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. 2019 Oct 15;15(10):1495-1502.
doi: 10.5664/jcsm.7984.

Ten-Year Secular Trends in Sleep/Wake Patterns in Shanghai and Hong Kong School-Aged Children: A Tale of Two Cities

Guanghai Wang  1   2 , Jihui Zhang  3 , Siu Ping Lam  3 , Shirley Xin Li  4   5 , Yanrui Jiang  1   2 , Wanqi Sun  1   2   4   6 , Ngan Yin Chan  3   4 , Alice Pik Shan Kong  7 , Yunting Zhang  1   2 , Shenghui Li  8 , Albert Martin Li  9 , Fan Jiang  1   2 , Xiaoming Shen  1   2 , Yun Kwok Wing  3
Affiliations

Ten-Year Secular Trends in Sleep/Wake Patterns in Shanghai and Hong Kong School-Aged Children: A Tale of Two Cities

Guanghai Wang et al. J Clin Sleep Med. .

Abstract

Study objectives: To compare the secular trends of sleep/wake patterns in school-aged children in Hong Kong and Shanghai, two major metropolitan cities in China with two different policies that school start time was delayed in Shanghai, but advanced in Hong Kong in 10 years' time.

Methods: Participants were from two waves of cross-sectional school-based surveys of children aged 6 to 11 years. In Shanghai, 4,339 and 13,795 children participated in the 2005 and 2014 surveys, respectively. In Hong Kong, 6,231 and 4,585 children participated in the 2003 and 2012 surveys, respectively. Parents reported their children's bedtime and wakeup time, and thus sleep duration, short sleep (≤ 9 hours) and weekend oversleep (difference in sleep duration between weekday and weekend > 2 hours) were determined.

Results: Hong Kong children had later bedtime and wakeup time and slept consistently less than their Shanghai counterparts at both survey time points. The shorter sleep duration was particularly marked during weekdays. Over the interval period, weekday sleep duration significantly decreased from 9.2 to 8.9 hours as wakeup time became earlier for Hong Kong children, but increased from 9.4 to 9.6 hours as wakeup time became later for children in Shanghai. Children from both cities slept longer on the weekends. Prevalence of weekend oversleep significantly increased in Hong Kong children, but no interval change was found in Shanghai children.

Conclusions: The findings indicate subcultural differences in sleep/wake patterns in Shanghai and Hong Kong school-aged children. In particular, sleep duration had increased for Shanghai children, but decreased for Hong Kong children over 10 years. The benefits and barriers of delaying school start time for optimizing sleep health in school-aged children should be further explored.

Keywords: China; school start time; school-aged children; secular trends; sleep patterns.

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Figures

Figure 1
Figure 1. Weekday sleep trend by sex and age.
Data depict 10-year average values for participants. HK = Hong Kong, SH = Shanghai.
Figure 2
Figure 2. Weekend sleep trend by sex and age.
Data depict 10-year average values for participants. HK = Hong Kong, SH = Shanghai.
Figure 3
Figure 3. Short sleep (< 9 hours) by sex and day type.
Data depict 10-year prevalence of participants. HK = Hong Kong, SH = Shanghai.
Figure 4
Figure 4. Irregular sleep (weekend oversleep > 2 hours) trend by sex.
Data depict 10-year prevalence of participants. HK = Hong Kong, SH = Shanghai.
See this image and copyright information in PMC

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