Association between sleep habits and height in children from low socioeconomic backgrounds: A cross-sectional study

Association between sleep habits and height in children from low socioeconomic backgrounds: A cross-sectional study

Authors

  • Meta Herdiana Hanindita Dr. Soetomo Academic General Hospital/Medical Faculty, Universitas Airlangga Surabaya https://orcid.org/0000-0001-8914-0007
  • Nur Aisiyah Widjaja Dr. Soetomo Academic General Hospital/Medical Faculty, Universitas Airlangga Surabaya

Keywords:

body height, children, sleep quality, short stature, stunted

Abstract

Background and aim: Good sleep habits, including sleep duration and sleep onset, are crucial for supporting optimal growth and development. Literature suggests that insufficient sleep duration is associated with the risk of overweight and obesity in children. However, the relationship between sleep duration and sleep onset and height in children with a low socioeconomic status has not been explored. This study aims to investigate the association between sleep duration, sleep onset, and the height of children with a low socioeconomic status.

Methods: A cross-sectional study was performed from October to November 2022 across five primary schools in Surabaya, involving second and third graders. Participants’ weight and height were measured, and they answered structured questionnaires. If children were unsure of answers, the forms were taken home for parental assistance. Inclusion criteria were students from households earning below the regional minimum wage, excluding those with incomplete data or chronic illnesses.

Results: Among the 264 participants (47.7% boys, 52.3% girls, average age 108.7 ± 7.9 months), significant associations were observed between sleep duration and height (r=0.205, P=0.004) as well as sleep onset and height (r=0.397, P<0.0001). No significant links were found between sleep and weight. However, sleep duration and onset were significantly associated with screen time (P=0.025 and P<0.0001, respectively).

Conclusions: Insufficient sleep duration and late bedtimes are strongly linked to shorter height in children from low-income families. Beyond duration, sleep timing also emerges as a critical factor in supporting optimal growth.

References

1. Ueda R, Okada T, Kita Y, et al. Psychological status associated with low quality of life in school-age children with neurodevelopmental disorders during COVID-19 stay-at-home period. Front Psychiatry. 2021;12:676493:1-9. doi:10.3389/fpsyt.2021.676493

2. Wang F, Liu H, Wan Y, et al. Sleep duration and overweight/obesity in preschool-aged children: A prospective study of up to 48,922 children of the Jiaxing Birth Cohort. Sleep. 2016;39(11):2013–9. doi:10.5665/sleep.6234

3. Grimberg A, DiVall SA, Polychronakos C, et al. Guidelines for growth hormone and insulin-like growth factor-I treatment in children and adolescents: Growth hormone deficiency, idiopathic short stature, and primary insulin-like growth factor-I deficiency. Horm Res Paediatr. 2016;86(6):361–97. doi:10.1159/000452150.

4. Antoniazzi F, Cavarzere P, Gaudino R. Growth hormone and early treatment. Minerva Endocrinol. 2015 Jun;40(2):129–43. PMID: 25734895.

5. Stich FM, Huwiler S, D’Hulst G, Lustenberger C. The potential role of sleep in promoting a healthy body composition: Underlying mechanisms determining muscle, fat, and bone mass and their association with sleep. Neuroendocrinol. 2022;112(7):673–701. doi:10.1159/000518691

6. Tham EKH, Schneider N, Broekman BFP. Infant sleep and its relation with cognition and growth: A narrative review. Nat Sci Sleep. 2017;9:135–49. doi:10.2147/NSS.S125992

7. Lewandowski AS, Toliver-Sokol M, Palermo TM. Evidence-based review of subjective pediatric sleep measures. J Pediatr Psychol. 2011 Aug;36(7):780-93. doi:10.1093/jpepsy/jsq119.

