Impact of sleep on injury risk among rural children

To examine sleep patterns in a large cohort of rural children and explore the association between sleep patterns and injury occurrence.

Cross-sectional analyses of the baseline survey from a prospective cohort study (2012 to 2017) was conducted with 46 rural schools in Saskatchewan, Canada who distributed surveys to parents of 2275 rural dwelling farm and nonfarm children aged 0 to 17 years. Parents reported child sleep characteristics and farm or nonfarm injury in the previous calendar year. Multivariable log-binomial regression examined associations between sleep characteristics and injury risk.

There was a significant trend of decreasing sleep duration with increasing age (P-trend < 0.001). Short sleep duration on weekdays (RR: 2.14; 95% CI: 1.25 to 3.66) and sleep debt (RR: 1.89; 95% CI: 1.21 to 2.95) increased injury risk in school-age children (7 to 12 years) but not in teens. A nearly fivefold increase in injury risk was identified among school-age children reporting all sleep problems (RR: 4.99; 95% CI: 1.99 to 12.50). Snoring in teens (13 to 17 years), often a symptom of obstructive sleep apnea, was associated with increased injury risk (RR: 1.98; 95% CI: 1.17 to 3.33). There were no statistically significant associations identified between sleep characteristics and injury risk in preschool children.

Injuries to rural children are an important public health concern. This study highlights the impact of sleep problems on risk for injury among rural children. These findings are discussed in light of the recent American Academy of Pediatrics Technical Report on Insufficient Sleep in Adolescents and Young Adults.