Geocultural differences in pre-schooler sleep profiles and family practices: an analysis of pooled data from 37 countries

Zhiguang Zhang; Chalchisa Abdeta; Mohamed Souhaiel Chelly; Jesús del Pozo-Cruz; Catherine E Draper; Elina Engberg; Alex Florindo; Leyna Germana; Fazlollah Ghofranipour; Hongyan Guan; Amy Sau-Ching Ha; Asmaa E l Hamdouchi; Hong K Tang; Mohammed Sorowar Hossain; Bayasgalan Jambaldorj; Dong Hoon Kim; Denise Koh; Anna Kontsevaya; Marie Löf; Himangi Lubree; Alejandra Jáuregui; Nyaradzai Munambah; Tawonga Mwase-Vuma; Aoko Oluwayomi; Bang Nguyen Pham; John J Reilly; Amanda E Staiano; Adang Suherman; Chiaki Tanaka; Stephen Tanui; Wei-Peng Teo; Mark S Tremblay; Ali Turab; Edin Užičanin; Sanne L C Veldman; E Kipling Webster; V Pujitha Wickramasinghe; Dyah Anantalia Widyastari; Anthony Okely

doi:10.1093/sleep/zsae305

Geocultural differences in pre-schooler sleep profiles and family practices: an analysis of pooled data from 37 countries

Zhiguang Zhang^*, Chalchisa Abdeta, Mohamed Souhaiel Chelly, Jesús del Pozo-Cruz, Catherine E Draper, Elina Engberg, Alex Florindo, Leyna Germana, Fazlollah Ghofranipour, Hongyan Guan, Amy Sau-Ching Ha, Asmaa E l Hamdouchi, Hong K Tang, Mohammed Sorowar Hossain, Bayasgalan Jambaldorj, Dong Hoon Kim, Denise Koh, Anna Kontsevaya, Marie Löf, Himangi LubreeAlejandra Jáuregui, Nyaradzai Munambah, Tawonga Mwase-Vuma, Aoko Oluwayomi, Bang Nguyen Pham, John J Reilly, Amanda E Staiano, Adang Suherman, Chiaki Tanaka, Stephen Tanui, Wei-Peng Teo, Mark S Tremblay, Ali Turab, Edin Užičanin, Sanne L C Veldman, E Kipling Webster, V Pujitha Wickramasinghe, Dyah Anantalia Widyastari, Anthony Okely

^*Corresponding author for this work

Physical Activity And Health

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Abstract

STUDY OBJECTIVES To examine 1) multidimensional sleep profiles in pre-schoolers (3-6 years) across geocultural regions and 2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, Latin America) and the Minority World (the Western world). METHODS Participants were 3507 pre-schoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n=1950) and family practices (parental questionnaire) were measured. Mixed models were used to estimate the marginal means of sleep characteristics by region and examine the differences. RESULTS Geocultural region explained up to 30% of variance in sleep characteristics. A pattern of short nighttime sleep duration, low sleep efficiency, and long nap duration was observed in Eastern Europe, Northeast Asia, and Southeast Asia. The second pattern, with later sleep midpoints and greater night-to-night sleep variability, was observed in South Asia, the Middle East and North Africa, and Latin America. Compared to the Minority World, less optimal sleep characteristics were observed in several Majority World regions, with medium-to-large effect sizes (∣d∣=0.48-2.35). Several Majority World regions reported more frequent parental smartphone use during bedtime routines (Northeast Asia, Southeast Asia: 0.77-0.99 units) and were more likely to have electronic devices in children’s bedroom (Eastern Europe, Latin America, South Asia: OR=5.97-16.57) and co-sleeping arrangement (Asia, Latin America: OR=7.05-49.86), compared to the Minority World. CONCLUSIONS Pre-schoolers’ sleep profiles and related family practices vary across geocultural regions, which should be considered in sleep health promotion initiatives and policies.

Original language	English
Article number	zsae305
Number of pages	12
Journal	SLEEP
Volume	48
Issue number	4
Early online date	23 Dec 2024
DOIs	https://doi.org/10.1093/sleep/zsae305
Publication status	Published - 11 Apr 2025

