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Jakobsson M. "I'm not sure if it works": School nurses' experiences of sleep-promoting work in Sweden. Sleep Health 2024; 10:272-278. [PMID: 38245476 DOI: 10.1016/j.sleh.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVES Lack of sleep is a common problem in children and adolescents of school age (students), and it is a health aspect that affects the ability to assimilate into the school's education and thereby falls within the school nurses promoting work. This study aimed to describe school nurses' experiences of sleep-promoting work. METHOD Data were collected by n = 61 school nurses' written narratives of their sleep-promotion work. Data were analyzed using qualitative content analysis. RESULTS The results describe school nurses' experiences of sleep-promoting work in three main categories: (1) Informing and providing knowledge is the primary task. School nurses do it systematically, through dialogs with an individual student, with several students simultaneously, or with parents. (2) Benefits take place when the needs of the student guide the work. Through curiosity about the personal story, the keys to sleep-promoting work can be found, appropriate strategies can be given, and the student can be guided further if needed. (3) Barriers challenge the outcome of the work. The school nurses experience these barriers in the form of unmotivated students, unsupportive parents, and lack of prerequisites, which make the school nurses unsure of their performance. CONCLUSIONS School nurses experience a significant benefit in their sleep-promoting work when the needs of the student guide the sleep-promoting information, strategies, and follow-ups. To avoid feeling insecure in sleep-promoting work, school nurses need updates on the state of knowledge and evidence-based tools. Further research on sleep-promoting work at school is necessary.
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Affiliation(s)
- Malin Jakobsson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden; CHILD-Research Group, Jönköping University, Jönköping, Sweden.
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Larsson I, Svedberg P, Nygren JM, Malmborg JS. Validity and reliability of the Swedish version of the Children's Sleep Habits Questionnaire (CSHQ-SWE). BMC Pediatr 2024; 24:378. [PMID: 38822278 PMCID: PMC11140946 DOI: 10.1186/s12887-024-04859-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND To translate and culturally adapt the Children's Sleep Habits Questionnaire (CSHQ) to a Swedish version, CSHQ-SWE, and to assess its validity and reliability for use with children with attention deficit hyperactivity disorder (ADHD). METHODS A total of 84 children with ADHD (51 boys and 33 girls; 6-12 years) and parents (7 men and 77 women; 28-51 years) were included in the study. CSHQ was translated and culturally adapted to Swedish, and assessed for concurrent validity with sleep actigraphy (analyzed by Kendall's Tau) and for reliability by internal consistency (analyzed by McDonald's Omega H). Face and content validity was evaluated by parents (n = 4) and healthcare professionals (n = 6) qualitatively (comprehensiveness, relevance, and comprehensibility assessed by interviews and analyzed by thematic analysis) and quantitatively (analyzed by content validity ratio and content validity index for 33 items and four non-scored inquiries). RESULTS Parent-reported sleep problems (CSHQ-SWE total score) were moderately correlated with less "Sleep Efficiency" (Tau = -0.305; p < 0.001) measured by sleep actigraphy. Parent-reported problems with "Sleep Onset Delay" was moderately correlated with measured time for "Sleep Onset Latency" (Tau = 0.433; p < 0.001). Parent-reported problems with "Night Wakings" were weakly correlated with measured time for "Wake After Sleep Onset" (Tau = 0.282; p < 0.001). Parents estimation of "Total daily sleep duration" was moderately correlated with measured "Total Sleep Time" (Tau = 0.386; p < 0.001). Five of the seven subscales reached an acceptable level for internal consistency (McDonald's Omega H > 0.700). Comprehensiveness, relevance, and comprehensibility of CSHQ-SWE were satisfactory overall. Content validity ratio was 0.80 to 1.00 for six items, 0.00 to 0.60 for 22 items, and < 0.00 for nine items. Content validity index was 0.22. CONCLUSIONS CSHQ-SWE demonstrated acceptable concurrent validity with objectively measured sleep and internal consistency, whereas the overall results of face and content validity assessment varied. The instrument needs to be further evaluated regarding construct validity, responsiveness, test-retest reliability, and its generalization to other populations.
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Affiliation(s)
- Ingrid Larsson
- School of Health and Welfare, Halmstad University, Box 823, Halmstad, SE-301 18, Sweden
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Box 823, Halmstad, SE-301 18, Sweden
| | - Jens M Nygren
- School of Health and Welfare, Halmstad University, Box 823, Halmstad, SE-301 18, Sweden
| | - Julia S Malmborg
- School of Health and Welfare, Halmstad University, Box 823, Halmstad, SE-301 18, Sweden.
