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Effect of the IDEFICS multilevel obesity prevention on children's sleep duration
N Michels1, S De Henauw1,2, G Eiben3
1Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Insights
The IDEFICS intervention showed a small, non-clinically significant effect on children's sleep duration. Future efforts need more targeted strategies to improve sleep in young children.
Area of Science:
- Pediatric Health
- Public Health Interventions
- Sleep Science
Background:
- Short sleep duration is linked to childhood overweight.
- Primary prevention of insufficient sleep in children is lacking.
- The IDEFICS study targeted sleep duration in a multilevel intervention.
Purpose of the Study:
- To evaluate the impact of the IDEFICS intervention on children's sleep duration.
- Assess changes in sleep duration over two years.
- Examine intervention effects on sleep environment factors like bedroom TV presence.
Main Methods:
- A multilevel intervention included sleep duration messages for parents and children.
- Sleep duration was measured using parental recall and diaries.
- Mixed linear and logistic models analyzed intervention effects on sleep duration and TV presence.
Main Results:
- A small, statistically significant intervention effect reduced the decrease in weeknight sleep duration by 4 minutes over two years.
- No significant intervention effect was observed for weekend sleep duration or TV in the bedroom.
- Parental awareness of the sleep intervention was reported by 51.1% in intervention regions.
Conclusions:
- The IDEFICS sleep intervention did not yield clinically significant improvements in children's sleep duration.
- Future interventions require more intensive and specific messaging for young children's sleep.
- Objective sleep measures and intermediate outcomes are recommended for future research.
Background:
According to recent findings, short sleep duration is associated with overweight in children. However, primary prevention efforts aimed at achieving adequate sleep among children are scarce. Therefore, the 'Identification and prevention of Dietary-induced and lifestyle-induced health EFfects In Children and infantS' (IDEFICS) study implemented a multilevel intervention that included sleep duration as a key behavioural target. The aim of this study is to evaluate sleep duration among children participating in the IDEFICS study.
Methods:
The IDEFICS nocturnal sleep intervention was included as part of stress reduction educational messages aimed at parents and children. Sleep was assessed by a parental 24-h recall (only weekdays; n = 8,543) and by a diary (weekdays and weekends separately; n = 4,150). Mixed linear models tested the intervention effect on sleep duration change between baseline when children were 2-9.9 years of age (2007/2008) and follow-up (2009/2010). Logistic mix models were used to study the intervention effect on the presence of TV in the children's bedroom (one of the intervention messages; n = 8,668). Additionally, parents provided qualitative data regarding exposure to the intervention.
Results:
About 51.1% of the parents in the intervention regions reported awareness of the sleep intervention. A small intervention effect was seen on weeknight sleep duration in that the decrease in sleep duration over 2 years was smaller in the intervention (15 min) as compared with control regions (19 min) (p = 0.044). There was no overall intervention effect on weekend sleep duration or on the presence of a TV in the bedroom. A small significant time effect between baseline and follow-up was found on bedroom TV presence depending on self-reported intervention exposure (3% increase in TV presence in exposed versus 6.6% increase in non-exposed). Children without a TV in the bedroom had longer nocturnal sleep duration.
Discussion:
The sleep component of the intervention did not lead to clinically relevant changes in sleep duration. Future interventions aimed at young children's sleep duration could benefit from more specific and intense messaging than that found in the IDEFICS intervention. Future research should use objective measures of sleep duration as well as intermediate outcomes (sleep knowledge, sleep environment and sleep practices).
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