Funding

The authors are grateful to the families that participated in the SUNRISE pilot study, the early childhood education and care services that facilitated participant recruitment, the data collectors, and the SUNRISE Coordinating Centre staff at the University of Wollongong. Study questionnaire data were collected and managed using REDCap electronic data capture tools [38, 39] hosted and supported by the University of Wollongong. National Health and Medical Research Council Investigator Grant, Australia (Grant No. APP1176858); Government of Andalusia, Research, Development, and Innovation Program (Grant No. PAIDI P20_1181) and requalification of university teaching staff - Ministry of Universities (Grant No. 22330), financed by the European Union - NextGenerationEU; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (N/A); International Society of Behavioral Nutrition and Physical Activity Pioneers Scholarship Program (ISBNPA-2021); Pham Ngoc Thach University of Medicine's Fund for Science, Vietnam (Grant No. 11320/HD-TDHYKPNT); Research University Grant and Faculty of Education Grant, Universiti Kebangsaan Malaysia, Malaysia (N/A); WHO European Office for the Prevention and Control of Noncommunicable Diseases (N/A); KEM Hospital Research Centre, India (N/A); The Fogarty International Center at the National Institute of Health, the United States of America (Grant No. A66864; Grant No. R25 TW011215); Sir Halley Stewart Trust (Grant No. 2674); The National Institute of Health Scholarship Travel Award, the United States of America (N/A); Ministry of Education and Culture in Finland, Juho Vainio Foundation, Signe and Ane Gyllenberg Foundation, Yrj\u00F6 Jahnsson Foundation, and Samfundet Folkh\u00E4lsan, Finland (N/A); American Council on Exercise, the United States of America (N/A); World Cancer Research Fund International and Cancer Australia (Grant No. PFG_FULL_2022_005); Faculty of Physical Education and Sport, University of Tuzla, Bosnia and Herzegovina (N/A); Amsterdam Public Health Health Behaviors and Chronic Diseases Project Grant, The Netherland (N/A); National Research Council of Thailand, through Mahidol University Fundamental Fund (Grant No. 198862); Thailand Physical Activity Knowledge Development Centre, Institute for Population and Social Research, Mahidol University, Thailand (N/A). National Health and Medical Research Council Investigator Grant, Australia (Grant No. APP1176858); Government of Andalusia, Research, Development, and Innovation Program (Grant No. PAIDI P20_1181) and requalification of university teaching staff\u2014Ministry of Universities (Grant No. 22330), financed by the European Union \u2013 NextGenerationEU; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (N/A); International Society of Behavioral Nutrition and Physical Activity Pioneers Scholarship Program (ISBNPA-2021); Pham Ngoc Thach University of Medicine\u2019s Fund for Science, Vietnam (Grant No. 1320/H\u0110-T\u0110HYKPNT); Research University Grant and Faculty of Education Grant, Universiti Kebangsaan Malaysia, Malaysia (N/A); WHO European Office for the Prevention and Control of Noncommunicable Diseases (N/A); KEM Hospital Research Centre, India (N/A); The Fogarty International Center at the National Institute of Health, the United States of America (Grant No. A66864; Grant No. R25 TW011215); Sir Halley Stewart Trust (Grant No. 2674); The National Institute of Health Scholarship Travel Award, the United States of America (N/A); Ministry of Education and Culture in Finland, Juho Vainio Foundation, Signe and Ane Gyllenberg Foundation, Yrj\u00F6 Jahnsson Foundation, and Samfundet Folkh\u00E4lsan, Finland (N/A); American Council on Exercise, the United States of America (N/A); World Cancer Research Fund International and Cancer Australia (Grant No. PFG_FULL_2022_005); Faculty of Physical Education and Sport, University of Tuzla, Bosnia and Herzegovina (N/A); Amsterdam Public Health Health Behaviors and Chronic Diseases Project Grant, The Netherland (N/A); National Research Council of Thailand, through Mahidol University Fundamental Fund (Grant No. 198862); Thailand Physical Activity Knowledge Development Centre, Institute for Population and Social Research, Mahidol University, Thailand (N/A).

Keywords

behavioural sleep
public health
early childhood
cross-cultural comparison

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/sleep/zsae305Licence: CC BY-NC 4.0

Zhang-etal-Sleep-Geocultural-differences-in-pre-schooler-sleep-profiles-and-family-practicesFinal published version, 1.21 MBLicence: CC BY-NC 4.0

Cite this

Zhang, Z., Abdeta, C., Chelly, M. S., del Pozo-Cruz, J., Draper, C. E., Engberg, E., Florindo, A., Germana, L., Ghofranipour, F., Guan, H., Ha, A. S.-C., Hamdouchi, A. E. L., Tang, H. K., Hossain, M. S., Jambaldorj, B., Kim, D. H., Koh, D., Kontsevaya, A., Löf, M., ... Okely, A. (2025). Geocultural differences in pre-schooler sleep profiles and family practices: an analysis of pooled data from 37 countries. SLEEP, 48(4), Article zsae305. https://doi.org/10.1093/sleep/zsae305

