Advertisement

Sleep Duration and Obesity in Children and Adolescents

      Abstract

      Increased rates of obesity internationally have drawn significant attention. In particular, researchers and practitioners are seeking new information about risk factors for obesity that could be areas for preventive interventions. Given that obesity rates in children and adolescents are increasing worldwide, particular attention to child and adolescent obesity is needed. A large, and growing, body of research indicates that inadequate sleep duration is linked to obesity. The current article reviews the extant literature concerning sleep duration and obesity in children and adolescents by reviewing current theories of obesity as well as available literature specifically evaluating the relationship of obesity and sleep in children and adolescents, including epidemiologic, experimental and intervention research. Overall, our literature review concludes that the relationship between shortened sleep and increased risk for obesity has research support internationally, including in the few Canadian articles available that are discussed in our review.

      Résumé

      L'augmentation des taux d'obésité dans le monde a beaucoup retenu notre attention. Notamment, les chercheurs et les praticiens tentent d'obtenir de nouvelles informations sur les facteurs de risque d'obésité qui pourraient potentiellement constituer des domaines d'interventions préventives. Puisque les taux d'obésité chez les enfants et les adolescents augmentent dans le monde entier, l'obésité de l'enfant et de l'adolescent doit faire l'objet d'une attention particulière. Un corpus vaste et croissant de recherche montre qu'une durée inadéquate de sommeil est liée à l'obésité. Dans le présent article, nous passons en revue la littérature existante sur la durée du sommeil et l'obésité de l'enfant et de l'adolescent ainsi que les théories actuelles sur l'obésité et la littérature qui porte précisément sur l'évaluation de la relation entre l'obésité et le sommeil chez les enfants et les adolescents, y compris la recherche épidémiologique, expérimentale et interventionnelle. Dans l'ensemble, la revue de littérature permet de conclure que la relation entre le sommeil de courte durée et l'augmentation du risque d'obésité reçoit l'appui de la recherche dans le monde entier, y compris des rares articles canadiens sur lesquels porte notre revue.

      Keywords

      Mots clés

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Diabetes
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Matricciani L.
        • Olds T.
        • Petkov J.
        In search of lost sleep: Secular trends in the sleep time of school-aged children and adolescents.
        Sleep Med Rev. 2012; 16: 203-211
        • Gangwisch J.E.
        • Malaspina D.
        • Boden-Albala B.
        • Heymsfield S.B.
        Inadequate sleep as a risk factor for obesity: Analyses of the NHANES I.
        Sleep. 2005; 28: 1289-1296
        • Hirshkowitz M.
        • Whiton K.
        • Albert S.M.
        • et al.
        National Sleep Foundation's sleep time duration recommendations: Methodology and results summary.
        Sleep Health. 2015; 1: 40-43
        • Pilcher J.J.
        • Huffcutt A.I.
        Effects of sleep deprivation on performance: A meta-analysis.
        Sleep. 1996; 19: 318-326
        • Knutson K.L.
        • Spiegel K.
        • Penev P.
        • Van Cauter E.
        The metabolic consequences of sleep deprivation.
        Sleep Med Rev. 2007; 11: 163-178
        • Knutson K.L.
        Sleep duration and cardiometabolic risk: A review of the epidemiologic evidence.
        Best Pract Res Clin Endocrinol Metab. 2010; 24: 731-743
        • Durmer J.S.
        • Dinges D.F.
        Neurocognitive consequences of sleep deprivation.
        Semin Neurol. 2005; 25: 117-129
        • Alhola P.
        • Polo-Kantola P.
        Sleep deprivation: Impact on cognitive performance.
        Neuropsychiatr Dis Treat. 2007; 3: 553-567
        • Williamson A.M.
        • Feyer A.M.
        Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication.
        Occup Environ Med. 2000; 57: 649-655
        • Walsh N.P.
        • Gleeson M.
        • Pyne D.B.
        • et al.
        Position statement, Part 2: Maintaining immune health.
        Exerc Immunol Rev. 2011; 17: 64-103
        • Magee C.A.
        • Huang X.F.
        • Iverson D.C.
        • Caputi P.
