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Physical activity, sedentary time and sleep in cystic fibrosis youth: A bidirectional relationship?

Melitta A McNarry¹, Daniel Stevens^2,3,4, Michelle Stone^2,3

¹Applied Sports, Technology, Exercise and Medicine Research Center (A-STEM), College of Engineering, Swansea University, Swansea, Wales, UK.

Pediatric Pulmonology

|November 25, 2020

Insights

Sedentary time negatively impacts sleep duration and quality in children with cystic fibrosis (CF) and healthy children. Sleep also influences subsequent physical activity (PA) levels, with a bidirectional relationship observed between sedentary behavior and sleep.

Area of Science:

Pediatric Health
Sleep Science
Exercise Physiology

Background:

Physical activity (PA) and sleep are crucial for children with cystic fibrosis (CF).
A bidirectional relationship between PA and sleep is suggested in healthy children.
The interplay between PA and sleep in youth with CF remains under-investigated.

Purpose of the Study:

To investigate the relationship between physical activity, sedentary time, and sleep in youth with CF.
To compare these relationships between children with CF and healthy controls.

Main Methods:

Objective measurement of PA, sedentary time (SED), and sleep over seven days in 58 youth (29 with CF).
Utilized generalized linear latent and mixed models.
Adjusted for age, sex, wear-time, type of day, group, and mean PA/SED and sleep.

Main Results:

Increased sedentary time (SED) was associated with reduced sleep and increased wake after sleep onset (WASO) in both CF and healthy children.
Physical activity (PA) intensity did not correlate with total sleep time.
Light PA (LPA) was linked to less WASO in healthy children, while more sleep correlated with less SED in both groups.
In CF, more sleep led to less LPA the next day.
In healthy children, poorer sleep quality (more WASO) correlated with increased LPA and moderate-to-vigorous PA the next day.

Conclusions:

A bidirectional relationship exists between sedentary time and total sleep time, independent of group.
The relationship between sleep and physical activity is dependent on the group (CF vs. healthy).
Findings highlight the reciprocal impact of promoting PA or sleep quantity/quality in youth.

Read full analysis

Abstract

Purpose:

Physical activity (PA) and sleep are highly important for those with cystic fibrosis (CF), yet, despite this and suggestions of a bidirectional relationship between these factors in healthy children, their relationship is yet to be investigated.

Methods:

PA, sedentary time (SED), and sleep were objectively derived over seven days in 58 youth (11.9 ± 2.7 years; 29 CF). Generalized linear latent and mixed models with a random intercept and slope at child-level were adjusted for age, sex, wear-time, type of day, group and mean PA/SED and sleep.

Results:

Every additional 10 min sedentary was associated with 5.6 and 5.0 min less sleep and 10.6 and 12.0 min less wake after sleep onset (WASO) that night, in CF and healthy children, respectively. PA, regardless of intensity, was not associated with total sleep time but every additional 10 min of light PA (LPA) was associated with 3.0 min less WASO in healthy participants. Ten mins more sleep was associated with 3.1 and 1.7 min less SED in CF and healthy children, respectively. In CF, greater sleep time led to less LPA (3.6 min) the following day, whereas, in healthy children, poor sleep quality (greater WASO) was associated with more LPA (1.4 min) and moderate-to-vigorous PA (5.2 min) the following day.

Conclusion:

A bidirectional relationship between SED and subsequent total sleep time was evident, irrespective of group, whereas the relationship between sleep and PA was group dependent. These findings have important implications regarding the reciprocal effects of promoting PA or sleep quantity or quality.

Keywords:

24-hour movement accelerometry child health chronic disease respiratory

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