1186/s12889-018-5610-7

14.

Desjardins

(2015). Activities of daily living and sleep/rest. Pediatric Skills for Occupational Therapy Assistants. Elsevier.

15.

Driver

H. S.

Taylor

S. R.

(2000). Exercise and sleep. Sleep Medicine Reviews, 4(4), 387–402. https://doi.org/10.1053/smrv.2000.0110

16.

Durmer

J. S.

Dinges

D. F.

(2005). Neurocognitive consequences of sleep deprivation. Seminars in Neurology, 25(1), 117–129. https://doi.org/10.1055/s-2005-867080

17.

Dursun

O. B.

Erhan

S. E.

Ibiş

E. Ö.

Esin

I. S.

Keleş

Şirinkan

Yörük

Ö.

Acar

Beyhun

N. E.

(2015). The effect of ice skating on psychological well-being and sleep quality of children with visual or hearing impairment. Disability and Rehabilitation, 37(9), 783–789. https://doi.org/10.3109/09638288.2014.942002

18.

Dworak

Wiater

Alfer

Stephan

Hollmann

Strüder

H. K.

(2008). Increased slow wave sleep and reduced stage 2 sleep in children depending on exercise intensity. Sleep Medicine, 9(3), 266–272. https://doi.org/10.1016/j.sleep.2007.04.017

19.

Ekstedt

Nyberg

Ingre

Ekblom

Ö.

Marcus

(2013). Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: A cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 10(1), 82. https://doi.org/10.1186/1479-5868-10-82

20.

Fadzil

(2021). Factors affecting the quality of sleep in children. Children, 8(2), 122. https://doi.org/10.3390/children8020122

21.

Faulkner

(2022). Sleep and occupational performance are inseparable: Why occupational therapy practice and research should consider sleep and circadian rhythm. British Journal of Occupational Therapy, 85(5), 305–307. https://doi.org/10.1177/03080226221089846

22.

Foti

K. E.

Eaton

D. K.

Lowry

McKnight-Ely

L. R.

(2011). Sufficient sleep, physical activity, and sedentary behaviors. American Journal of Preventive Medicine, 41(6), 596–602. https://doi.org/10.1016/j.amepre.2011.08.009

23.

Gordon

A. M.

Carrillo

Barnes

C. M.

(2021). Sleep and social relationships in healthy populations: A systematic review. Sleep Medicine Reviews, 57, 101428. https://doi.org/10.1016/j.smrv.2021.101428

24.

Gruber

Somerville

Bergmame

Fontil

Paquin

(2016). School-based sleep education program improves sleep and academic performance of school-age children. Sleep Medicine, 21, 93–100. https://doi.org/10.1016/j.sleep.2016.01.012

25.

Hart

R. A.

(2013). Children’s participation: The theory and practice of involving young citizens in community development and environmental care. Routledge.

26.

E. C. M.

Siu

A. M. H.

(2018). Occupational therapy practice in sleep management: A review of conceptual models and research evidence. Occupational Therapy International, 2018, 8637498. https://doi.org/10.1155/2018/8637498

27.

Hoedlmoser

Kloesch

Wiater

Schabus

(2010). Self-reported sleep patterns, sleep problems, and behavioral problems among school children aged 8–11 years. Somnologie–Schlafforschung und Schlafmedizin, 14(1), 23–31. https://doi.org/10.1007/s11818-010-0450-4

28.

Howell

Pierce

(2000). Exploring the forgotten restorative dimension of occupation: Quilting and quilt use. Journal of Occupational Science, 7(2), 68–72. https://doi.org/10.1080/14427591.2000.9686467

29.

Iwata

Iemura

Iwasaki

Matsuishi

(2011). Determinants of sleep patterns in healthy Japanese 5-year-old children. International Journal of Developmental Neuroscience, 29(1), 57–62. https://doi.org/10.1016/j.ijdevneu.2010.09.004

30.

