Abstract: Objective To examine the association of screen exposure, outdoor activities and sleep among toddlers, so as to provide scientific basis for the prevention and intervention of children's sleep problems. Methods Based on the established maternal and infant health birth cohort in Ma'anshan, single live infants born from June 2015 to June 2016 were followed up to 2 years of age. The information on social demographic, screen exposure, outdoor activities and sleep were collected. A total of 1 575 valid questionnaires were obtained, including 833 boys and 742 girls. χ² test and Logistic regression were used to analyze data. Results The incidence rate of poor sleep quality among toddlers was 26.16%. The proportion of TV turning on time (not necessarily watching) ≥2 h/d, TV watching time ≥1 h/d and mobile phone playing time ≥30 min/d were 50.73%, 45.21% and 26.03%, respectively. The proportion of outdoor activity time ≥2 h/d was 71.30%. The proportion of went to outdoor places ≥2 times/week and the average time spent in outdoor places ≥2 h/time were 76.31% and 37.71%, respectively. After adjusting for confounding factors such as demographic data, average time on TV (not necessarily watching TV) ≥2 h/d (OR=1.40, 95%CI:1.11 - 1.77), average time spent on watching TV ≥1 h/d (OR=1.39, 95%CI:1.11 - 1.75), and average time spent on using mobile phones ≥30 min/d (OR=1.55, 95%CI:1.21 - 1.99) all increased the risk of poor sleep quality in toddlers(P＜0.05), but frequency of outdoor activities ≥2 times per week (OR=0.72, 95%CI:0.55 - 0.93) and average time spent outdoors ≥1 hour per time (OR=0.78, 95%CI:0.62 - 0.99) were associated with reduced risk of poor sleep quality in children(P＜0.05). Conclusions There are a certain proportion of toddlers with sleep problems. Screen exposure and outdoor activities are associated with toddler's sleep. It is suggested to reduce screen time and do more outdoor activities to improve toddler's sleep.

Key words: screen exposure, outdoor activities, sleep, children

摘要： 目的 分析视屏暴露和户外活动与幼儿睡眠的相关性,为预防和干预儿童睡眠问题提供科学依据。方法 基于已建立的马鞍山市母婴健康出生队列,对2015年6月—2016年6月出生的单胎活产儿,随访至2岁,收集社会人口统计学、视屏暴露、户外活动和睡眠情况的资料。共获得有效问卷1 575份,男童833人,女童742人。使用χ²检验和Logistic回归模型对数据进行分析。结果 幼儿睡眠质量差的发生率为26.16%;电视打开时间(不一定在看)≥2 h/d、看电视≥1 h/d、玩手机≥30 min/d分别占50.73%、45.21%和26.03%,户外活动≥2 h/d的比例为71.30%;去户外场所的频率≥2次/周和在户外场所≥1 h/次的比例分别为76.31%和37.71%。调整人口统计学等混杂因素后,打开电视时间(不一定在看电视)≥2 h/d(OR=1.40,95%CI:1.11～1.77)、看电视时间≥1 h/d(OR=1.39,95%CI:1.11～1.75)、玩手机时间≥30 min/d(OR=1.55,95%CI:1.21～1.99)均会增加幼儿睡眠质量差发生的风险;去户外场所的频率≥2次/周(OR=0.72,95%CI:0.55～0.93)和在户外场所时间≥1 h/次(OR=0.78,95%CI:0.62～0.99)则能降低发生幼儿睡眠质量差的风险。结论 幼儿睡眠问题存在一定比例,视屏暴露和户外活动均与幼儿睡眠相关,在儿童保健门诊中应对家长进行科学指导,减少视屏暴露时间,增加户外活动,以减少儿童睡眠问题的发生。

关键词: 视屏暴露, 户外活动, 睡眠, 儿童