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Sancho-Domingo C, Garmy P, Norell A. Nighttime Texting on Social Media, Sleep Parameters, and Adolescent Sadness: A Mediation Analysis. Behav Sleep Med 2024:1-11. [PMID: 38781096 DOI: 10.1080/15402002.2024.2314281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVES The use of social media during bedtime has increased in the past years among adolescents, contributing to disturbed sleep quality, which could potentially be related to emotional problems. This study aimed to analyze the mediation effects of sleep parameters on the relationship between NightTime Texting (NTT) on social media and adolescent sadness. METHODS We used a cross-sectional study and evaluated a total of 1464 Swedish students aged 15-17 (55.7% girls) to examine their frequency of NTT on social media, sleep parameters, and adolescent sadness. Bivariate and mediation analyses were performed. RESULTS Approximately 60% (n = 882) of adolescents engaged in nighttime instant messaging, with 37% (n = 330) reporting texting every night. Higher frequency of NTT was significantly associated with later bedtimes (η2 > 0.12), extended weekend wake-up times (η2 = 0.07), increased social jetlag (η2 = 0.07), and reduced sleep duration on schooldays (η2 = 0.10). Multicategorical parallel mediation analyses revealed that sleep duration on schooldays had an indirect effect on the relationship between both Occasional NTT (a11b1 = 0.05, p < .05) and Daily NTT (a21b1 = 0.12, p < .05) with sadness. Mediation effects were not moderated by gender (p > .05), however, the association between Occasional NTT and higher sadness was significantly linked to boys (t = 2.72; p = .007). CONCLUSIONS Findings showed a large percentage of adolescents engaging in nighttime social media use with worse quality of sleep, and underlined sleep duration on schooldays as a mediator associated with emotional problems in adolescents. These insights can aid in developing strategies for healthier habits to address the misuse of social media and prevent related health problems.
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Affiliation(s)
- Clara Sancho-Domingo
- Center of Applied Psychology, Miguel Hernández University, Elche, Spain
- School of Behavioral, Social and Legal Sciences, Örebro University, Örebro, Sweden
| | - Pernilla Garmy
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Clinical Health Promotion Centre, WHO-CC, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Annika Norell
- School of Behavioral, Social and Legal Sciences, Örebro University, Örebro, Sweden
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Bruni O, Angriman M, Miano S, DelRosso LM, Spruyt K, Mogavero MP, Ferri R. Individualized approaches to pediatric chronic insomnia: Advancing precision medicine in sleep disorders. Sleep Med Rev 2024; 76:101946. [PMID: 38735089 DOI: 10.1016/j.smrv.2024.101946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/25/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
The manifestations of chronic insomnia undergo age-related changes. In younger infants and children, behavioral insomnia emerges as the most prevalent form and typically responds to behavioral interventions. However, distinct clusters of clinical presentations suggest the presence of various phenotypes, potentially implicating the primary involvement of specific neurotransmitters. These conceptualizations, coupled with genetic studies on pleiotropy and polygenicity, may aid in identifying individuals at risk of persistent insomnia into adulthood and shed light on novel treatment options. In school-age children, the predominant presentation is sleep-onset insomnia, often linked with nighttime fears, anxiety symptoms, poor sleep hygiene, limit-setting issues, and inadequate sleep duration. The manifestations of insomnia in adolescence correlate with the profound changes occurring in sleep architecture, circadian rhythms, and homeostatic processes. The primary symptoms during adolescence include delayed sleep onset, sleep misperception, persistent negative thoughts about sleep, and physiological hyperarousal-paralleling features observed in adult insomnia. An approach centered on distinct presentations may provide a framework for precision-based treatment options. Enhanced comprehension of insomnia's manifestations across diverse developmental stages can facilitate accurate assessment. Efforts to subtype insomnia in childhood align with this objective, potentially guiding the selection of appropriate treatments tailored to individual neurobiological, clinical, and familial features.