Jacquier

Lenighan

Anater

Kinneman

(2020). Screen-use, active-play and sleep behaviours in a nationally representative sample of infants, toddlers and pre-school children from the U.S. Proceedings of the Nutrition Society, 79, Article E215. https://doi.org/10.10177/S0029665120001639

31.

Knutson

K. L.

Lauderdale

D. S.

(2009). Sociodemographic and behavioral predictors of bed time and wake time among US adolescents aged 15 to 17 years. Journal of Pediatrics, 154(3), 426–430. https://doi.org/10.1016/j.jpeds.2008.08.035

32.

Koca

(2016). Motivation to learn and teacher-student relationship. Journal of International Education and Leadership, 6(2), n2.

33.

Lee

J. S.

(2014). The relationship between student engagement and academic performance: Is it a myth or reality? Journal of Educational Research, 107(3), 177–185. https://doi.org/10.1080/00220671.2013.807491

34.

Lenhart

Smith

Anderson

Duggan

Perrin

(2015). Teens, technology and friendships: Video games, social media and mobile phones play an integral role in how teens meet and interact with friends. Pew Research Center.

35.

Lewis

C. P.

(2004). The relation between extracurricular activities with academic and social competencies in school-age children: A meta-analysis. Texas A&M University.

36.

Lin

Borghese

M. M.

Janssen

(2018). Bi-directional association between sleep and outdoor active play among 10–13 year olds. BMC Public Health, 18(1), Article 224. https://doi.org/10.1186/s12889-018-5122-5

37.

Ludwig

Eakman

Bath-Scheel

Siengsukon

(2022). How occupational therapists assess and address the occupational domain of sleep: A survey study. American Journal of Occupational Therapy, 76(6), 7606345010. https://doi.org/10.5014/ajot.2022.049379

38.

Matricciani

Paquet

Fraysse

Wake

Olds

(2020). Sleep profiles of Australian children aged 11–12 years and their parents: Sociodemographic characteristics and lifestyle correlates. Sleep Medicine, 73, 53–62. https://doi.org/10.1016/j.sleep.2020.04.017

39.

Meltzer

L. J.

Mindell

J. A.

(2006). Sleep and sleep disorders in children and adolescents. Psychiatric Clinics of North America. Psychiatric Clinics, 29(4), 1059–1076. https://doi.org/10.1016/j.psc.2006.08.004

40.

Meltzer

L. J.

Montgomery-Downs

H. E.

(2011). Sleep in the family. Pediatric Clinics of North America. Pediatric Clinics, 58(3), 765–774. https://doi.org/10.1016/j.pcl.2011.03.010

41.

Mindell

J. A.

Owens

J. A.

(2015). A clinical guide to pediatric sleep: Diagnosis and management of sleep problems. Lippincott Williams & Wilkins.

42.

Mindell

J. A.

Sadeh

Kohyama

How

T. H.

(2010). Parental behaviors and sleep outcomes in infants and toddlers: A cross-cultural comparison. Sleep Medicine, 11(4), 393–399. https://doi.org/10.1016/j.sleep.2009.11.011

43.

Paavonen

E. J.

Räikkönen

Pesonen

A. K.

Lahti

Komsi

Heinonen

Järvenpää

A. L.

Strandberg

Kajantie

Porkka-Heiskanen

(2010). Sleep quality and cognitive performance in 8-year-old children. Sleep Medicine, 11(4), 386–392. https://doi.org/10.1016/j.sleep.2009.09.009

44.

Pascoe

M. C.

Hetrick

S. E.

Parker

A. G.

(2020). The impact of stress on students in secondary school and higher education. International Journal of Adolescence and Youth, 25(1), 104–112. https://doi.org/10.1080/02673843.2019.1596823

45.

Perenboom

R. J.

Chorus

A. M.

(2003). Measuring participation according to the International Classification of Functioning, Disability and Health (ICF). Disability and Rehabilitation, 25(11–12), 577–587. https://doi.org/10.1080/0963828031000137081

46.

Ribeiro

Stickgold

(2014). Sleep and school education. Trends in Neuroscience and Education, 3(1), 18–23. https://doi.org/10.1016/j.tine.2014.02.004

47.

