Sleep timing and health indicators in children and adolescents: a systematic review
Bibliographic record
Abstract
INTRODUCTION: To continue to inform sleep health guidelines and the development of evidence-based healthy sleep interventions for children and adolescents, it is important to better understand the associations between sleep timing (bedtime, wake-up time, midpoint of sleep) and various health indicators. The objective of this systematic review was to examine the associations between sleep timing and 9 health indicators in apparently healthy children and adolescents 5 to 18 years old. METHODS: Studies published in the 10 years preceding January 2021 were identified from searches in four electronic databases. This systematic review followed the guidelines prescribed in PRISMA 2020, the methodological quality and risk of bias were scored, and the summary of results used a best-evidence approach for accurate and reliable reporting. RESULTS: Forty-six observational studies from 21 countries with 208 992 unique participants were included. Sleep timing was assessed objectively using actigraphy in 24 studies and subjectively in 22 studies. The lack of studies in some of the health outcomes and heterogeneity in others necessitated using a narrative synthesis rather than a metaanalysis. Findings suggest that later sleep timing is associated with poorer emotional regulation, lower cognitive function/academic achievement, shorter sleep duration/ poorer sleep quality, poorer eating behaviours, lower physical activity levels and more sedentary behaviours, but few studies demonstrated associations between sleep timing and adiposity, quality of life/well-being, accidents/injuries, and biomarkers of cardiometabolic risk. The quality of evidence was rated as "very low" across health outcomes using GRADE. CONCLUSION: The available evidence, which relies on cross-sectional findings, suggests that earlier sleep timing is beneficial for the health of school-aged children and adolescents. Longitudinal studies and randomized controlled trials are needed to better advance this field of research. (PROSPERO registration no.: CRD42020173585).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.043 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.008 |
| Bibliometrics | 0.008 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".