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Affiliation(s)
- Oliviero Bruni
- Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
| | - Marco Angriman
- Child Neurology and Neurorehabilitation Unit, Bolzano Hospital, Via Guncina 54, 39100, Bolzano, Italy
| | - Silvia Miano
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Via Tesserete 46, 6900, Lugano, Switzerland
| | - Lourdes M DelRosso
- University of California San Francisco, Fresno, 2625 E. Divisadero St. Fresno, CA, 93721, USA
| | - Karen Spruyt
- Université de Paris, NeuroDiderot Inserm, Academic Hospital Robert Debré Ap-Hp in the Building Bingen, 48 Bd Sérurier, 75019, Paris, France
| | - Maria P Mogavero
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Via C. Ruggero 73, 94018, Troina, Italy
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Anne-Laure HS, Maxime M, Denise BM, Nathalie B, Cindy S. Determining adolescent health information needs: A survey in Geneva, 2022. Prev Med Rep 2024; 41:102682. [PMID: 38524270 PMCID: PMC10959694 DOI: 10.1016/j.pmedr.2024.102682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose When adolescents feel that their opinions are valued and respected, they are more likely to seek and use health services. Our aim was to identify what health information adolescents in Geneva, Switzerland, want and how much they are willing to participate in health promotion, linking it to international recommendations. Method Data were collected from 970 adolescents (aged 12-15 years), between September and November 2022, using a classroom-based survey. Results Adolescents expressed their preferences: the study showed that the topics of sleep, self-perception, biology, mental health, and physical activity received the highest interest. Girls were more interested than boys in the issues of sleep, mental health, violence, and social life. Adolescents' increasing interest in sexuality issues as they get older is inversely proportional to their interest in other issues such as pandemics, medical research, and the environment, which they are more interested in during early adolescence. Everyone over two felt it was important to promote health in their social environment. And more than a third of teens are open to participating in such activities. Discussion Adolescents are open to various health subjects, except for pandemics. Age dependent interest highlights the importance of tailoring intervention programs. Adolescents consider health promotion important and are willing to participate, as recommended by the World Health Organization. By involving them as experts in their adolescence, we have taken an essential step. We strongly recommend continuing involving and trusting adolescents in shaping future interventions.
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Affiliation(s)
| | - Morsa Maxime
- Psychology Department, Adaptation, Resilience & Changement Unit of Research, University of Liège, Belgium
- Sorbonne North Paris University (LEPS) – Bobigny Campus, Paris, France
| | - Baratti-Mayer Denise
- Service de Santé de l'Enfance et de la Jeunesse (SSEJ), Département de Instruction Publique, de la formation et de la jeunesse (DIP), Geneva, Switzerland
| | - Bonvin Nathalie
- Service de Santé de l'Enfance et de la Jeunesse (SSEJ), Département de Instruction Publique, de la formation et de la jeunesse (DIP), Geneva, Switzerland
| | - Soroken Cindy
- Division of General Pediatrics, Department of Maternity, Adolescent and Child Health, Geneva University Hospitals (HUG), Geneva, Switzerland
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Martínez-Gómez J, Fernández-Alvira JM, de Cos-Gandoy A, Bodega P, de Miguel M, Tresserra-Rimbau A, Laveriano-Santos EP, Carral V, Carvajal I, Estruch R, Lamuela-Raventós RM, Santos-Beneit G, Fuster V, Fernández-Jiménez R. Sleep duration and its association with adiposity markers in adolescence: a cross-sectional and longitudinal study. Eur J Prev Cardiol 2023; 30:1236-1244. [PMID: 37140006 DOI: 10.1093/eurjpc/zwad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
AIMS Large studies linking adolescents' objectively measured sleep duration and adiposity markers are lacking. We characterized sleep duration and its cross-sectional and longitudinal associations with adiposity markers in adolescence. METHODS AND RESULTS Seven-day accelerometry was performed in a cohort of adolescents enrolled in the SI! Program for Secondary Schools trial in Spain at approximately ages 12 (1216 adolescents, 49.6% girls), 14 (1026 adolescents, 51.3% girls), and 16 (872 adolescents, 51.7% girls) years. Participants were classified as very short sleepers (VSS; <7 h), short sleepers (SS; 7-<8 h), or recommended-time sleepers (RTS; 8-10 h). Adjusted associations between sleep duration and adiposity markers were analysed using generalized linear and Poisson models. At ∼12 years, 33.7% of adolescents met sleep recommendations, and this percentage decreased with advancing age (22.6% at ∼14 and 18.7% at ∼16 years). Compared with RTS, overweight/obesity prevalence ratios at ∼12, 14, and 16 years among SS were 1.19 [95% confidence interval (CI): 1.09-1.30], 1.41 (95% CI: 1.34-1.48), and 0.99 (95% CI: 0.77-1.26) and among VSS were 1.30 (95% CI: 1.28-1.32), 1.93 (95% CI: 1.41-2.64), and 1.32 (95% CI: 1.26-1.37). Compared with adolescents who always met sleep recommendations, the prevalence of overweight/obesity was ∼5 times higher in those never meeting recommendations or meeting them only once. Similar trends were observed for the waist-to-height ratio (P = 0.010) and fat mass index (P = 0.024). CONCLUSION Most adolescents did not meet sleep recommendations. Shorter sleep duration was independently associated with unfavourable adiposity markers, and such adverse impact was cumulative. Health promotion programmes should emphasize the importance of good sleep habits.