@article{b0424fc1779a4da1b67b375866529bd1,

title = "Geocultural differences in pre-schooler sleep profiles and family practices: an analysis of pooled data from 37 countries",

abstract = "STUDY OBJECTIVES To examine 1) multidimensional sleep profiles in pre-schoolers (3-6 years) across geocultural regions and 2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, Latin America) and the Minority World (the Western world). METHODS Participants were 3507 pre-schoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n=1950) and family practices (parental questionnaire) were measured. Mixed models were used to estimate the marginal means of sleep characteristics by region and examine the differences. RESULTS Geocultural region explained up to 30% of variance in sleep characteristics. A pattern of short nighttime sleep duration, low sleep efficiency, and long nap duration was observed in Eastern Europe, Northeast Asia, and Southeast Asia. The second pattern, with later sleep midpoints and greater night-to-night sleep variability, was observed in South Asia, the Middle East and North Africa, and Latin America. Compared to the Minority World, less optimal sleep characteristics were observed in several Majority World regions, with medium-to-large effect sizes (∣d∣=0.48-2.35). Several Majority World regions reported more frequent parental smartphone use during bedtime routines (Northeast Asia, Southeast Asia: 0.77-0.99 units) and were more likely to have electronic devices in children{\textquoteright}s bedroom (Eastern Europe, Latin America, South Asia: OR=5.97-16.57) and co-sleeping arrangement (Asia, Latin America: OR=7.05-49.86), compared to the Minority World. CONCLUSIONS Pre-schoolers{\textquoteright} sleep profiles and related family practices vary across geocultural regions, which should be considered in sleep health promotion initiatives and policies.",

keywords = "behavioural sleep, public health, early childhood, cross-cultural comparison",

author = "Zhiguang Zhang and Chalchisa Abdeta and Chelly, {Mohamed Souhaiel} and {del Pozo-Cruz}, Jes{\'u}s and Draper, {Catherine E} and Elina Engberg and Alex Florindo and Leyna Germana and Fazlollah Ghofranipour and Hongyan Guan and Ha, {Amy Sau-Ching} and Hamdouchi, {Asmaa E l} and Tang, {Hong K} and Hossain, {Mohammed Sorowar} and Bayasgalan Jambaldorj and Kim, {Dong Hoon} and Denise Koh and Anna Kontsevaya and Marie L{\"o}f and Himangi Lubree and Alejandra J{\'a}uregui and Nyaradzai Munambah and Tawonga Mwase-Vuma and Aoko Oluwayomi and Pham, {Bang Nguyen} and Reilly, {John J} and Staiano, {Amanda E} and Adang Suherman and Chiaki Tanaka and Stephen Tanui and Wei-Peng Teo and Tremblay, {Mark S} and Ali Turab and Edin U{\v z}i{\v c}anin and Veldman, {Sanne L C} and Webster, {E Kipling} and Wickramasinghe, {V Pujitha} and Widyastari, {Dyah Anantalia} and Anthony Okely",

year = "2025",

month = apr,

day = "11",

doi = "10.1093/sleep/zsae305",

language = "English",

volume = "48",

journal = "SLEEP",

issn = "0161-8105",

publisher = "Oxford University Press",

number = "4",

}

Zhang, Z, Abdeta, C, Chelly, MS, del Pozo-Cruz, J, Draper, CE, Engberg, E, Florindo, A, Germana, L, Ghofranipour, F, Guan, H, Ha, AS-C, Hamdouchi, AEL, Tang, HK, Hossain, MS, Jambaldorj, B, Kim, DH, Koh, D, Kontsevaya, A, Löf, M, Lubree, H, Jáuregui, A, Munambah, N, Mwase-Vuma, T, Oluwayomi, A, Pham, BN, Reilly, JJ, Staiano, AE, Suherman, A, Tanaka, C, Tanui, S, Teo, W-P, Tremblay, MS, Turab, A, Užičanin, E, Veldman, SLC, Webster, EK, Wickramasinghe, VP, Widyastari, DA & Okely, A 2025, 'Geocultural differences in pre-schooler sleep profiles and family practices: an analysis of pooled data from 37 countries', SLEEP, vol. 48, no. 4, zsae305. https://doi.org/10.1093/sleep/zsae305

