Association Between The Risk Of Malnutrition And Sleep Disorders In Preschoolers

Objective This study compares the differences in the incidence of sleep disorders in many aspects of preschool children with different characteristics.By evaluating the risk of malnutrition through dietary quality,this study compares whether differences in the risk of malnutrition are related with differences in the risk of developing sleep disorders so as to provide new ideas for promoting sleep development through improving dietary quality as well as scientific references for the development of sleep health care strategies for preschoolers.Methods The author has selected kindergartens in different areas of Hefei through cluster sampling with preschool children aged 3 to 5 years as targeted population and distributed digital questionnaires to the parents of 6 134 preschool children.Through a series of inclusion and exclusion criteria,data collation and exclusion,complete information of 5 896 preschool children was finally collected,including demographic characteristics and lifestyles,sleep-related and food intake frequency information.Children’s multifaceted sleep disorders were measured by children’s sleep habits questionnaire scale,with the degree of malnutrition risk of the Global Diet Quality Score as references.This paper adopted the chi-square test and one-way ANOVA to compare the differences in sleep disorders among children with different characteristics,and took multivariate logistics regression analysis to dig out the relationship between the risk of malnutrition,food intake frequency and the risk of sleep disorders.Results This study compared differences in the occurrence of sleep disorders and risk of malnutrition among preschool children with different characteristics.Through data analysis,it was shown that of all the subjects,the prevalence of average sleep duration not up to standard and overall poor sleep quality was 56.5% and 8.9% respectively,and the percentage of other aspects of sleep problems ranged from 2% to 70%.The prevalence of associated sleep problems varied among different subgroups of characteristics such as child age,dermatitis conditions,physical development,presence of siblings,time of outdoor activity,primary caregiver,maternal education,and maternal age,it was also found that the prevalence of high risk of malnutrition is relatively low among children who are brought up by parents,have a standard number of hours of outdoor activity,and have older and more educated mothers.Besides,those subjects with a higher risk of malnutrition also have higher incidence of poor sleep quality,substandard average sleep duration,sleep impedance,sleep onset delay,irregular sleep duration,sleep anxiety,parasomnias,sleep disordered breathing,and daytime sleepiness(P < 0.05).The results of one-way ANOVA analysis showed that the score of overall sleep quality(F=0.361,P<0.001),bedtime resistance(F=38.532,P<0.001),sleep onset delay(F=34.100,P<0.001),sleep duration(F=42.519,P<0.001),sleep anxiety(F=11.621,P<0.001),night wakings(F=5.823,P<0.01),parasomnias(F=16.330,P<0.001),sleep disordered breathing(F=10.556,P<0.001)and daytime sleepiness(F=47.803,P<0.001)were different in the risk of malnutrition among different levels.The higher the risk of malnutrition,the overall poor sleep quality,bedtime resistance,sleep onset delay,irregular sleep duration and daytime sleepiness were reported more serious.Compared with low level of malnutrition risk,high(P<0.001)and medium(P<0.01)level of malnutrition risk had significantly worse sleep anxiety problem.In terms of the problem of night wakings,the high risk of malnutrition(P<0.01)is more serious than the low risk.Compared with low(P<0.001)and medium(P<0.01)level of malnutrition risk,parasomnias matter in the high risk group was obviously more serious.Sleep disordered breathing trouble was better in low(P<0.01) and medium(P<0.01)risk of malnutrition level when compared with the high.The results of multivariate logistic analysis showed that compared with those exposed to high malnutrition risks,children exposed to medium and low malnutrition risks have significantly lower probability for bad sleep quality(Medium risk group: OR= 0.60,95%CI: 0.49~0.74;Low risk group: OR = 0.44,95%CI: 0.34~0.58),abnormal sleeping hours(Medium risk group: OR = 0.83,95%CI: 0.73~0.94;Low risk group: OR = 0.61,95%CI: 0.52~0.70),bedtime resistance(Medium risk group: OR = 0.78,95%CI: 0.67~0.90;Low risk group:OR = 0.53,95%CI: 0.45~0.63),sleep onset delay(Medium risk group: OR = 0.75,95%CI: 0.65~0.87;Low risk group: OR = 0.59,95%CI: 0.50~0.71),sleep duration(Medium risk group: OR = 0.67,95%CI: 0.69~0.76;Low risk group: OR = 0.51,95%CI: 0.43~0.59),sleep anxiety(Medium risk group: OR = 0.85,95%CI: 0.75~0.97;Low risk group: OR =0.68,95%CI: 0.59~0.79);parasomnias(Medium risk group: OR = 0.67,95%CI:0.51~0.86;Low risk group: OR = 0.56,95%CI: 0.41~0.77);sleep disordered breathing(Medium risk group: OR = 0.60,95%CI: 0.40~0.90;Low risk group: OR =0.54,95%CI: 0.33~0.88)and daytime sleepiness(Medium risk group: OR = 0.63,95%CI: 0.50~0.79;Low risk group: OR = 0.48,95%CI: 0.36~0.64).The frequency of food intake was used as a continuous variable for multivariate logistic analysis displayed that high frequency of coagulated animal blood(OR=0.79,95%CI:0.64~0.98)has a correlation with lower probability of bad sleep quality,and more red-and yellow-colored vegetables(OR=0.91,95%CI:0.85~0.98)or dairy products(OR=0.91,95%CI:0.86~0.97)intake have a correlation with lower possibility of substandard average sleep duration.High frequency of sugar(OR=1.28,95%CI:1.14~1.44)and sugary drinks intake(OR=1.27,95%CI:1.12~1.45)has a correlation with higher risk of sleep disorders.Conclusions This study analyzed the association between the risk of malnutrition and the risk of developing sleep disorders through a multicenter field survey.The research findings demonstrate that malnutrition caused by dietary intake is strongly related with sleep development of preschool children,and that an higher risk of malnutrition may increase the risk of abnormal sleep in children at this stage,implying that improving dietary quality may promote sleep quality of preschoolers.