8. Turnbull K, Reid GJ, Morton JB. Behavioral sleep problems and their potential impact on developing executive function in children. Sleep. 2013;36(7):1077–84. doi:10.5665/sleep.2814

9. Honda Y, Takahashi K, Takahashi S et al. Growth hormone secretion during nocturnal sleep in normal subjects. J Clin Endocrinol Metab. 1969;29(1):20–9. doi: 10.1210/jcem-29-1-20

10. Haile B, Headey D. Growth in milk consumption and reductions in child stunting: Historical evidence from cross-country panel data. Food Policy. 2023 Jul;118:102485. doi:10.1016/j.foodpol.2023.102485.

11. Dor C, Stark AH, Dichtiar R, Keinan-Boker L, Shimony T, Sinai T. Milk and dairy consumption is positively associated with height in adolescents: results from the Israeli National Youth Health and Nutrition Survey. Eur J Nutr. 2022 Feb;61(1):429-438. doi:10.1007/s00394-021-02661-6.

12. Nguyen Bao KL, Sandjaja S, Poh BK et al; SEANUTS Study Group. The Consumption of dairy and its association with nutritional status in the South East Asian Nutrition Surveys (SEANUTS). Nutrients. 2018 Jun 13;10(6):759. doi: 10.3390/nu10060759.10.

13. Sawyer E, Heussler H, Gunnarsson R. Defining short and long sleep duration for future paediatric research: A systematic literature review. J Sleep Res. 2019;28(6):e12839. doi: 10.1111/jsr.12839

14. Cremone A, de Jong DM, Kurdziel LBF, et al. Sleep tight, act right: Negative affect, sleep and behavior problems during early childhood. Child Dev. 2018;89(2):e42-59. doi: 10.1111/cdev.12717

15. Chaput JP, Janssen I. Sleep duration estimates of Canadian children and adolescents. J Sleep Res. 2016;25(5):441-8. doi: 10.1111/jsr.12410

16. Chase JD, Busa MA, Staudenmayer JW, Sirard JR. Sleep measurement using wrist-worn accelerometer data compared with polysomnography. Sensors. 2022;22(13):5041. doi: 10.3390/s22135041

17. Simpkin CT, Jenni OG, Carskadon MA, et al. Chronotype is associated with the timing of the circadian clock and sleep in toddlers. J Sleep Res. 2014;23(4):435–42. doi: 10.1111/jsr.12142.

18. Dogan DG, Canaloglu SK, Kivilcim M, Kum YE, Topal E, Catal F. Sleep patterns of young children with newly diagnosed atopic dermatitis. Postępy Dermatologii i Alergol. 2017;34(2):143-7. doi: 10.5114/ada.2017.67080.

19. Papatriantafyllou E, Efthymiou D, Zoumbaneas E, Popescu CA, Vassilopoulou E. Sleep deprivation: Effects on weight loss and weight loss maintenance. Nutrients. 2022;14(8):1549. doi: 10.3390/nu14081549.

20. Garfield V. The association between body mass index (BMI) and sleep duration: Where are we after nearly two decades of epidemiological research? Int J Environ Res Public Health. 2019;16(22):4327. doi: 10.3390/ijerph16224327.

21. Moreno JP, Razjouyan J, Lester H, et al. Later Sleep timing predicts accelerated summer weight gain among elementary school children: A prospective observational study. Int J Behav Nutr Phys Act. 2021;18(1):1-13. doi: 10.1186/s12966-021-01165-0.

22. Rosi A, Calestani M V, Parrino L, et al. Weight status is related with gender and sleep duration but not with dietary habits and physical activity in primary school Italian children. Nutrients. 2017;9(6):579. doi: 10.3390/nu9060579.

23. Ramírez-Contreras C, Santamaría-Orleans A, Izquierdo-Pulido M, Zerón-Rugerio MF. Sleep dimensions are associated with obesity, poor diet quality and eating behaviors in school-aged children. Front Nutr. 2022;9:959503. doi: 10.3389/fnut.2022.959503

24. Van Den Berg JF, Knvistingh Neven A, Tulen JHM, et al. Actigraphic sleep duration and fragmentation are related to obesity in the elderly: The Rotterdam Study. Int J Obes. 2008;32(7):1083–90. doi: 10.1038/ijo.2008.57.

