Environmental Health (Dec 2021)

Exposure to second-hand smoke during early life and subsequent sleep problems in children: a population-based cross-sectional study

  • Li-Zi Lin,
  • Shu-Li Xu,
  • Qi-Zhen Wu,
  • Yang Zhou,
  • Hui-Min Ma,
  • Duo-Hong Chen,
  • Peng-Xin Dong,
  • Shi-Min Xiong,
  • Xu-Bo Shen,
  • Pei-En Zhou,
  • Ru-Qing Liu,
  • Gongbo Chen,
  • Hong-Yao Yu,
  • Bo-Yi Yang,
  • Xiao-Wen Zeng,
  • Li-Wen Hu,
  • Yuan-Zhong Zhou,
  • Guang-Hui Dong

DOI
https://doi.org/10.1186/s12940-021-00793-0
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 10

Abstract

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Abstract Background Previous studies have revealed that current secondhand smoke exposure showed highly suggestive evidence for increased risk of simultaneous sleep problems in children. Data on the associations between early-life exposure to SHS with subsequent sleep problems in children were scarce. We aimed to evaluate the associations of early-life SHS exposure with sleep problems in children. Methods In this cross-sectional study, children were recruited from elementary and middle schools in Liaoning Province, China between April 2012 and January 2013. We assessed early-life SHS exposure (pregnancy and the first 2 years of life) via questionnaires. Sleep problems and different types of sleep-related symptoms were measured based on the validated tool of the Sleep Disturbance Scale for Children (SDSC). Generalized linear mixed models were applied to estimate the associations of early-life SHS exposure with sleep problems. Results We included a total of 45,562 children (22,657 [49.7%] males; mean [SD] age, 11.0 [2.6] years) and 6167 of them (13.5%) were exposed to early-life SHS during both pregnancy and the first 2 years of life. Compared with unexposed counterparts, children exposed to early-life SHS had higher total T-scores of SDSC (β = 4.32; 95%CI: 4.06, 4.58) and higher odds of increased sleep problems (OR = 2.14; 95%CI: 1.89, 2.42). When considering different sleep-related symptoms, the associations between early-life SHS exposure and symptom of sleep-wake transition disorders (i.e., bruxism) were the strongest in all analyses. Conclusions Early-life SHS exposure was associated with higher odds of global sleep problems and different sleep-related symptoms in children aged 6–18 years. Our findings highlight the importance to strengthen efforts to support the critical importance of maintaining a smoke-free environment especially in early life.

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