Temporal and bidirectional associations between physical activity and sleep in primary school-aged children

These practice parameters are an update of the previously-published recommendations regarding the indications for polysomnography and related procedures in the diagnosis of sleep disorders. Diagnostic categories include the following: sleep related breathing disorders, other respiratory disorders, narcolepsy, parasomnias, sleep related seizure disorders, restless legs syndrome, periodic limb movement sleep disorder, depression with insomnia, and circadian rhythm sleep disorders. Polysomnography is routinely indicated for the diagnosis of sleep related breathing disorders; for continuous positive airway pressure (CPAP) titration in patients with sleep related breathing disorders; for the assessment of treatment results in some cases; with a multiple sleep latency test in the evaluation of suspected narcolepsy; in evaluating sleep related behaviors that are violent or otherwise potentially injurious to the patient or others; and in certain atypical or unusual parasomnias. Polysomnography may be indicated in patients with neuromuscular disorders and sleep related symptoms; to assist in the diagnosis of paroxysmal arousals or other sleep disruptions thought to be seizure related; in a presumed parasomnia or sleep related seizure disorder that does not respond to conventional therapy; or when there is a strong clinical suspicion of periodic limb movement sleep disorder. Polysomnography is not routinely indicated to diagnose chronic lung disease; in cases of typical, uncomplicated, and noninjurious parasomnias when the diagnosis is clearly delineated; for patients with seizures who have no specific complaints consistent with a sleep disorder; to diagnose or treat restless legs syndrome; for the diagnosis of circadian rhythm sleep disorders; or to establish a diagnosis of depression.

Sleep deficits are associated with a wide range of detrimental physical and mental health outcomes. There is concern that children are not getting enough sleep, and that sleep duration has been declining. However, evidence is sparse. A systematic review of world literature was conducted to locate studies reporting the sleep duration of children aged 5-18 years. Monte Carlo simulation was used to generate pseudodata from summary data, which were combined with raw data and analysed by linear regression of sleep duration on year of measurement at the age × sex × day type × country level. Data were available on 690,747 children from 20 countries, dating from 1905 to 2008. From these data, 641 regressions were derived. The sample-weighted median rate of change was -0.75 min nightly per year, indicating a decrease of more than 1 h per night over the study period. Rates of change were negative across age, sex and day type categories, but varied according to region, with Europe, the USA, Canada and Asia showing decreases and Australia, the UK and Scandinavia showing increases. Over the last 103 years, there have been consistent rapid declines in the sleep duration of children and adolescents. Copyright © 2011 Elsevier Ltd. All rights reserved.