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Affiliation(s)
- Jesús Martínez-Gómez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 3 Melchor Fernández Almagro, Madrid 28029, Spain
| | | | - Amaya de Cos-Gandoy
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 3 Melchor Fernández Almagro, Madrid 28029, Spain
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Patricia Bodega
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 3 Melchor Fernández Almagro, Madrid 28029, Spain
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Mercedes de Miguel
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 3 Melchor Fernández Almagro, Madrid 28029, Spain
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Anna Tresserra-Rimbau
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l'Alimentació, XIA, INSA, Universitat de Barcelona, Barcelona, Spain
| | - Emily P Laveriano-Santos
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l'Alimentació, XIA, INSA, Universitat de Barcelona, Barcelona, Spain
| | - Vanesa Carral
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Isabel Carvajal
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Ramón Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rosa María Lamuela-Raventós
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l'Alimentació, XIA, INSA, Universitat de Barcelona, Barcelona, Spain
| | - Gloria Santos-Beneit
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 3 Melchor Fernández Almagro, Madrid 28029, Spain
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Rodrigo Fernández-Jiménez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 3 Melchor Fernández Almagro, Madrid 28029, Spain
- Department of Cardiology, Hospital Universitario Clínico San Carlos, s/n Profesor Martín Lagos, Madrid 28040, Spain
- Centro de Investigación Biomédica en Red en Enfermedades CardioVasculares (CIBERCV), 3-5 Monforte de Lemos (Pabellón 11), Madrid 28029, Spain
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Malmborg JS, Roswall J, Almquist-Tangen G, Dahlgren J, Alm B, Bergman S. Associations between pain, health, and lifestyle factors in 10-year-old boys and girls from a Swedish birth cohort. BMC Pediatr 2023; 23:328. [PMID: 37386396 PMCID: PMC10308737 DOI: 10.1186/s12887-023-04139-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/19/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Pain is common in children and its associations with various biopsychosocial factors is complex. Comprehensive pain assessments could contribute to a better understanding of pediatric pain, but these assessments are scarce in literature. The aim of this study was to examine differences in pain prevalence and pain patterns in 10-year-old boys and girls from a Swedish birth cohort and to study associations between pain, health-related quality of life and various lifestyle factors stratified by sex. METHODS 866 children (426 boys and 440 girls) and their parents from the "Halland Health and Growth Study" participated in this cross-sectional study. Children were categorized into two pain groups, "infrequent pain" (never-monthly pain) or "frequent pain" (weekly-almost daily pain), based on a pain mannequin. Univariate logistic regression analyses, stratified by sex, were performed to study associations between frequent pain and children's self-reports of disease and disability and health-related quality of life (Kidscreen-27, five domains), and parents' reports of their child's sleep (quality and duration), physical activity time, sedentary time, and participation in organized physical activities. RESULTS The prevalence of frequent pain was 36.5% with no difference between boys and girls (p = 0.442). Boys with a longstanding disease or disability had higher odds of being in the frequent pain group (OR 2.167, 95% CI 1.168-4.020). Higher scores on health-related quality of life in all five domains for girls, and in two domains for boys, was associated with lower odds of being categorized into the frequent pain group. Frequent pain was associated with poor sleep quality (boys OR 2.533, 95% CI 1.243-5.162; girls OR 2.803, 95% CI 1.276-6.158) and more sedentary time (boys weekends OR 1.131, 95% CI 1.022-1.253; girls weekdays OR 1.137, 95% CI 1.032-1.253), but not with physical activity. CONCLUSIONS The high prevalence of frequent pain needs to be acknowledged and treated by school health-care services and the healthcare sector in order to prevent pain from influencing health and lifestyle factors negatively in children.
