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Table 5 Association between sleep duration and growth in children aged 0–4 years

From: Systematic review of the relationships between sleep duration and health indicators in the early years (0–4 years)

No of studies Design Quality Assessment No of participants Absolute effect Quality
Risk of bias Inconsistency Indirectness Imprecision Other
Mean age ranged between 4 months and 17 months. Data were collected cross-sectionally and up to 13 months. Sleep duration was assessed by actigraphy or parent report. Growth was assessed using the maximum stretch technique and using weight above the expected weight for length.
1 Longitudinal studya Serious risk of biasb No serious inconsistency No serious indirectness No serious imprecision None 23 Saltatory length growth was associated with increased total daily sleep hours (p < 0.001) and number of sleep bouts (p = 0.001). Subject-specific probabilities of a growth saltation associated with sleep included a mean odds ratio of 1.20 for each additional hour of sleep (n = 8, 95% CI 1.15–1.29) and 1.43 for each additional sleep bout (n = 12, 95% CI 1.21–2.03) [29]. VERY LOW
1 Cross-sectional studyc No serious risk of bias No serious inconsistency No serious indirectness Serious imprecisiond None 139,305 Using actigraphy, sleep duration was associated with weight-to-length ratio (r = −0.47, p < 0.01) in girls only. Using the questionnaire, night sleep duration was associated with weight-to-length ratio (r = −0.26, p < 0.05) and weight above the expected weight for length (r = −0.25, p < 0.05) in the total sample [77]. VERY LOW
  1. aIncludes 1 longitudinal study [29]
  2. bSleep duration was parent-reported with no psychometric properties reported. Therefore, the quality of evidence was downgraded from “low” to “very low”
  3. cIncludes 1 cross-sectional study [77]
  4. dOnly one study was published, including a convenience sample of infants and showing differences between boys and girls with the use of actigraphy, so the risk of imprecision is high. Therefore, the quality of evidence was downgraded from “low” to “very low”. Due to the fact that only two studies were published on sleep duration and growth, a meta-analysis was not possible