        Examining the pathways linking chronic sleep restriction to obesity.
        J Obes. 2010; 2010: 821710
        • Nieto J.
        • Surani S.
        • Huerta-Alardin A.L.
        • Varon J.
        Sleep-related disorders, diabetes and obesity: Understanding the facts.
        Curr Respir Med Rev. 2006; 2: 325-329
        • Leinum C.J.
        • Dopp J.M.
        • Morgan B.J.
        Sleep-disordered breathing and obesity: Pathophysiology, complications, and treatment.
        Nutr Clin Pract. 2009; 24: 675-687
        • Flint J.
        • Kothare S.V.
        • Zihlif M.
        • et al.
        Association between inadequate sleep and insulin resistance in obese children.
        J Pediatr. 2007; 150: 364-369
        • Punjabi N.M.
        • Shahar E.
        • Redline S.
        • et al.
        Sleep-disordered breathing, glucose intolerance, and insulin resistance: The Sleep Heart Health Study.
        Am J Epidemiol. 2004; 160: 521-530
        • Dorkova Z.
        • Petrasova D.
        • Molcanyiova A.
        • Popovnakova M.
        • Tkacova R.
        Effects of continuous positive airway pressure on cardiovascular risk profile in patients with severe obstructive sleep apnea and metabolic syndrome.
        Chest. 2008; 134: 686-692
        • Gozal D.
        • Capdevila O.S.
        • Kheirandish-Gozal L.
        Metabolic alterations and systemic inflammation in obstructive sleep apnea among nonobese and obese prepubertal children.
        Am J Respir Crit Care Med. 2008; 177: 1142-1149
        • Redenius R.
        • Murphy C.
        • O'Neill E.
        • Al-Hamwi M.
        • Zallek S.N.
        Does CPAP lead to change in BMI?.
        J Clin Sleep Med. 2008; 4: 205-209
        • Albrecht U.
        The circadian clock, metabolism and obesity.
        Obes Rev. 2017; 18: 25-33
        • Valladares M.
        • Obregón A.M.
        • Chaput J.P.
        Association between genetic variants of the clock gene and obesity and sleep duration.
        J Physiol Biochem. 2015; 71: 855-860
        • Allebrandt K.V.
        • Teder-Laving M.
        • Akyol M.
        • et al.
        CLOCK gene variants associate with sleep duration in two independent populations.
        Biol Psychiatry. 2010; 67: 1040-1047
        • Mishima K.
        • Tozawa T.
        • Satoh K.
        • Saitoh H.
        • Mishima Y.
        The 3111T/C polymorphism of hClock is associated with evening preference and delayed sleep timing in a Japanese population sample.
        Am J Med Genet B Neuropsychiatr Genet. 2005; 133B: 101-104
        • Monteleone P.
        • Tortorella A.
        • Docimo L.
        • et al.
        Investigation of 3111T/C polymorphism of the CLOCK gene in obese individuals with or without binge eating disorder: Association with higher body mass index.
        Neurosci Lett. 2008; 435: 30-33
        • Scott E.M.
        • Carter A.M.
        • Grant P.J.
        Association between polymorphisms in the Clock gene, obesity and the metabolic syndrome in man.
        Int J Obes (Lond). 2008; 32: 658-662
        • Garaulet M.
        • Lee Y.C.
        • Shen J.
        • et al.
        Genetic variants in human CLOCK associate with total energy intake and cytokine sleep factors in overweight subjects (GOLDN population).
        Eur J Hum Genet. 2010; 18: 364-369
        • Ramos-Lopez O.
        • Samblas M.
        • Milagro F.I.
        • et al.
        Circadian gene methylation profiles are associated with obesity, metabolic disturbances and carbohydrate intake.
        Chronobiol Int. 2018; 35: 969-981
        • Chaput J.P.
        • Klingenberg L.
        • Sjödin A.
        Do all sedentary activities lead to weight gain: Sleep does not.
        Curr Opin Clin Nutr Metab Care. 2010; 13: 601-607
        • Morselli L.
        • Leproult R.
        • Balbo M.
        • Spiegel K.
        Role of sleep duration in the regulation of glucose metabolism and appetite.