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Affiliation(s)
- Julia S. Malmborg
- School of Health and Welfare, Halmstad University, Box 823, SE-301 18 Halmstad, Sweden
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74 Halmstad, Sweden
| | - Josefine Roswall
- Department of Pediatrics, The Sahlgrenska Academy, University of Gothenburg, SE-416 85 Gothenburg, Sweden
- Department of Pediatrics, Halland Hospital, SE-301 85 Halmstad, Sweden
| | - Gerd Almquist-Tangen
- Department of Pediatrics, The Sahlgrenska Academy, University of Gothenburg, SE-416 85 Gothenburg, Sweden
- Child Health Care Unit, Region Halland, SE-301 80 Halmstad, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, The Sahlgrenska Academy, University of Gothenburg, SE-416 85 Gothenburg, Sweden
| | - Bernt Alm
- Department of Pediatrics, The Sahlgrenska Academy, University of Gothenburg, SE-416 85 Gothenburg, Sweden
| | - Stefan Bergman
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74 Halmstad, Sweden
- Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 454, SE-405 30 Gothenburg, Sweden
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The Effect of Learning Burnout on Sleep Quality in Primary School Students: The Mediating Role of Mental Health. Healthcare (Basel) 2022; 10:healthcare10102076. [PMID: 36292523 PMCID: PMC9602333 DOI: 10.3390/healthcare10102076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022] Open
Abstract
Due to the growth of research on sleep, mental health, and learning burnout on healthy growth and its related public health significance of adolescents, this study aimed to provide a deeper understanding of the effect of mental health and learning burnout on sleep among primary school students. The sleep quality (subjective sleep quality, sleep time, sleep latency, sleep duration, sleep efficiency, sleep disturbance, and daytime dysfunction), mental health, and learning burnout (exhaustion, learning cynicism, and reduced efficacy) of 900 students of grades 3–6 in primary schools were assessed in 2020. The PSQI scores of participants were 4.19 ± 2.545, of which a number of 322 (39.03%) students had sleep disturbance (PSQI scores ≧ 5). Binary logistic regression analysis showed that screen time (OR = 1.518, 95% CI: 1.164–1.980), ranking status (OR = 0.659, 95% CI: 0.480–0.907), learning burnout (OR = 1.088, 95% CI: 1.067–1.108), and mental health (OR = 4.672, 95% CI: 1.954–11.173) were the influencing factors for sleep quality of grade 3–6 students. According to the mediation effect analyses, mental health played a mediating effect (58.73% of the total effect) on the relationship between learning burnout and sleep quality. In conclusion, primary school students in Hunan of China have prominent sleep problems, and the daytime dysfunction caused by sleep problems is the most serious. Learning burnout positively predicted poorer sleep quality, and mental health played a mediating effect on the relationship between learning burnout and sleep quality.
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Ali RA. Changes in sleeping habits during the pubertal years; A descriptive study conducted in Jordan. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-e2206030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
There is limited information about changes in sleeping habits during the pubertal years of development among adolescents in Jordan.
Objective:
This study examined sleeping habits at the onset and end of puberty.
Methods:
This study utilized data from a nationwide survey in Jordan.
Participants: Sleeping habits were obtained from 3,661 adolescents aged 11(onset of puberty) and 15 years (end of puberty) and their mothers using a self-reported questionnaire. The number of hours slept and bedtimes and wake-up times on both school and non-school days were examined.
Results:
On school days, 60% of 11-year-old and 34% of 15-year-old adolescents slept between 8:00-10:00 pm. On school days, the 11-year-old adolescent group reported sleeping significantly longer than the 15-year-old adolescent group, and the proportions of adolescents who met the minimal recommended sleeping hours were 64% and 54%, respectively. Sleeping hours were long for both groups attending government schools; for the 15-year-old adolescent group, sleeping hours varied with family income and maternal education. In the case of both groups, on non-school days sleeping hours varied with gender, family income, and type of school.
Conclusion:
At the end of pubertal years, adolescent sleeping habits differ significantly from those of adolescents at the onset of puberty. On school days, insufficient sleep is much evident in the case of both 11 and 15-year-old adolescent groups, but more pronounced in the latter. Nursing initiatives to address poor sleeping habits among adolescents are warranted, given their efficacy in promoting healthy growth and development within this age group.
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Time Spent on Daily Activities and Its Association with Life Satisfaction among Czech Adolescents from 1992 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159422. [PMID: 35954778 PMCID: PMC9367733 DOI: 10.3390/ijerph19159422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/15/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Life satisfaction, an important precursor of adolescents’ well-being, is linked to daily activities. Substantial changes have been noted in adolescents’ daily activities over the years, raising the question of possible consequences for life satisfaction. This study aimed to explore changes in adolescents’ life satisfaction and their time spent on daily activities (sleeping, engaging in sports, online gaming, school commuting, time spent at school) and further investigate the associations between adolescents’ life satisfaction and these daily activities. The sample comprised 2715 adolescents from birth cohorts surveyed at four time points between 1992 and 2019. Participants were administered the Daily Activities Inventory and the Berne Questionnaire on Adolescents’ Well-Being. Robust ANOVA with post hoc tests and spline regression were employed. We found cohort differences in sleep duration (8.6 h a day on average in 1992 and 7.5 in 2019). Sleep duration of 8 h and 1 h of sports activities had a beneficial effect on life satisfaction, while more than 1 h of online gaming had a negative impact. Neither school attendance nor commuting to school was associated with adolescents’ life satisfaction. The results of this study can inform public-health policies to promote sleeping and sports habits in adolescence.
