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Aim: Using national Australian time-diary data, we aimed to empirically determine sleep duration thresholds beyond which children have poorer health, learning, quality of life, and weight status and parents have poorer mental health.Methods: Design/setting: Cross-sectional data from the first three waves of the Longitudinal Study of Australian Children.Participants: A nationally representative sample of 4983 4-5-year-olds, recruited in 2004 from the Australian Medicare database and followed biennially; 3631 had analyzable sleep information and a concurrent measure of health and well-being for at least one wave.Main Measures: Exposure: At each wave, a parent completed 24-h time-use diaries for one randomly selected weekday and one weekend day, including a "sleeping/napping" category.Outcomes: Parent-reported child mental health, health-related quality of life, and maternal/paternal mental health; teacher-reported child language, literacy, mathematical thinking, and approach to learning; and assessed child body mass index and girth.Results: Linear regression analyses revealed weak, inconsistent relationships between sleep duration and outcomes at every wave. For example, children with versus without psychosocial health-related quality of life problems slept slightly less at 6-7 years (adjusted mean difference 0.12 h; 95% confidence interval 0.01-0.22, p = 0.03), but not at 4-5 (0.00; -0.10 to 0.11, p = 1.0) or 8-9 years (0.09; -0.02 to 0.22, p = 0.1). Empirical exploration using fractional polynomials demonstrated no clear thresholds for sleep duration and any adverse outcome at any wave.Conclusions: Present guidelines in terms of children's short sleep duration appear misguided. Other parameters such as sleep timing may be more meaningful for understanding optimal child sleep. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to use national Australian time-diary data to examine both (1) cross-sectionally and (2) longitudinally whether being late versus early to sleep or wake is associated with poorer child behavior, quality of life, learning, cognition and weight status, and parental mental health.Methods: Design/setting: Data from the first three waves of the Longitudinal Study of Australian Children were taken.Participants: A national representative sample of 4983 4-5-year-olds, recruited in 2004 from the Australian Medicare database and followed up biennially, was taken; 3631 had analyzable sleep information and a concurrent measure of health and well-being for at least one wave.Measures: Exposure: Parents completed 24-h child time-use diaries for one week and one weekend day at each wave. Using median splits, sleep timing was categorized into early-to-sleep/early-to-wake (EE), early-to-sleep/late-to-wake (EL), late-to-sleep/early-to-wake (LE), and late-to-sleep/late-to-wake (LL) at each wave.Outcomes: The outcomes included parent-reported child behavior, health-related quality of life, maternal/paternal mental health, teacher-reported child language, literacy, mathematical thinking, and approach to learning. The study assessed child body mass index and girth.Results: (1) Using EE as the comparator, linear regression analyses revealed that being late-to-sleep was associated with poorer child quality of life from 6 to 9 years and maternal mental health at 6-7 years. There was inconsistent or no evidence for associations between sleep timing and all other outcomes. (2) Using the count of the number of times (waves) at which a child was categorized as late-to-sleep (range 0-3), longitudinal analyses demonstrated that there was a cumulative effect of late-to-sleep profiles on poorer child and maternal outcomes at the child age of 8-9 years.Conclusions: Examined cross-sectionally, sleep timing is a driver of children's quality of life and maternal depression. Examined longitudinally, there appears to be cumulative and adverse relationships between late-to-sleep profiles and poorer child and maternal outcomes at the child age of 8-9 years. Understanding how other parameters - such as scheduling consistency, sleep efficiency and hygiene - are also related to child and parent outcomes will help health professionals better target sleep management advice to families. [ABSTRACT FROM AUTHOR]