Rosa

C. C.

Tebar

W. R.

Oliveira

C. B. S.

Farah

B. Q.

Casonatto

Saraiva

B. T. C.

Christofaro

D. G. D.

(2021). Effect of different sports practice on sleep quality and quality of life in children and adolescents: Randomized clinical trial. Sports Medicine–Open, 7(1), 83. https://doi.org/10.1186/s40798-021-00376-w

48.

Rosenberg

Pade

Reizis

Bar

M. A.

(2019). Associations between meaning of everyday activities and participation among children. American Journal of Occupational Therapy, 73(6), 7306205030p1–7306205030p10. https://doi.org/10.5014/ajot.2019.032508

49.

Sadeh

(2007). Consequences of sleep loss or sleep disruption in children. Sleep Medicine Clinics, 2(3), 513–520. https://doi.org/10.1016/j.jsmc.2007.05.012

50.

Sadeh

Mindell

J. A.

Luedtke

Wiegand

(2009). Sleep and sleep ecology in the first 3 years: A web-based study. Journal of Sleep Research, 18(1), 60–73. https://doi.org/10.1111/j.1365-2869.2008.00699.x

51.

Sadeh

Raviv

Gruber

(2000). Sleep patterns and sleep disruptions in school-age children. Developmental Psychology, 36(3), 291–301. https://doi.org/10.1037//0012-1649.36.3.291

52.

Sexton-Radek

(2013). Adolescent sleep quality measured during leisure activities. Health Psychology Research, 1(2), Article e23. https://doi.org/10.4081/hpr.2013.e23

53.

Sorić

Starc

Borer

K. T.

Jurak

Kovač

Strel

Mišigoj-Duraković

(2015). Associations of objectively assessed sleep and physical activity in 11-year old children. Annals of Human Biology, 42(1), 31–37. https://doi.org/10.3109/03014460.2014.928367

54.

Tester

N. J.

Foss

J. J.

(2018). Sleep as an occupational need. American Journal of Occupational Therapy, 72(1), 7201347010p1–7201347010p4. https://doi.org/10.5014/ajot.2018.020651

55.

U.S. Census Bureau. (2021). The U.S. Census Bureau reviewed this data product for unauthorized disclosure of confidential information and approved the disclosure avoidance practices applied to this release [Data Users Frequently Asked Questions (FAQs)] (CBDRB-FY21-POP001-0161). https://www2.census.gov/programs-surveys/nsch/technical-documentation/methodology/2020-NSCH-FAQs.pdf

56.

U.S. Census Bureau. (2023). The U.S. Census Bureau reviewed this data product for unauthorized disclosure of confidential information and approved the disclosure avoidance practices applied to this release [Methodology Report] (CBDRB-FY21-POP001-0198). https://www2.census.gov/programs-surveys/nsch/technical-documentation/methodology/2020-NSCH-Methodology-Report.pdf

57.

Wagman

Håkansson

Björklund

(2012). Occupational balance as used in occupational therapy: A concept analysis. Scandinavian Journal of Occupational Therapy, 19(4), 322–327. https://doi.org/10.3109/11038128.2011.596219

58.

Waters

K. A.

Suresh

Nixon

G. M.

(2013). Sleep disorders in children. Medical Journal of Australia, 199, S31–S35. https://doi.org/10.5694/mja13.10621

59.

Wiseman-Hakes

Colantonio

Gargaro

(2009). Sleep and wake disorders following traumatic brain injury: A systematic review of the literature. Critical Reviews in Physical and Rehabilitation Medicine, 21(3–4), 317–374. https://doi.org/10.1615/CritRevPhysRehabilMed.v21.i3-4.70

60.

World Health Organization. (2010). Global recommendations on physical activity for health.

61.

Wen

L. M.

Hardy

L. L.

Rissel

(2016). Associations of outdoor play and screen time with nocturnal sleep duration and pattern among young children. Acta Paediatrica, 105(3), 297–303. https://doi.org/10.1111/apa.13285