***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The current study aim ed to examine the changes following a sleep hygiene intervention on sleep hygiene practice s , sleep quality , and daytime symptoms in youth . Methods Participants aged 10–18 years with self-identified sleep problems completed our age-appropriate F.E.R.R.E.T ( an acronym for the categories of Food , Emotions , Routine , Restrict , Environment and Timing )  sleep hygiene programme  ; each category has three simple rules to encourage good sleep . Participants ( and parents as appropriate ) completed the Adolescent Sleep Hygiene Scale ( ASHS ) , Pittsburgh Sleep Quality Index ( PSQI ) , Sleep Disturbance Scale for Children ( SDSC ) , Pediatric Daytime Sleepiness Scale ( PDSS ) , and wore Actical ® monitors  twice before ( 1 and 2 weeks ) and three times after ( 6 , 12 and 20 weeks ) the intervention . Anthropometric data were collected two weeks before and 20 weeks post-intervention . Results Thirty-three youths ( mean age 12.9 years ; M/F = 0.8 ) enrolled , and retention was 100 % . ASHS scores significantly improved ( p = 0.005 ) from a baseline mean ( SD ) of 4.70 ( 0.41 ) to 4.95 ( 0.31 ) post-intervention , as did PSQI scores [ 7.47 ( 2.43 ) to 4.47 ( 2.37 ) ; p < 0.001 ] and SDSC scores [ 53.4 ( 9.0 ) to 39.2 ( 9.2 ) ; p < 0.001 ] . PDSS scores improved from a baseline of 16.5 ( 6.0 ) to 11.3 ( 6.0 ) post- intervention ( p < 0.001 ) . BMI z-scores with a baseline of 0.79 ( 1.18 ) decreased significantly ( p = 0.001 ) post-intervention to 0.66 ( 1.19 ) . Despite these improvements , sleep duration as estimated by Actical accelerometry did not change . There was however a significant decrease in daytime sedentary/light energy expenditure . Conclusions Our findings suggest the F.E.R.R.E.T sleep hygiene education programme might be effective in improving sleep in children and adolescents . However because this was a before and after study and a pilot study with several limitations , the findings need to be addressed with caution , and would need to be replicated within a r and omised controlled trial to prove efficacy . Trial registration Australian New Zeal and Clinical Trials Registry : Background Sufficient sleep during childhood is essential to ensure a transition into a healthy adulthood . However , chronic sleep loss continues to increase worldwide . In this context , it is imperative to make sleep a high-priority and take action to promote sleep health among children . The present series of studies aim ed to shed light on sleep patterns , on the longitudinal association of sleep with school performance , and on practical intervention strategy for Chinese school-aged children . Methods and Findings A serial sleep research es , including a national cross-sectional survey , a prospect i ve cohort study , and a school-based sleep intervention , were conducted in China from November 2005 through December 2009 . The national cross-sectional survey was conducted in 8 cities and a r and om sample of 20,778 children aged 9.0±1.61 years participated in the survey . The five-year prospect i ve cohort study included 612 children aged 6.8±0.31 years . The comparative cross-sectional study ( baseline : n = 525 , aged 10.80±0.41 ; post-intervention follow-up : n = 553 , aged 10.81±0.33 ) was undertaken in 6 primary schools in Shanghai . A battery of parent and teacher reported question naires were used to collect information on children ’s sleep behaviors , school performance , and sociodemographic characteristics . The mean sleep duration was 9.35±0.77 hours . The prevalence of daytime sleepiness was 64.4 % ( sometimes : 37.50 % ; frequently : 26.94 % ) . Daytime sleepiness was significantly associated with impaired attention , learning motivation , and particularly , academic achievement . By contrast , short sleep duration only related to impaired academic achievement . After delaying school start time 30 minutes and 60 minutes , respectively , sleep duration correspondingly increased by 15.6 minutes and 22.8 minutes , respectively . Moreover , intervention significantly improved the sleep duration and daytime sleepiness . Conclusions Insufficient sleep and daytime sleepiness commonly existed and positively associated with the impairment of school performance , especially academic achievement , among Chinese school-aged children . The effectiveness of delaying school staring time emphasized the benefits of optimal school schedule regulation to children ’s sleep health A total of 36 toddlers and preschool children exhibiting bedtime tantrum activity were r and omly assigned to one of three groups : positive routines , graduated extinction , or control . Positive routines involved changing the child 's bedtime to coincide with when he naturally fell asleep , as well as parent and child engaging in a series of four to seven enjoyable activities before the child being placed in bed . During the treatment period , bedtimes were systematic ally scheduled earlier such that the child went to bed at the time parents had originally