        Best Pract Res Clin Endocrinol Metab. 2010; 24: 687-702
        • Cummings D.E.
        • Foster K.E.
        Ghrelin-leptin tango in body-weight regulation.
        Gastroenterology. 2003; 124: 1532-1535
        • Seeley R.
        • VanPutte C.
        • Regan J.
        • Russo A.
        Seeley's anatomy and physiology.
        McGraw-Hill, New York2011
        • Nedeltcheva A.V.
        • Kessler L.
        • Imperial J.
        • Penev P.D.
        Exposure to recurrent sleep restriction in the setting of high caloric intake and physical inactivity results in increased insulin resistance and reduced glucose tolerance.
        J Clin Endocrinol Metab. 2009; 94: 3242-3250
        • Schmid S.M.
        • Hallschmid M.
        • Jauch-Chara K.
        • Born J.
        • Schultes B.
        A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men.
        J Sleep Res. 2008; 17: 331-334
        • Spiegel K.
        • Tasali E.
        • Penev P.
        • Van Cauter E.
        Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite.
        Ann Intern Med. 2004; 141: 846-850
        • Spiegel K.
        • Leproult R.
        • L'hermite-Balériaux M.
        • Copinschi G.
        • Penev P.D.
        • Van Cauter E.
        Leptin levels are dependent on sleep duration: Relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin.
        J Clin Endocrinol Metab. 2004; 89: 5762-5771
        • Chaput J.P.
        • Klingenberg L.
        • Astrup A.
        • Sjödin A.M.
        Modern sedentary activities promote overconsumption of food in our current obesogenic environment.
        Obes Rev. 2011; 12: e12-e20
        • Tajeu G.S.
        • Sen B.
        New pathways from short sleep to obesity? Associations between short sleep and “secondary” eating and drinking behavior.
        Am J Health Promot. 2017; 31: 181-188
        • Demos K.E.
        • Sweet L.H.
        • Hart C.N.
        • et al.
        The effects of experimental manipulation of sleep duration on neural response to food cues.
        Sleep. 2017; 40
        • McHill A.W.
        • Wright K.P.
        Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease.
        Obes Rev. 2017; 18: 15-24
        • Kenney E.L.
        • Gortmaker S.L.
        United States adolescents' television, computer, videogame, smartphone, and tablet use: Associations with sugary drinks, sleep, physical activity, and obesity.
        J Pediatr. 2017; 182: 144-149
        • Blass E.M.
        • Anderson D.R.
        • Kirkorian H.L.
        • Pempek T.A.
        • Price I.
        • Koleini M.F.
        On the road to obesity: Television viewing increases intake of high-density foods.
        Physiol Behav. 2006; 88: 597-604
        • McCann B.S.
        • Warnick G.R.
        • Knopp R.H.
        Changes in plasma lipids and dietary intake accompanying shifts in perceived workload and stress.
        Psychosom Med. 1990; 52: 97-108
        • Stroebele N.
        • de Castro J.M.
        Listening to music while eating is related to increases in people's food intake and meal duration.
        Appetite. 2006; 47: 285-289
        • Nedeltcheva A.V.
        • Kilkus J.M.
        • Imperial J.
        • Kasza K.
        • Schoeller D.A.
        • Penev P.D.
        Sleep curtailment is accompanied by increased intake of calories from snacks.
        Am J Clin Nutr. 2009; 89: 126-133
        • Brondel L.
        • Romer M.A.
        • Nougues P.M.
        • Touyarou P.
        • Davenne D.
        Acute partial sleep deprivation increases food intake in healthy men.
        Am J Clin Nutr. 2010; 91: 1550-1559
        • Hicks R.A.
        • McTighe S.
        • Juarez M.
        Sleep duration and eating behaviors of college students.
        Percept Mot Skills. 1986; 62: 25-26
        • Schmid S.M.
        • Hallschmid M.
        • Jauch-Chara K.
        • et al.
        Short-term sleep loss decreases physical activity under free-living conditions but does not increase food intake under time-deprived laboratory conditions in healthy men.
        Am J Clin Nutr. 2009; 90: 1476-1482
        • Tan D.X.
        • Manchester L.C.
