Citation
Juhari, Nur Amalin
(2019)
Factors contributing toward sleep quality among primary school children in Batu Pahat, Johor, Malaysia.
Masters thesis, Universiti Putra Malaysia.
Abstract
Poor sleep quality in children leads to physical and mental health problems; it
can be a prognostic indicator of emotion and behavioural problems in
adolescence and adulthood. This cross-sectional study aimed to determine
factors contributing toward sleep quality among primary school children (aged 7
to 11 years) in Batu Pahat district, Johor. The present study involved 627 pairs
of children-parent from six randomly selected primary schools in Batu Pahat,
Johor. The parents completed a set of questionnaire which contained
information on socio-demographic characteristics, sleep quality, eating styles
and food groups consumption of their children. Meanwhile, the children
completed a set of questionnaire that assessed physical activity andmeal
intakes frequency. Their body weight, height and waist circumference were
measured by a trained researcher, and their BMI-for-age and central obesity
were determined. Also, each child was interviewed on a one-to-one manner for
their dietary intakes in the past 24 hours by a trained nutritionist.
The present study found that the mean total sleep disorder score of children
was 52.3 ± 7.8, with a poor sleep quality prevalence of 74.2%. Meanwhile, the
average total sleep duration of children was almost 9 hours 22 minutes per day
(8.9 ± 1.2 hours), and 74.3% of them had inadequate total hours of sleep. In
bivariate analyses, parental education (father: r=-0.095, p<0.05; mother: r=-
0.136, p<0.05), monthly household income (r=-0.128, p<0.05), frequency of
fruits group intake (r= -0.131, p<0.05), frequency of vegetables group intake
(r=-0.133, p<0.05), frequency of milk and dairy milk products group intake (r=-
0.086, p<0.05), desire to drink (r=0.176, p<0.05), food responsiveness
(r=0.245, p<0.05), emotional over-eating (r=0.267, p<0.05), satiety
responsiveness (r=0.192, p<0.05), emotional under-eating (r=0.185, p<0.05),
and slowness in eating (r=0.175, p<0.05) were significantly correlated with
sleep quality of the children. Nevertheless, no significant results were found
between age, sex, ethnicity, BMI-for-age, waist circumference, physical activity, macronutrient intakes, adequacy of fruit and vegetable intake, meal intake
frequencies and sleep quality in bivariate analyses.
Variables with p<0.25 in univariate regression analysis such as ethnicity,
parental educations, monthly household income, physical activity, total energy
intake (kcal), frequency intakes of vegetables, milk and dairy milk products,
afternoon tea, and supper, enjoyment of food, desire to drink, food
responsiveness, emotional overeating, satiety responsiveness, emotional
undereating, and slowness in eating were included in multiple linear regression
(MLR) model. By using stepwise method in MLR, the result showed that Indian
ethnicity (β=3.858), low monthly household income (β=-3.213), high emotional
over-eating (β=0.383), high food responsiveness (β=0.302), high satiety
responsiveness (β=0.357), increased in slowness in eating (β=0.256), and less
frequent vegetables group consumption (β=-1.579) contributed significantly
toward poor sleep quality of the children. These significant factors explained
18.6% of the total variances in sleep quality of the children. Further, being
emotional overeating was found to be as the most important contributor in poor
sleep quality of the children, with the highest R2 changed (7.1%) as compared
to other factors.
In conclusion, a majority of children (74.2%) were having poor sleep quality.
Being an Indian, with lower total household income, increased intake of food
due to emotions, high responsiveness towards food, high responsiveness of
feeling full, eating very slowly and less frequent intakes of vegetables were
associated with poorer sleep quality in children. Hence, future health promotion
programmes for children should consider improving sleep quality as one of the
main health outcomes. The proposed programme should consider to promote
healthy dietary practices in enhancing the sleep quality of children.
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