used . Graduated extinction consisted of the parent putting the child to bed and ignoring the tantrum activity for increasingly longer amounts of time throughout the treatment . Children in these two treatment groups had tantrums less frequently and for shorter periods than control subjects during 6 weeks of treatment and during two follow-up observations 3 and 6 weeks after treatment . Although both treatments were more effective than waiting for the child to outgrow this problem , parents of the positive routine group reported significantly improved marital satisfaction , suggesting additional benefits of this treatment strategy Abstract ObjectiveS leep deprivation among teens is a major health issue . Only 15 % of teens get 8.5 h of sleep on school nights . Sleep deprivation can lead to poor grade s , sleepiness and moodiness . We undertook a study to assess the prevalence of sleep habit disturbance among elementary school students in South Texas with Hispanic ethnicity predominance . We also found how much a video based on sleep education had an impact on these children . Method Once the Corpus Christi Independent School District ( CCISD ) approved the collection of baseline sleep data , question naires were administered using the Children ’s Sleep Habit Question naire ( CSHQ . ) These question naires were distributed prior to the viewing of the educational and animated movie KNIGHTS ( Keep Nurturing and Inspiring Good Habits in Teen Sleep ) . Four months later , a r and om follow-up was performed and the children were requested to respond to the same CSHQ . Results 264 children from two elementary schools participated in this educational program . At baseline , 55.56 % of the children had trouble sleeping . When the question naire was administered four months later , only 23.26 % ( p < 0.05 ) had trouble sleeping . Additionally , at baseline , approximately 60–70 % children had some baseline bedtime resistance , anxiety dealing with sleep , issues with sleep duration and /or awakenings in the middle of the night . In the follow up question naire , results showed significant improvements in overall sleep habits , bedtime resistance , sleep anxiety and night awakenings amongst students ( p < 0.05 ) . However , no significant differences were seen in sleep duration and daytime sleepiness . ConclusionS leep deprivation and good sleep habits remain as a pervasive challenge among elementary school students . Administering an animated video about sleep education along with a provider-based education may be an effective tool for educating elementary school students and decreasing the prevalence of these sleep-related issues . Future prospect i ve r and omized studies are suggested PURPOSE The implication s of sleep patterns for adolescent health are well established , but we know less about larger context ual influences on youth sleep . We focused on parents ' workplace experiences as extrafamilial forces that may affect youth sleep . METHODS In a group-r and omized trial focused on employee work groups in the information technology division of a Fortune 500 company , we tested whether a workplace intervention improved sleep latency , duration , night-to-night variability in duration , and quality of sleep of employees ' offspring , aged 9 - 17 years . The intervention was aim ed at promoting employees ' schedule control and supervisor support for personal and family life to decrease employees ' work-family conflict and thereby promote the health of employees , their families , and the work organization . Analyses focused on 93 parent-adolescent dyads ( 57 dyads in the intervention and 46 in the comparison group )  that completed baseline and 12-month follow-up home interviews and a series of telephone diary interviews that were conducted on eight consecutive evenings at each wave . RESULTS Intent-to-treat analyses of the diary interview data revealed main effects of the intervention on youth 's sleep latency , night-to-night variability in sleep duration , and sleep quality , but not sleep duration . CONCLUSIONS The intervention focused on parents ' work conditions , not on their parenting or parent-child relationships , attesting to the role of larger context ual influences on youth sleep and the importance of parents ' work experiences in the health of their children BACKGROUND : Although observational studies have consistently reported an association between media use and  child sleep problems  , it is unclear whether the relationship is causal or if an intervention targeting healthy media use can improve sleep in preschool-aged children . METHODS : We conducted a r and omized controlled trial of a healthy media use intervention in families of children aged 3 to 5 years . The intervention encouraged families to replace violent or age-inappropriate media content with quality educational and prosocial content , through an initial home visit and follow-up telephone calls over 6 months . Sleep measures were derived from the Child Sleep Habits Question naire and were collected at 6 , 12 , and 18 months after baseline ; repeated- measures regression analyses were used . RESULTS : Among the 565 children analyzed , the most common sleep problem was delayed sleep-onset latency ( 38 % ) . Children in the intervention group had significantly lower odds of “ any sleep problem ” at follow-up in the repeated- measures analysis ( odds ratio = 0.36 ; 95 % confidence interval : 0.16 to 0.83 ) , with a trend toward a decrease in intervention effect over time ( P = .07 ) . Although there was no significant effect modification detected by baseline sleep or behavior problems , gender , or low-income status , there was a trend ( P = .096 ) toward an increased effect among those with high levels of violence exposure at baseline . CONCLUSIONS : The significant effects of a healthy media use intervention on  child sleep problems  in the context of a r and omized controlled trial suggest that the previously reported relationship between media use and  child sleep problems is indeed causal in nature There is considerable research that suggests that school-based social – emotional programs can foster improved mental health and reduce problem behaviors for participating youth ; in contrast , much less is known about the impact of these programs on physical health , even though some of these programs also include at least limited direct attention to promoting physical health behaviors . We examined the effects of one such program , Positive Action ( PA ) , on physical health behaviors and body mass index ( BMI ) , and tested for mediation of program effects through a measure of social – emotional and character development ( SECD ) . Participating schools in the matched-pair , cluster-r and omized trial were 14 low-performing K-8 Chicago Public Schools . We followed a cohort of students in each school from grade s 3 to 8 ( eight waves of data collection ; 1170 total students ) . Student self-reports of health behaviors served as the basis for measures of healthy eating and exercise , unhealthy eating , personal hygiene , consistent bedtime , and SECD . We collected height and weight measurements at endpoint to calculate age- and gender-adjusted BMI z-scores . Longitudinal multilevel modeling analyses revealed evidence of favorable program effects on personal hygiene [ effect size ( ES ) = 0.48 ] , healthy eating and exercise ( ES = 0.21 ) , and unhealthy eating ( ES = −0.19 ) ; in addition , BMI z-scores were lower among students in PA schools at endpoint ( ES = −0.21 ) . Program effects were not moderated by either gender or student mobility . Longitudinal structural equation modeling demonstrated mediation through SECD for healthy eating and exercise , unhealthy eating , and personal hygiene . Findings suggest that a SECD program without a primary focus on health behavior promotion can have a modest impact on outcomes in this domain during the childhood to adolescence transition OBJECTIVE Sleep difficulties are common reasons why parents seek medical intervention in children with autism spectrum disorders ( ASDs ) . We determined whether a pamphlet alone could be used by parents to help their child ’s insomnia . METHODS Thirty-six children with ASD , ages 2 to 10 years , were enrolled . All had prolonged sleep latency confirmed by actigraphy showing a mean sleep latency of 30 minutes or more . Parents were r and omly assigned to receive the  sleep education pamphlet or no intervention . Children wore an actigraphy device to record baseline sleep parameters , with the primary outcome variable being change in sleep latency . Actigraphy data were collected a second time 2 weeks after the parent received the r and omization assignment and analyzed by using Student ’s t test . Parents were also asked a series of questions to gather information about the pamphlet and its usefulness . RESULTS Although participants r and omized to the 2 arms did not differ statistically in age , gender , socioeconomic status , total Children ’s Sleep Habits Question naire score , or actigraphy parameters , some differences may be large enough to affect results . Mean change in sleep-onset latency did not differ between the r and omized groups ( pamphlet versus no pamphlet ) . Parents commented that the pamphlet contained good information , but indicated that it would have been more useful to be given specific examples of how to take the information and put it into practice . CONCLUSIONS A sleep education pamphlet did not appear to improve sleep latency in children with ASDs PURPOSE To 
    Output:
    
Overall , no evidence was found favoring a particular intervention strategy .
Conclusion : Due to few high quality studies , evidence for the effectiveness of any particular intervention strategy to stimulate healthy sleep in children is still inconclusive .
However , the more effective interventions in stimulating healthy sleep duration and adherence to regular bedtimes were mostly multi-behavioral interventions that included creating daily healthy routines and combined intervention setting s ( e.g. home and school ) .