        • Fuentes-Broto L.
        • Paredes S.D.
        • Reiter R.J.
        Significance and application of melatonin in the regulation of brown adipose tissue metabolism: Relation to human obesity.
        Obes Rev. 2011; 12: 167-188
        • Taheri S.
        The link between short sleep duration and obesity: We should recommend more sleep to prevent obesity.
        Arch Dis Child. 2006; 91: 881-884
        • Reiter R.
        • Tan D.
        • Sanchez-Barceló E.
        • Mediavilla M.
        • Gitto E.
        • Korkmaz A.
        Circadian mechanisms in the regulation of melatonin synthesis.
        J Exp Integr Med. 2011; 1: 13-22
        • Cappuccio F.P.
        • Taggart F.M.
        • Kandala N.B.
        • et al.
        Meta-analysis of short sleep duration and obesity in children and adults.
        Sleep. 2008; 31: 619-626
        • Chen X.
        • Beydoun M.A.
        • Wang Y.
        Is sleep duration associated with childhood obesity? A systematic review and meta-analysis.
        Obesity (Silver Spring). 2008; 16: 265-274
        • Marshall N.S.
        • Glozier N.
        • Grunstein R.R.
        Is sleep duration related to obesity? A critical review of the epidemiological evidence.
        Sleep Med Rev. 2008; 12: 289-298
        • Patel S.R.
        • Hu F.B.
        Short sleep duration and weight gain: A systematic review.
        Obesity (Silver Spring). 2008; 16: 643-653
        • St-Onge M.P.
        Sleep-obesity relation: Underlying mechanisms and consequences for treatment.
        Obes Rev. 2017; 18: 34-39
        • Chaput J.P.
        • Gray C.E.
        • Poitras V.J.
        • et al.
        Systematic review of the relationships between sleep duration and health indicators in the early years (0–4 years).
        BMC Public Health. 2017; 17: 855
        • Ruan H.
        • Xun P.
        • Cai W.
        • He K.
        • Tang Q.
        Habitual sleep duration and risk of childhood obesity: Systematic review and dose-response meta-analysis of prospective cohort studies.
        Sci Rep. 2015; 5: 16160
        • Fatima Y.
        • Doi S.A.
        • Mamun A.A.
        Longitudinal impact of sleep on overweight and obesity in children and adolescents: A systematic review and bias-adjusted meta-analysis.
        Obes Rev. 2015; 16: 137-149
        • Chaput J.P.
        • Brunet M.
        • Tremblay A.
        Relationship between short sleeping hours and childhood overweight/obesity: Results from the Québec en Forme Project.
        Int J Obes (Lond). 2006; 30: 1080-1085
        • Sluggett L.
        • Wagner S.L.
        • Hardy C.
        • Harris R.L.
        Associations between sleep duration and indicators of cardiometabolic disease in Canadian children and adolescents: Analyses of the 2007–2009 Canadian Health Measures Survey.
        Child Obes. 2016; 12: 325-333
        • Wu J.
        • Wu H.
        • Wang J.
        • Guo L.
        • Deng X.
        • Lu C.
        Associations between sleep duration and overweight/obesity: Results from 66,817 Chinese adolescents.
        Sci Rep. 2015; 5: 16686
        • Eisenmann J.C.
        • Ekkekakis P.
        • Holmes M.
        Sleep duration and overweight among Australian children and adolescents.
        Acta Paediatr. 2006; 95: 956-963
        • Morrissey B.
        • Malakellis M.
        • Whelan J.
        • et al.
        Sleep duration and risk of obesity among a sample of Victorian school children.
        BMC Public Health. 2016; 16: 245
        • Knutson K.L.
        Sex differences in the association between sleep and body mass index in adolescents.
        J Pediatr. 2005; 147: 830-834
        • Cao M.
        • Zhu Y.
        • He B.
        • et al.
        Association between sleep duration and obesity is age- and gender-dependent in Chinese urban children aged 6–18 years: A cross-sectional study.
        BMC Public Health. 2015; 15: 1029
        • Wang F.
        • Liu H.
        • Wan Y.
        • et al.
        Sleep duration and overweight/obesity in preschool-aged children: A prospective study of up to 48,922 children of the Jiaxing Birth Cohort.
