Elsevier

The Journal of Pediatrics

Volume 151, Issue 5, November 2007, Pages 518-522.e4
The Journal of Pediatrics

Original article
Daytime Sleepiness and Associated Factors in Japanese School Children

https://doi.org/10.1016/j.jpeds.2007.04.036Get rights and content

Objective

To examine daytime sleepiness and sleepiness interrelationship with sleep-wake patterns, eating habits, physical activity, and TV/video game time.

Study design

A cross-sectional survey with 9,261 school children (mean age of 12.8 years) from 93 junior high schools in Toyama prefecture, Japan.

Results

The main outcome measures were daytime sleepiness during schooldays and sleepiness interrelationship with sleep-wake patterns, eating habits, physical activity, and visual media use. A total of 2,328 children (25.2%) reported sleepiness almost always and 4,401 (47.6%) sleepiness often. Regarding sex difference, a higher proportion of girls reported sleepiness in comparison to boys (79% vs 66%, P < .001). Higher body mass index values were associated with the presence of sleepiness. In girls with preferences for daily snack (versus those who reported no snack) sleepiness presented significantly (P < .001) higher values. Reduced sleep time was significantly associated with sleepiness. The prevalence of sleepiness did not significantly differ among groups who had 7.5 hours sleep or more. A dose-response relation was found between sleepiness and sleep disturbances, physical activity, and media use time.

Conclusions

Sleep insufficiency represents a main cause for daytime sleepiness in Japanese junior high school children. Proper sleep habits, high physical activity level, and limited TV viewing time should be promoted among school children.

Section snippets

Study Site

The study was conducted in 93 public junior high schools, located in Toyama prefecture, on the Japan Sea side of the central part of Honshu main island, northwestern Japan. Toyama prefecture is a typical postindustrial province, with no significant economic, social, or cultural differences between the cities (n = 9), towns (n = 18) and villages (n = 8) that participated in the present study. The area is highly developed and the economy is predominately industrial and high technology. The

Results

The Figure shows the characteristics of the subjects by sex. Sleepiness episodes were reported as almost always or often by 25.2% and 47.6%, respectively. No episode of sleepiness was reported only by only 10.4%. After combining the categories of “almost always” and “often” into one group to derive the measure of sleepiness, in parallel with the categories “seldom” and “never” to derive the measure of “no sleepiness,” we examined the difference by sex; 34% of boys versus only 20.8% of girls

Discussion

Junior high school appears to be a high risk period for the development of sleepiness and other sleep disturbances as a result of chronic sleep deficiency.16, 17 In our sample of children, 25.1% and 47.5%, respectively, reported their sleepiness episodes as almost always or often. In adolescent studies, the prevalence of sleepiness starts at 10%, with upper reported values between 20% and 60%.12, 18, 19, 20, 21 Saarenpaa-Heikkila et al21 mentioned that sleepiness was more common in adolescents

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