title: Sleep habits and pattern in 1-14 years old children and relationship with video devices use and evening and night child activities.
abstract: BACKGROUND
  Sleep in childhood and adolescence is crucial for mental and physical health; however several researches reported an increasing trend towards a sleep deprivation in this age. Due to the lack of recent epidemiological studies in Italy, the aim of our study was to depict sleep habits and patterns in Italian children aged 1-14 years and to evaluate their relationships with video devices use (TV, tablet, smartphone, PC) and evening/night child activities.
  
  
  METHODS
  A structured interview was conducted during 2015 by 72 Family Pediatricians in 2030 healthy children aged 1-14 years by a cross-sectional survey named "Ci piace sognare". Total sleep duration was calculated, 2015 National Sleep Foundation Recommendations were used as reference. Optimal sleepers were defined children sleeping in own bed all night without awakenings. Multivariable median regression was performed to identify predictors of sleep duration and multivariable logistic regression for predictors of optimal sleep.
  
  
  RESULTS
  Total sleep duration and numbers of awakenings decreased with age. Only 66.9% of children had sleep duration in agreement with Recommendations (50% in 10-14 years group). Before sleeping 63.5% of children used video devices (39.6% at 1-3 years), 39.1% read, 27.5% drank and 19.5% ate. Bottle users at bedtime were 30.8% at 1-3 years, 16.6% at 3-5 years and 4.9% at 5-7 years. Overall, 23.4% of children changed sleeping place during the night, 22.4% referred sleeping problems in the first year of life. Video devices use was negative predictor of sleep duration (-0.25 h [95%CI:-0.35,-0.14], p < 0.001). Optimal sleep was inversely related with bedroom TV (OR 0.63 [0.50,0.79], p < 0.001), with sleeping disorders in the first year (OR 0.62 [0.48,0.80], p < 0.001)), with bottle use (OR 0.64 [0.44,0.94], p < 0.05) and posivively related with high mother's education level (OR 1.44 [1.11,1.88], p < 0.01).
  
  
  CONCLUSIONS
  About one third of 1 to 14 year Italian children sleep less than recommended, one half in teenage. Modifiable risk factors for sleep abnormalities such as video devices use, bedroom TV and bottle use should be target of preventive strategies for a correct sleep. Pediatricians should give priority to the identification of sleep disorders early in life.
authors.affiliation: Family Pediatrician, Azienda Tutela della Salute (ATS) Città Metropolitana di Milano, Via Parada 32, 20854, Vedano al Lambro, MB, Italy. paolo.brambilla3@gmail.com.
authors.forename: Paolo
authors.identifier: http://orcid.org/0000-0002-6527-1835
authors.initials: P
authors.lastname: Brambilla
authors.affiliation: Family Pediatrician, Azienda Tutela della Salute (ATS) Città Metropolitana di Milano, Via Parada 32, 20854, Vedano al Lambro, MB, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Giussani
authors.affiliation: Family Pediatrician, ULSS 6 Vicenza, Vicenza, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Pasinato
authors.affiliation: Family Pediatrician, Azienda Tutela della Salute Bergamo, Bergamo, Italy.
authors.forename: Leonello
authors.initials: L
authors.lastname: Venturelli
authors.affiliation: Family Pediatrician, Azienda Sanitaria Provinciale Catania, Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Privitera
authors.affiliation: Dipartimento della Donna e del Bambino, Seconda Università di Napoli, Napoli, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Miraglia Del Giudice
authors.affiliation: AOU Meyer, Department of Health Science, Università di Firenze, Florence, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Sollai
authors.affiliation: Family Pediatrician, Azienda Tutela della Salute (ATS) Città Metropolitana di Milano, Via Parada 32, 20854, Vedano al Lambro, MB, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Picca
authors.affiliation: Family Pediatrician, Azienda Sanitaria Locale Caserta, Caserta, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Mauro
authors.affiliation: Neuropsichiatria Infantile, Università della Sapienza, Rome, Italy.
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
authors.affiliation: AOU Meyer, Department of Health Science, Università di Firenze, Florence, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006184:Habits; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D010290:Parents; D015995:Prevalence; D012307:Risk Factors; D000070263:Sleep Hygiene; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013690:Television / Q000706:statistics & numerical data*; D018910:Video Games / Q000706:statistics & numerical data*
keywords: Bedroom TV; Body Mass Index; Bottle use; Sleep continuity; Sleep duration; Sleep recommendations; Video devices