        Sleep. 2016; 39: 2013-2019
        • Reilly J.J.
        • Armstrong J.
        • Dorosty A.R.
        • et al.
        Early life risk factors for obesity in childhood: Cohort study.
        BMJ. 2005; 330: 1357
        • Snell E.K.
        • Adam E.K.
        • Duncan G.J.
        Sleep and the body mass index and overweight status of children and adolescents.
        Child Dev. 2007; 78: 309-323
        • Agras W.S.
        • Hammer L.D.
        • McNicholas F.
        • Kraemer H.C.
        Risk factors for childhood overweight: A prospective study from birth to 9.5 years.
        J Pediatr. 2004; 145: 20-25
        • Landhuis C.E.
        • Poulton R.
        • Welch D.
        • Hancox R.J.
        Childhood sleep time and long-term risk for obesity: A 32-year prospective birth cohort study.
        Pediatrics. 2008; 122: 955-960
        • Klingenberg L.
        • Christensen L.B.
        • Hjorth M.F.
        • et al.
        No relation between sleep duration and adiposity indicators in 9–36 months old children: The SKOT cohort.
        Pediatr Obes. 2013; 8: e14-e18
        • Lesley P.
        • Nxxx A.L.
        • Yang C.
        • et al.
        Longitudinal analysis of sleep duration and cardiometabolic risk in young children.
        Child Obes. 2017; 13: 291-299
        • Tarokh L.
        • Raffray T.
        • Van Reen E.
        • Carskadon M.A.
        Physiology of normal sleep in adolescents.
        Adolesc Med State Art Rev. 2010; 21 (vii): 401-417
        • Hayes J.F.
        • Balantekin K.N.
        • Altman M.
        • Wilfley D.E.
        • Taylor C.B.
        • Williams J.
        Sleep patterns and quality are associated with severity of obesity and weight-related behaviors in adolescents with overweight and obesity.
        Child Obes. 2018; 14: 11-17
        • Arora T.
        • Taheri S.
        Associations among late chronotype, body mass index and dietary behaviors in young adolescents.
        Int J Obes (Lond). 2015; 39: 39-44
        • Thellman K.E.
        • Dmitrieva J.
        • Miller A.
        • Harsh J.R.
        • LeBourgeois M.K.
        Sleep timing is associated with self-reported dietary patterns in 9- to 15-year-olds.
        Sleep Health. 2017; 3: 269-275
        • Golley R.K.
        • Maher C.A.
        • Matricciani L.
        • Olds T.S.
        Sleep duration or bedtime? Exploring the association between sleep timing behaviour, diet and BMI in children and adolescents.
        Int J Obes (Lond). 2013; 37: 546-551
        • Olds T.S.
        • Maher C.A.
        • Matricciani L.
        Sleep duration or bedtime? Exploring the relationship between sleep habits and weight status and activity patterns.
        Sleep. 2011; 34: 1299-1307
        • He F.
        • Bixler E.O.
        • Liao J.
        • et al.
        Habitual sleep variability, mediated by nutrition intake, is associated with abdominal obesity in adolescents.
        Sleep Med. 2015; 16: 1489-1494
        • Gonzaga N.
        • Sena A.
        • Coura A.
        • Dantas F.
        • Oliviera R.
        • Medeiros C.
        Sleep quality and metabolic syndrome in overweight or obese children and adolescents.
        Rev Nutr. 2016; 29: 377-389
        • Beebe D.W.
        • Lewin D.
        • Zeller M.
        • et al.
        Sleep in overweight adolescents: Shorter sleep, poorer sleep quality, sleepiness, and sleep-disordered breathing.
        J Pediatr Psychol. 2007; 32: 69-79
        • Gupta N.K.
        • Mueller W.H.
        • Chan W.
        • Meininger J.C.
        Is obesity associated with poor sleep quality in adolescents?.
        Am J Hum Biol. 2002; 14: 762-768
        • Valrie C.R.
        • Bond K.
        • Lutes L.D.
        • Carraway M.
        • Collier D.N.
        Relationship of sleep quality, baseline weight status, and weight-loss responsiveness in obese adolescents in an immersion treatment program.
