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Table 6 Association between sleep duration and sedentary behaviour 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 6 months and 4.5 years. Data were collected cross-sectionally and up to 4 years. Sleep duration was assessed by parent report. Sedentary behaviors (screen time) were assessed using time-use diaries or questionnaires.
1 Longitudinal studya Serious risk of biasb No serious inconsistency No serious indirectness No serious imprecision None 2984 Sleep duration at 4 years of age was inversely associated with television viewing (β = −0.07, p = 0.003) and computer use (β = −0.04, p = 0.001) at 6 years of age [22]. VERY LOW
4 Cross-sectional studyc Serious risk of biasd No serious inconsistency No serious indirectness No serious imprecision None 42,751 Short sleep duration was associated with time spent watching TV (OR: 1.65, 95% CI 1.23–2.21 per additional hour/24 h) in boys. In girls, the association was not significant (p = 0.75) [31].
Infants who were exposed to screen media in the evening at 12 months of age had a 28-min lower nighttime sleep duration on weekdays. Moreover, infants who were exposed to screen media in the evening at age 6 months and 12 months had shorter 12-month nighttime sleep duration compared with those who were not exposed to screen media after 7 pm at both ages [78].
Watching more than an hour of TV in the evening was associated with short sleep duration (OR = 1.89, 95% CI 1.26–2.84). However, the association was not significant with watching more than an hour of TV in the morning (OR = 1.13, 95% CI 0.80–1.58) [79].
Short sleep duration was associated with longer hours spent watching television (OR = 1.91, 95% CI 1.26–2.90 for ≥4 h/day) and playing computer games (OR = 1.62, 95% CI 1.18–2.23 for ≥2 h/day) compared to not watching/playing [80].
VERY LOW
  1. Due to heterogeneity in the measurement of sleep and sedentary behaviors, a meta-analysis was not possible
  2. aIncludes 1 longitudinal study [22]
  3. bSleep duration was parent-reported with no psychometric properties reported. Therefore, the quality of evidence was downgraded from “low” to “very low”
  4. cIncludes 4 cross-sectional studies [31, 78,79,80]
  5. dSleep duration was parent-reported with no psychometric properties reported. Therefore, the quality of evidence was downgraded from “low” to “very low”