TY - JOUR

T1 - Geocultural differences in pre-schooler sleep profiles and family practices

T2 - an analysis of pooled data from 37 countries

AU - Zhang, Zhiguang

AU - Abdeta, Chalchisa

AU - Chelly, Mohamed Souhaiel

AU - del Pozo-Cruz, Jesús

AU - Draper, Catherine E

AU - Engberg, Elina

AU - Florindo, Alex

AU - Germana, Leyna

AU - Ghofranipour, Fazlollah

AU - Guan, Hongyan

AU - Ha, Amy Sau-Ching

AU - Hamdouchi, Asmaa E l

AU - Tang, Hong K

AU - Hossain, Mohammed Sorowar

AU - Jambaldorj, Bayasgalan

AU - Kim, Dong Hoon

AU - Koh, Denise

AU - Kontsevaya, Anna

AU - Löf, Marie

AU - Lubree, Himangi

AU - Jáuregui, Alejandra

AU - Munambah, Nyaradzai

AU - Mwase-Vuma, Tawonga

AU - Oluwayomi, Aoko

AU - Pham, Bang Nguyen

AU - Reilly, John J

AU - Staiano, Amanda E

AU - Suherman, Adang

AU - Tanaka, Chiaki

AU - Tanui, Stephen

AU - Teo, Wei-Peng

AU - Tremblay, Mark S

AU - Turab, Ali

AU - Užičanin, Edin

AU - Veldman, Sanne L C

AU - Webster, E Kipling

AU - Wickramasinghe, V Pujitha

AU - Widyastari, Dyah Anantalia

AU - Okely, Anthony

PY - 2025/4/11

Y1 - 2025/4/11

N2 - STUDY OBJECTIVES To examine 1) multidimensional sleep profiles in pre-schoolers (3-6 years) across geocultural regions and 2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, Latin America) and the Minority World (the Western world). METHODS Participants were 3507 pre-schoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n=1950) and family practices (parental questionnaire) were measured. Mixed models were used to estimate the marginal means of sleep characteristics by region and examine the differences. RESULTS Geocultural region explained up to 30% of variance in sleep characteristics. A pattern of short nighttime sleep duration, low sleep efficiency, and long nap duration was observed in Eastern Europe, Northeast Asia, and Southeast Asia. The second pattern, with later sleep midpoints and greater night-to-night sleep variability, was observed in South Asia, the Middle East and North Africa, and Latin America. Compared to the Minority World, less optimal sleep characteristics were observed in several Majority World regions, with medium-to-large effect sizes (∣d∣=0.48-2.35). Several Majority World regions reported more frequent parental smartphone use during bedtime routines (Northeast Asia, Southeast Asia: 0.77-0.99 units) and were more likely to have electronic devices in children’s bedroom (Eastern Europe, Latin America, South Asia: OR=5.97-16.57) and co-sleeping arrangement (Asia, Latin America: OR=7.05-49.86), compared to the Minority World. CONCLUSIONS Pre-schoolers’ sleep profiles and related family practices vary across geocultural regions, which should be considered in sleep health promotion initiatives and policies.

AB - STUDY OBJECTIVES To examine 1) multidimensional sleep profiles in pre-schoolers (3-6 years) across geocultural regions and 2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, Latin America) and the Minority World (the Western world). METHODS Participants were 3507 pre-schoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n=1950) and family practices (parental questionnaire) were measured. Mixed models were used to estimate the marginal means of sleep characteristics by region and examine the differences. RESULTS Geocultural region explained up to 30% of variance in sleep characteristics. A pattern of short nighttime sleep duration, low sleep efficiency, and long nap duration was observed in Eastern Europe, Northeast Asia, and Southeast Asia. The second pattern, with later sleep midpoints and greater night-to-night sleep variability, was observed in South Asia, the Middle East and North Africa, and Latin America. Compared to the Minority World, less optimal sleep characteristics were observed in several Majority World regions, with medium-to-large effect sizes (∣d∣=0.48-2.35). Several Majority World regions reported more frequent parental smartphone use during bedtime routines (Northeast Asia, Southeast Asia: 0.77-0.99 units) and were more likely to have electronic devices in children’s bedroom (Eastern Europe, Latin America, South Asia: OR=5.97-16.57) and co-sleeping arrangement (Asia, Latin America: OR=7.05-49.86), compared to the Minority World. CONCLUSIONS Pre-schoolers’ sleep profiles and related family practices vary across geocultural regions, which should be considered in sleep health promotion initiatives and policies.

KW - behavioural sleep

KW - public health

KW - early childhood

KW - cross-cultural comparison

U2 - 10.1093/sleep/zsae305

DO - 10.1093/sleep/zsae305

M3 - Article

SN - 0161-8105

VL - 48

JO - SLEEP

JF - SLEEP

IS - 4

M1 - zsae305

ER -

Geocultural differences in pre-schooler sleep profiles and family practices: an analysis of pooled data from 37 countries

Abstract

Funding

Keywords

UN SDGs

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