Social and Family Factors as Determinants of Sleep Habits in Japanese Elementary School Children: A Cross-Sectional Study from the Super Shokuiku School Project.

This study explored the associations of lifestyle, familial, and social factors with sleep habits in 1882 elementary school children, aged 6-13 years, from the Super Shokuiku School Project in January 2016. A survey assessed sex, grade, sleep habits, lifestyle, social background, and parental lifestyle. Bedtime "≥22:00," wake-up time "≥07:00," sleep duration "<8 h," and "daytime sleepiness" were defined as poor sleep habits; correlates were analyzed using logistic regression. Skipping breakfast was consistently significantly associated with poor sleep, especially among children with late wake-up times (adjusted odds ratio 5.45; 95% confidence interval 3.20-9.30). Excessive screen time was associated with late bed and wake-up times. Physical inactivity was significantly associated with daytime sleepiness. Children of mothers with poor lifestyle habits were likely to go to bed late and feel sleepy the next day. Social and family factors were associated with children's sleep habits. Several behaviors, including skipping breakfast, excessive screen time, and physical inactivity, were associated with poor sleep habits, manifesting as a night-oriented lifestyle. Although a longitudinal study is needed to determine causality, in addition to sleep education for children, sleep education for parents and society at large may be necessary to improve children's sleep habits.