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Hedin G, Norell-Clarke A, Tønnesen H, Westergren A, Garmy P. Contributory Factors for Teen Insomnia Symptoms: A Prospective Cohort Study in Sweden. Front Neurosci 2022; 16:904974. [PMID: 35837125 PMCID: PMC9275817 DOI: 10.3389/fnins.2022.904974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Insufficient sleep is a public health problem that impacts the mental and physical health of children and adolescents. Complaints of insomnia are particularly pervasive among adolescents. This longitudinal study investigates factors that contribute to teen insomnia symptoms. Design Five-year prospective follow-up study. Setting School-based. Participants A total of 522 children (49.8% girls) aged 9.4 ± 1.3 years at baseline; 14.4 ± 0.7 years at follow-up. Measurements The dependent variable of insomnia symptoms at follow-up was assessed with the Minimal Insomnia Symptom Scale-Revised. The independent variables at baseline were the perceived family financial situation, tiredness at school, problems waking up, short sleep duration, sleeping difficulties, having a bedroom Television (TV), and time spent with a TV/computer. Multivariate binary logistic regression analyses were used to examine whether the independent variables at baseline predicted insomnia symptoms at follow-up. Results Perceived quite bad/very bad family financial situation (OR 3.1; CI 1.4–6.7) and short sleep duration (<10 h) (OR 2.3; CI 1.0–5.3) among girls at baseline were associated with insomnia symptoms at follow-up. Having problems waking up among boys at baseline was associated with insomnia symptoms at follow-up (OR 4.9; CI 1.6–14.4). Conclusion Short sleep duration, problems waking up, and perceived bad family financial situation during childhood were linked with adolescent insomnia symptoms. The sex-based differences in these associations warrant further investigation to effectively mitigate adolescent insomnia.
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Affiliation(s)
- Gita Hedin
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Clinical Health Promotion Centre, WHO-Collaborating Centre, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- *Correspondence: Gita Hedin,
| | - Annika Norell-Clarke
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Hanne Tønnesen
- Clinical Health Promotion Centre, WHO-Collaborating Centre, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Albert Westergren
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Pernilla Garmy
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Clinical Health Promotion Centre, WHO-Collaborating Centre, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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12
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Hyndman KA, Crossman DK. Kidney cell type-specific changes in the chromatin and transcriptome landscapes following epithelial Hdac1 and Hdac2 knockdown. Physiol Genomics 2022; 54:45-57. [PMID: 34890513 PMCID: PMC8791845 DOI: 10.1152/physiolgenomics.00102.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/21/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023] Open
Abstract
Recent studies have identified at least 20 different kidney cell types based upon chromatin structure and gene expression. Histone deacetylases (HDACs) are epigenetic transcriptional repressors via deacetylation of histone lysines resulting in inaccessible chromatin. We reported that kidney epithelial HDAC1 and HDAC2 activity is critical for maintaining a healthy kidney and preventing fluid-electrolyte abnormalities. However, to what extent does Hdac1/Hdac2 knockdown affect chromatin structure and subsequent transcript expression in the kidney? To answer this question, we used single nucleus assay for transposase-accessible chromatin-sequencing (snATAC-seq) and snRNA-seq to profile kidney nuclei from male and female, control, and littermate kidney epithelial Hdac1/Hdac2 knockdown mice. Hdac1/Hdac2 knockdown resulted in significant changes in the chromatin structure predominantly within the promoter region of gene loci involved in fluid-electrolyte balance such as the aquaporins, with both increased and decreased accessibility captured. Moreover, Hdac1/Hdac2 knockdown resulted different gene loci being accessible with a corresponding increased transcript number in the kidney, but among all mice only 24%-30% of chromatin accessibility agreed with transcript expression (e.g., open chromatin and increased transcript). To conclude, although chromatin structure does affect transcription, ∼70% of the differentially expressed genes cannot be explained by changes in chromatin accessibility and HDAC1/HDAC2 had a minimal effect on these global patterns. Yet, the genes that are targets of HDAC1 and HDAC2 are critically important for maintaining kidney function.
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Affiliation(s)
- Kelly A Hyndman
- Section of Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - David K Crossman
- The UAB Genomics Core Facility, Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama
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13
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Nordman A, Friberg M, Forsell Y. Is There a Dose-Response Relationship between Acute Physical Activity and Sleep Length? A Longitudinal Study with Children and Adolescents Living in Sweden. CHILDREN-BASEL 2021; 8:children8090808. [PMID: 34572240 PMCID: PMC8471754 DOI: 10.3390/children8090808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
A declining physical activity (PA) and sleep in children and adolescents have been observed during the previous decades. PA could benefit sleep, but the findings are mixed. The aim of the present study was to examine if there is a dose-response relationship between time spent in acute moderate and vigorous physical activity (MVPA) and sleep length in children and adolescents. Additional aims were to examine if the sleep length is higher for children and adolescents who conduct at least an average of 60 min in MVPA/day and to study differences between sex and school years. The study population consists of 262 participants in school year 5 (aged 11 years), 7 (aged 13 years), and 9 (aged 15 years). Accelerometers measured MVPA while sleep diaries measured sleep length. A linear and longitudinal mixed effect linear regression was conducted to study the primary aim. The secondary aims were studied with linear regressions. Included confounders were sex, school year, school stress, screen time, menstruation onset, family household economy, and health status. A stratified regression for sex and school year was conducted. The linear regression showed no statistically significant findings in the crude or adjusted model. The stratified linear regression found a significant positive association for girls but a negative association for school year 5. No associations were found in the longitudinal regression or when comparing sleep length for participants that did and did not spend an average of at least 60 min in MVPA/day. A dose-response relationship was found in the stratified linear regression, implying a possible weak association. The statistically non-significant differences between participants that did and did not spend an average of at least 60 min in MVPA/day implies that spending an average of at least 60 min in MVPA/day may not be associated with a higher mean sleep length.
