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11-12-2011 | Psychology | Article

Lack of sleep risks accidental falls in children


Free abstract

MedWire News: Children who get less than 8 hours of sleep a night face an elevated risk for accidental falls, report researchers who found daytime naps had a protective effect.

"Sleep debt is undoubtedly a risk factor for unintentional injury and therefore promotion of good sleep habits should be part of every childhood routine consultation," Leonor Reis Boto (Hospital de Santa Maria, Lisbon, Portugal) and colleagues comment in the journal Sleep Medicine.

In developed countries, unintentional injuries are the main cause of death in children over 1 year of age, with average annual mortality rates of 10.9 per 100,000 in the European Union.

In adults, sleep deprivation causes excessive daytime sleepiness and previous work has shown a causative role for this in accidents, namely road traffic accidents. In children, however, sleep deprivation does not seem to lead to excessive daytime sleepiness, but rather to hyperactivity and attention deficit disorder.

"Since 2001, a limited number of studies have looked at the possibility of a relationship between sleep deprivation and injury risk in children but due to the limited number of participants, the very different methodologies, and a great number of possible confounders, its effect is not fully understood," Boto et al comment.

In the current study, the researchers obtained 834 questionnaires from children aged 1-14 years attending an emergency room for accidental falls and 267 similarly aged children attending regular healthcare visits at a primary care center.

In both groups, parents or caregivers answered the questionnaire that included demographic characteristics, medical history, previous week's sleep pattern (PWSP), sleep duration and sleep pattern in the preceding 24 hours, mechanism of fall, and injury severity. Exclusion criteria included acute or chronic disease or exposure to drugs interfering with sleep.

They found a significantly increased risk for accidental falls associated with not having a daytime nap in the preceding 24 hours (odds ratio [OR]=2.1) after controlling for age, gender, paternal education and maternal profession, summer holidays, PWSP, and total sleep duration in the 24 hours that preceded the accident/healthcare appointment.

Usual sleep duration shorter than 8 hours was also associated with increased risk for accidental falls (OR=2.7) after controlling for confounders.

Among the demographic variables, male gender and the summer holiday period were associated with an increased fall risk (ORs=1.7 and 2.8, respectively), whereas children aged 3-5 years were the least vulnerable to falls (OR=0.5).

"The mechanism by which sleep deprivation increases the risk of accidents in children is not fully understood, but studies have shown that it results in neurocognitive dysfunction, which impacts behavior, mood, and motor skills, and might increase the risk of accidents," Boto el al conclude.

By Andrew Czyzewski

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