        Sleep Med. 2015; 16: 432-434
        • Beebe D.W.
        • Simon S.
        • Summer S.
        • Hemmer S.
        • Strotman D.
        • Dolan L.M.
        Dietary intake following experimentally restricted sleep in adolescents.
        Sleep. 2013; 36: 827-834
        • Hart C.N.
        • Carskadon M.A.
        • Considine R.V.
        • et al.
        Changes in children's sleep duration on food intake, weight, and leptin.
        Pediatrics. 2013; 132: e1473-e1480
        • Simon S.L.
        • Field J.
        • Miller L.E.
        • DiFrancesco M.
        • Beebe D.W.
        Sweet/dessert foods are more appealing to adolescents after sleep restriction.
        PLoS ONE. 2015; 10 (e0115434)
        • Klingenberg L.
        • Chaput J.P.
        • Holmbäck U.
        • Jennum P.
        • Astrup A.
        • Sjödin A.
        Sleep restriction is not associated with a positive energy balance in adolescent boys.
        Am J Clin Nutr. 2012; 96: 240-248
        • Talarico R.
        • Janssen I.
        Compositional associations of time spent in sleep, sedentary behavior and physical activity with obesity measures in children.
        Int J Obes (Lond). 2018; (epub ahead of print)
        • Carson V.
        • Tremblay M.S.
        • Chaput J.P.
        • Chastin S.F.
        Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses.
        Appl Physiol Nutr Metab. 2016; 41: S294-S302
        • Vijakkhana N.
        • Wilaisakditipakorn T.
        • Ruedeekhajorn K.
        • Pruksananonda C.
        • Chonchaiya W.
        Evening media exposure reduces night-time sleep.
        Acta Paediatr. 2015; 104: 306-312
        • Ikeda M.
        • Kaneita Y.
        • Kondo S.
        • Itani O.
        • Ohida T.
        Epidemiological study of sleep habits among four-and-a-half-year-old children in Japan.
        Sleep Med. 2012; 13: 787-794
        • McDonald L.
        • Wardle J.
        • Llewellyn C.H.
        • van Jaarsveld C.H.
        • Fisher A.
        Predictors of shorter sleep in early childhood.
        Sleep Med. 2014; 15: 536-540
        • Sampasa-Kanyinga H.
        • Hamilton H.A.
        • Chaput J.P.
        Use of social media is associated with short sleep duration in a dose-response manner in students aged 11 to 20 years.
        Acta Paediatr. 2018; 107: 694-700
        • Chaput J.P.
        • Tremblay M.S.
        • Katzmarzyk P.T.
        • et al.
        Sleep patterns and sugar-sweetened beverage consumption among children from around the world.
        Public Health Nutr. 2018; 21: 2385-2393
        • Sampasa-Kanyinga H.
        • Hamilton H.A.
        • Chaput J.P.
        Sleep duration and consumption of sugar-sweetened beverages and energy drinks among adolescents.
        Nutrition. 2018; 48: 77-81
        • Asarnow L.D.
        • Greer S.M.
        • Walker M.P.
        • Harvey A.G.
        The impact of sleep improvement on food choices in adolescents with late bedtimes.
        J Adolesc Health. 2017; 60: 570-576
        • Beebe D.W.
        • Zhou A.
        • Rausch J.
        • Noe O.
        • Simon S.L.
        The impact of early bedtimes on adolescent caloric intake varies by chronotype.
        J Adolesc Health. 2015; 57: 120-122
        • Minges K.E.
        • Redeker N.S.
        Delayed school start times and adolescent sleep: A systematic review of the experimental evidence.
        Sleep Med Rev. 2016; 28: 86-95
        • Boergers J.
        • Gable C.J.
        • Owens J.A.
        Later school start time is associated with improved sleep and daytime functioning in adolescents.
        J Dev Behav Pediatr. 2014; 35: 11-17
        • Wilson K.E.
        • Miller A.L.
        • Bonuck K.
        • Lumeng J.C.
        • Chervin R.D.
        Evaluation of a sleep education program for low-income preschool children and their families.
        Sleep. 2014; 37: 1117-1125