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Affiliation(s)
- Alexandra Nordman
- Department of Global Public Health, Karolinska Institutet, 17177 Solna, Sweden;
| | - Marita Friberg
- Department of Living Conditions and Lifestyles, Public Health Agency of Sweden, 17165 Solna, Sweden;
| | - Yvonne Forsell
- Department of Global Public Health, Karolinska Institutet, 17177 Solna, Sweden;
- Correspondence: ; Tel.: +46-709-460-991
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14
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How do children and adolescents of separated parents sleep? An investigation of custody arrangements, sleep habits, sleep problems, and sleep duration in Sweden. Sleep Health 2021; 7:716-722. [PMID: 34413000 DOI: 10.1016/j.sleh.2021.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 06/07/2021] [Accepted: 06/23/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES An increasing number of children and adolescents divide their time between their separated parents' homes. Although marital conflict is disadvantageous for children's sleep, little is known about how children of separated parents sleep. The objective was to investigate the association between children's custody arrangements and sleep habits and sleep initiation difficulties. DESIGN Cross sectional nationally representative samples of adolescents from the WHO study Health Behaviour in School-aged Children (HBSC) (n = 11,802). SETTING Sweden in 2013/2014 and 2017/2018. PARTICIPANTS Adolescents in grades 5, 7, and 9 from Swedish compulsory comprehensive school. MEASUREMENTS The survey included questions on sleep behaviors including bedtime, wake-up time and frequency of sleep onset problems. The analysis methods used were ordinary least squares and logistic regression. RESULTS The results show differences by custody arrangement, but they are not uniform across the dependent variables. Children and adolescents in sole maternal custody were less likely to sleep as much as recommended (P < .001), more likely to have late bedtimes (P < .001), report sleep initiation difficulties (P < .01) and to report social jetlag between school mornings and weekends (P < .05) compared to those in 2-parent families. Shared physical custody was associated with a higher likelihood of late bedtimes (P < .05) and sleep initiation difficulties (P < .05) compared to those in 2-parent families, but not of sleeping less than recommended or reporting social jetlag. Less-than-equal sharing was generally associated with worse sleep than in 2-parent families. CONCLUSIONS As custody arrangements seem to be associated with sleep, it is important to understand the mechanisms behind the findings.
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15
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Ahnaou A, Drinkenburg WHIM. Sleep, neuronal hyperexcitability, inflammation and neurodegeneration: Does early chronic short sleep trigger and is it the key to overcoming Alzheimer's disease? Neurosci Biobehav Rev 2021; 129:157-179. [PMID: 34214513 DOI: 10.1016/j.neubiorev.2021.06.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/13/2021] [Accepted: 06/25/2021] [Indexed: 01/13/2023]
Abstract
Evidence links neuroinflammation to Alzheimer's disease (AD); however, its exact contribution to the onset and progression of the disease is poorly understood. Symptoms of AD can be seen as the tip of an iceberg, consisting of a neuropathological build-up in the brain of extracellular amyloid-β (Aβ) plaques and intraneuronal hyperphosphorylated aggregates of Tau (pTau), which are thought to stem from an imbalance between its production and clearance resulting in loss of synaptic health and dysfunctional cortical connectivity. The glymphatic drainage system, which is particularly active during sleep, plays a key role in the clearance of proteinopathies. Poor sleep can cause hyperexcitability and promote Aβ and tau pathology leading to systemic inflammation. The early neuronal hyperexcitability of γ-aminobutyric acid (GABA)-ergic inhibitory interneurons and impaired inhibitory control of cortical pyramidal neurons lie at the crossroads of excitatory/inhibitory imbalance and inflammation. We outline, with a prospective framework, a possible vicious spiral linking early chronic short sleep, neuronal hyperexcitability, inflammation and neurodegeneration. Understanding the early predictors of AD, through an integrative approach, may hold promise for reducing attrition in the late stages of neuroprotective drug development.
