{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:46:08Z","timestamp":1777697168727,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,4,2]],"date-time":"2023-04-02T00:00:00Z","timestamp":1680393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Research in Nursing &amp; Health"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This was a cross\u2010sectional study to examine sleep and its variability in relation to behavioral outcomes in school\u2010age children with overweight and obesity. A total of 246 school\u2010age children with overweight or obesity were recruited between 2019 and 2021 from 10 public elementary schools in Northern Taiwan. Parents completed sleep and behavior questionnaires, with children wearing an actigraphy monitor for 7 days. Average daily sleep duration by actigraphy was 7.52\u2009h, with 84.6% of the children having clinically significant sleep disturbance scores and 68.3% having a total behavior problem score in the clinical range. Children were categorized by median split for sleep duration and sleep duration variability. Multivariate regression analyses showed that children in the insufficient (duration)\u2010stable (variability) sleep category had significantly higher scores for emotion problems (<jats:italic>B<\/jats:italic>\u2009=\u20090.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), self\u2010control problems (<jats:italic>B<\/jats:italic>\u2009=\u20091.61, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and total behavior problems (<jats:italic>B<\/jats:italic>\u2009=\u20093.38, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) compared to children in the sufficient\u2010stable sleep (reference) category. Children in the insufficient\u2010variable sleep category had significantly higher self\u2010control problem scores compared to children in the reference category (<jats:italic>B<\/jats:italic>\u2009=\u20091.03, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Findings from our study suggest that school\u2010age children with overweight and obesity coexist with sleep and behavioral problems, and those who have consistently insufficient sleep are at the greatest risk for the worst behavioral outcomes. Screening for sleep habits and behavioral problems should be considered a standard practice in pediatric overweight and obesity.<\/jats:p>","DOI":"10.1002\/nur.22308","type":"journal-article","created":{"date-parts":[[2023,4,2]],"date-time":"2023-04-02T12:59:50Z","timestamp":1680440390000},"page":"289-298","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Sleep and its variability in relation to behavioral outcomes in school\u2010age children with overweight and obesity"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2874-5202","authenticated-orcid":false,"given":"Shao\u2010Yu","family":"Tsai","sequence":"first","affiliation":[{"name":"School of Nursing, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Department of Nursing National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010Ching","family":"Tung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuen\u2010Min","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Information Management National Yunlin University of Science and Technology Yunlin Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien\u2010Chang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-10-49"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0028204"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894211028489"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8624.00392"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.07.004"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-019-4734-x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anr.2015.10.010"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/7854_2011_154"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.22419"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/nbu.12576"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-019-0862-x"},{"key":"e_1_2_10_13_1","unstructured":"Health Promotion Administration Ministry of Health and Welfare. 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