RESUMEN
BACKGROUND: Sleep hygiene is crucial for child development, influencing physical health, cognitive function, and emotional well-being. Parental knowledge and practices significantly influence children's sleep habits, yet gaps in understanding persist, impacting sleep quality and overall health outcomes. In Saudi Arabia, rapid societal changes and modern lifestyles pose unique challenges to maintaining healthy sleep habits among children. This study aims to assess parental knowledge and management of sleep hygiene, providing insights for targeted interventions tailored to Saudi cultural contexts. METHODS: This cross-sectional study assessed parental knowledge and management of sleep hygiene among children in Saudi Arabia. Participants (N=729) were recruited from pediatric clinics and online forums, comprising parents with at least one child aged 0-18 years who completed surveys in Arabic or English. A comprehensive survey collected demographic data, parental sleep hygiene knowledge, practices, and concerns. Data were gathered between January and March 2024 via online and clinic-based distribution and analyzed using SPSS version 25 for descriptive statistics. RESULTS: The survey was completed by 729 participants, predominantly aged 25-44 years (70.4%), holding predominantly bachelor's degrees (34.7%), and employed full-time (49.7%). The majority reported having 2-3 children (54.9%). Findings indicated that 69.1% (504 participants) correctly identified school-aged children's sleep needs, and 71.0% (518 participants) recognized the importance of limiting electronic device use before bedtime. Sleep management practices revealed that 81.3% (592 participants) of parents adhered to bedtime routines, and 65.6% (478 participants) managed electronic device use appropriately. Bedtimes typically ranged from 7 to 9 PM for 90.5% (658 participants) of children, with wake-up times clustered between 6 and 8 AM for 75.6% (551 participants). Parental concerns showed reliance on online resources (60.4%) and pediatricians (54.7%) for sleep information, with 73.9% (539 participants) expressing interest in further education on sleep hygiene. CONCLUSIONS: This study highlights parental awareness of sleep hygiene practices in Saudi Arabia but underscores gaps in knowledge regarding caffeine effects and optimal napping practices. Tailored educational interventions are essential to enhance parental understanding and promote healthier sleep habits, thereby optimizing child well-being in the region.
RESUMEN
BACKGROUND/AIMS: Quantitative serum hepatitis B surface antigen (qHBsAg) has been evaluated in limited patient groups as a marker of histological fibrosis. The accurate identification of inactive chronic hepatitis B virus (HBV) carriers from those with active carriers is difficult because of wide and frequent HBV DNA fluctuations. We aimed to assess the utility of qHBsAg in distinguishing histologically significant fibrosis in untreated HBeAg-negative chronic HBV patients. PATIENTS AND METHODS: qHBsAg levels were measured at baseline as single-point quantification and correlated with virologic and biochemical profiles of consecutive carriers (median, 29; range, 12-110 months). HBeAg-negative patients (n = 75) with HBV DNA <2000 (n = 5), 2000-20,000 (n = 16) and >20,000 IU/mL (n = 54) were included and all had liver biopsy. A qHBsAg cutoff point of 1000 IU/mL was assessed to demonstrate whether it better delineated patients with non-significant histology (F0-1, inflammatory grade A0-1). RESULTS: Mean age of the patients was 39.4 ± 11.4 years and 58 (77.3%) were male. Patients with qHBsAg levels >1000 IU/mL were more likely to be males (84.5%, P = 0.006) or with elevated AST (68.4%, P = 0.0002) and ALT levels (72.4%, P < 0.0001), higher HBV DNA (log10 6.4 ± 1.4, P < 0.0001) and those with F2-4 fibrosis (48.3%, P = 0.028). Serum log10 qHBsAg were significantly lower in patients with HBV DNA <2000 (2.80 ± 1.47) and HBV DNA 2000-20,000 (2.71 ± 0.83) vs. >20,000 IU/mL (3.89 ± 0.61, P < 0.0001). Overall, qHBsAg were not different in patients with F0-1 (3.44 ± 0.91) and F2-4 fibrosis (3.74 ± 0.85, P = 0.161). Serum qHBsAg were higher in patients with significant (A2-3) inflammation (3.85 ± 0.72) compared to A0-1 (3.38 ± 0.95; P = 0.018). Serum qHBsAg demonstrated poor accuracy (AUROC, 0.61, P = 0.111) in identification of F2-4 fibrosis. CONCLUSION: Serum qHBsAg levels do not help differentiate between those with HBV DNA <2000 or 2000 - 20,000 IU/mL or distinguish patients with significant fibrosis. Moreover, more than half of the patients with non-significant fibrosis have a qHBsAg level greater than 1000 IU/mL.