25. Hart CN, Hawley NL, Coffman DL, et al. Randomized controlled trial to enhance children’s sleep, eating, and weight. Pediatr Res. 2022;92(4):1075-81. doi: 10.1038/s41390-021-01870-3

26. Hale L, Guan S. Screen time and sleep among school-aged children and adolescents: A systematic literature review. Sleep Med Rev. 2015;21:50-8.. doi: 10.1016/j.smrv.2014.07.007.

27. Philbrook LE, Aguilar K, Bohan AR, Daza KM, Harris SL. Bedtime parenting practices and sensitivity are associated with young children’s sleep. J Fam Psychol. 2022;36(8):1473-9. doi: 10.1037/fam0001027

28. Almuaigel D, Alanazi A, Almuaigel M, et al. Impact of technology use on behavior and sleep scores in preschool children in Saudi Arabia. Front Psychiatry. 2021;12:649095. doi: 10.3389/fpsyt.2021.649095

29. Brinkman JE, Tariq MA, Leavitt L, et al. Physiology, Growth Hormone. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.

30. Reale L, Guarnera M, Mazzone L. The effects of sleep disturbance on school performance: A preliminary investigation of children attending elementary grades. Sch Psychol Int. 2014;35(4):391–405. doi:10.1177/0143034313485850

31. Kim TW, Jeong JH, Hong SC. The Impact of sleep and circadian disturbance on hormones and metabolism. Int J Endocrinol. 2015;591729. doi: 10.1155/2015/591729

32. Brandenberger G, Weibel L. The 24-hour growth hormone rhythm in men: Sleep and circadian influences questioned. J Sleep Res. 2004 Sep;13(3):251–5. doi: 10.1111/j.1365-2869.2004.00415.x.

33. Dzaja A, Dalal MA, Himmerich H, Uhr M, Pollmächer T, Schuld A. Sleep enhances nocturnal plasma ghrelin levels in healthy subjects. Am J Physiol Metab. 2004;286(6):e963–7. doi: 10.1152/ajpendo.00527.2003.

34. Everson CA, Crowley WR. Reductions in circulating anabolic hormones induced by sustained sleep deprivation in rats. Am J Physiol Metab. 2004;286(6):e1060-70. doi: 10.1152/ajpendo.00553.2003.

35. Victora CG, Adair L, Fall C, et al. Maternal and child undernutrition: Consequences for adult health and human capital. Lancet. 2008;371(9609):340–57. doi: 10.1016/S01406736(07)61692-4.

36. Zhou Y, Aris IM, Tan SS, et al. Sleep duration and growth outcomes across the first two years of life in the GUSTO study. Sleep Med. 2015;16(10):1281–6. doi:10.1016/j.sleep.2015.07.006.

37. Lampl M, Johnson ML. Infant growth in length follows prolonged sleep and increased naps. Sleep. 2011;34(5):641–50. doi: 10.1093/sleep/34.5.641

38. Jiang YR, Spruyt K, Chen WJ, Shen XM, Jiang F. Somatic growth of lean children: the potential role of sleep. World J Pediatr. 2014;10(3):245-50. doi: 10.1007/s12519-014-0500-2

39. Jenni OG, Molinari L, Caflisch JA, Largo RH. Sleep duration from ages 1 to 10 years: Variability and stability in comparison with growth. Pediatrics. 2007;120(4):e769–76. doi: 10.1542/peds.2006-3300

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Published

28-10-2025

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Section

PEDIATRICS AND ADOLESCENT MEDICINE

How to Cite

1.
Hanindita MH, Widjaja NA. Association between sleep habits and height in children from low socioeconomic backgrounds: A cross-sectional study. Acta Biomed. 2025;96(5):16600. doi:10.23750/abm.v96i5.16600