Aims: To determine at school entry (i) the prevalence and types of child sleep problems; (ii) sleep difficulties and hygiene practices associated with sleep problems; and (iii) their associations with child health-related quality of life, mental health and parent mental health. Methods: We conducted a cross-sectional community-based study at 22 primary schools in Melbourne, Australia. One thousand five hundred and twelve (70%) parents of children in the first 6 months of the child's first year of primary school took part. Parent report of child sleep problems (none, mild, and moderate/severe); sleep difficulties; pre-bedtime activities (television in bedroom, television or electronic games before bedtime, television or electronic games >2 h/day) and caffeine intake; child mental health (Strengths and Difficulties Questionnaire), health-related quality of life (Pediatric Quality of Life Inventory); and parent mental health (Depression Anxiety Stress Scale-21). Results: 38.6% of children had a parent-reported sleep problem (27.9% mild, 10.8% moderate/severe). Sleep problems were characterised by problematic sleep difficulties but not poor sleep hygiene practices. Moderate/severe sleep problems were associated with poorer child mental health (mean difference −0.8; 95% confidence interval (CI) −1.1 to −0.5, P < 0.001), health-related quality of life (mean difference −9.9; 95% CI −11.9 to −7.9, P < 0.001) and parent mental health (mean difference 9.8; 95% CI 7.7-11.9, P < 0.001). Conclusions: In new school entrants, sleep problems are common and associated with poorer child mental health, health-related quality of life and parent mental health. Future research needs to determine if systematically addressing sleep problems improves these outcomes. [ABSTRACT FROM AUTHOR]

Background: Low academic achievement is common and is associated with adverse outcomes such as grade repetition, behavioural disorders and unemployment. The ability to accurately identify these children and intervene before they experience academic failure would be a major advance over the current 'wait to fail' model. Recent research suggests that a possible modifiable factor for low academic achievement is working memory, the ability to temporarily store and manipulate information in a 'mental workspace'. Children with working memory difficulties are at high risk of academic failure. It has recently been demonstrated that working memory can be improved with adaptive training tasks that encourage improvements in working memory capacity. Our trial will determine whether the intervention is efficacious as a selective prevention strategy for young children at risk of academic difficulties and is cost-effective. Methods/Design: This randomised controlled trial aims to recruit 440 children with low working memory after a school-based screening of 2880 children in Grade one. We will approach caregivers of all children from 48 participating primary schools in metropolitan Melbourne for consent. Children with low working memory will be randomised to usual care or the intervention. The intervention will consist of 25 computerised working memory training sessions, which take approximately 35 minutes each to complete. Follow-up of children will be conducted at 6, 12 and 24 months post-randomisation through child face-to-face assessment, parent and teacher surveys and data from government authorities. The primary outcome is academic achievement at 12 and 24 months, and other outcomes include child behaviour, attention, health-related quality of life, working memory, and health and educational service utilisation. Discussion: A successful start to formal learning in school sets the stage for future academic, psychological and economic well-being. If this preventive intervention can be shown to be efficacious, then we will have the potential to prevent academic underachievement in large numbers of at-risk children, to offer a ready-to-use intervention to the Australian school system and to build international research partnerships along the healtheducation interface, in order to carry our further studies of effectiveness and generalisability. [ABSTRACT FROM AUTHOR]

Objective: Few studies have examined the sleep behaviors associated with a caregiver-reported sleep problem beyond early childhood and across different age groups. This study examined sleep behaviors associated with a caregiver-reported sleep problem from birth to middle childhood.Methods: Participants were 5107 children from the Longitudinal Study of Australian Children-Birth Cohort. Caregiver-reported child sleep problems and sleep behaviors were assessed biennially from ages 0-1 to 10-11 years. Logistic regressions were used to examine associations between three child sleep behaviors (waking overnight, difficulty falling asleep, and difficulty sleeping alone) and the odds of having a caregiver-reported sleep problem at each age.Results: Caregiver-reported child sleep problems were most prevalent in infancy (17.1%) and decreased through middle childhood (7.7%). All three sleep behaviors were associated with a sleep problem at each age. Whereas waking overnight was the most common sleep behavior and was associated with the highest odds of having a sleep problem from infancy to age 6-7 years (ORs = 5.78-8.29), difficulty falling asleep was the most common sleep behavior and was associated with the highest odds of having a sleep problem at ages 8-9 and 10-11 years (ORs = 10.65 and 17.78, respectively).Conclusion: Caregivers' endorsement of a child sleep problem was associated with developmentally-relevant sleep behaviors, with night awakenings most relevant during infancy and difficulty falling asleep most relevant in middle childhood. Study findings have implications for targeted and developmentally-focused sleep problem screening questions in child healthcare settings. Future research examining additional indicators of caregiver-defined sleep problems is required. [ABSTRACT FROM AUTHOR]