Bi-directional Association between Sleep and Outdoor Active Play among 10- to 13-year-olds
Purpose: The purpose of this study was to investigate whether there is a bi-directional relationship between sleep characteristics (time in bed, sleep duration, sleep efficiency) and outdoor active play (OAP) within children. Methods: Participants consisted of 433 children aged 10-13 years. Time in bed, sleep duration, and sleep efficiency were measured for 8 consecutive nights using data from a sleep log and Actical accelerometer. OAP was measured for the 7 days that fell in between these 8 nights using a combination of data from accelerometers, global positioning system (GPS) loggers, and geographic information system (GIS). Generalized estimating equation (GEE) models with first-order autoregressive matrix [AR(1)] were used to assess the relationships of interest. These models accounted for the repeated measures nested within participants and adjusted for several confounders. Results: Time in bed, sleep duration, and sleep efficiency were not significantly associated with the following day’s OAP. There was a small but significant (p = 0.017) association between OAP and the following night’s time in bed, which suggested that each hour increase in OAP was associated with a 5.1 minute (95% CI: 0.9 - 9.4) increase in time in bed. OAP was not significantly associated with sleep duration or sleep efficiency. Conclusions: None of the sleep characteristics predicted the following day’s OAP. Higher levels of OAP predicted a longer time in bed, but not sleep duration or sleep efficiency.
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