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Affiliation(s)
- A Ahnaou
- Dept. of Neuroscience Discovery, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse, B-2340, Belgium.
| | - W H I M Drinkenburg
- Dept. of Neuroscience Discovery, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse, B-2340, Belgium
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16
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Sundell AL, Angelhoff C. Sleep and its relation to health-related quality of life in 3-10-year-old children. BMC Public Health 2021; 21:1043. [PMID: 34078330 PMCID: PMC8173783 DOI: 10.1186/s12889-021-11038-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 05/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Considering the reports of increasing sleep problems in children, affecting health and well-being in young children and their families, we found it important to gain more knowledge about sleep and its correlation to health-related quality of life (HRQoL) in young, healthy children. The aims with this study were to describe sleep quality, sleep duration, and HRQoL in healthy 3–10-year-old children and to test associations between children’s sleep and HRQoL. Methods Parents of 160 children (average age: 6.9 years, SD ±2.2) participated in the study. Sleep onset problems (SOP), sleep maintenance problems (SMP), and sleep duration were measured by the Pediatric Insomnia Severity Index (PISI). KIDSCREEN-27 was used to measure HRQoL in five dimensions: physical well-being, psychological well-being, autonomy and parent relation, social support and peers, and school environment. Results The average score was 2.2 for SOP (SD +/− 2.2) and 1.3 for SMP (SD +/− 1.6). Few children (2%) were reported to sleep less than 8 h per night. Younger children had statistically significant higher SOP and SMP than older children. Correlations were found between SOP and poor psychological well-being (p < 0.05, ρ = − 0.16), and between SMP and poor physical wellbeing (p < 0.05, ρ = − 0.16), psychological well-being (p < 0.05, ρ = − 0.21), poor school environment (p < 0.01, ρ = − 0.29), autonomy and parent relation (p < 0.05, ρ = − 0.16), and poor social support and peers (p < 0.05, ρ = − 0.19). Conclusion Children’s sleep associates with health-related quality of life and needs to be acknowledged in child health care settings and schools.
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Affiliation(s)
- Anna Lena Sundell
- Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping, Sweden.,Centre of Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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17
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Relationships between Extra-School Tutoring Time, Somatic Symptoms, and Sleep Duration of Adolescent Students: A Panel Analysis Using Data from the Korean Children and Youth Panel Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218037. [PMID: 33142769 PMCID: PMC7663676 DOI: 10.3390/ijerph17218037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/20/2022]
Abstract
As private tutoring has expanded worldwide, it has been noted that private tutoring and associated emotional distress can affect sleep duration and the health of adolescent students. However, the relationships between extra-school tutoring time, somatic symptoms, defined as physical symptoms of emotional distress, and sleep duration in adolescents has rarely been determined. The aim of this study was to identify these relationships in adolescent students. Data from the Korean Children and Youth Panel Survey were analyzed to address the research questions. Weekday sleep duration, extra-school tutoring time, and somatic symptoms were measured using adolescents’ self-report questionnaires. A multilevel, structural equation model was utilized to test the relationships between these variables and was deemed appropriate considering the repeated measure of the panel data. After controlling for respondent sex, parent working status and education level, and family structure, adolescents’ extra-school tutoring time and level of somatic symptoms were associated with sleep duration during weekdays. Furthermore, the association between extra-school tutoring time and sleep duration was partially mediated by somatic symptoms. Korean adolescent students slept less than the recommended duration. Intervention programs that increase parental interest and attention in adolescent students’ lives, not only focused on academic achievement but also emotional distress is needed. Researchers and policymakers should understand recommended age-appropriate sleep duration and the educational culture and provide balanced strategies between the consideration of the effect of private education on academic achievement and the need to guarantee physical and mental health in adolescent students.
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18
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Dance intervention for adolescent girls: Effects on daytime tiredness, alertness and school satisfaction. A randomized controlled trial. J Bodyw Mov Ther 2020; 26:505-514. [PMID: 33992289 DOI: 10.1016/j.jbmt.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 08/14/2020] [Accepted: 09/12/2020] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Daytime tiredness is a risk factor for poor health and well-being in the short and long term and is often associated with sleep problems, stress-related mental health complaints and decreased school functioning. This study investigates the effect of an 8 month dance intervention study on daytime tiredness, alertness, sleep duration, sleep quality and school satisfaction. METHODS Randomized controlled intervention study that included a total of 112 girls aged 13-18 years old with stress-related somatic and mental health problems. Dance intervention with focus on enjoyment were performed semiweekly for 8 months. Questionnaire-based measurements regarding self-reported daytime tiredness, alertness, school satisfaction, sleep duration and quality were evaluated at baseline and at 8-, 12- and 20- month follow-ups. RESULTS Daytime tiredness decreased significantly in the dance group compared to control group at all follow-ups. Alertness increased significant within the dance group, but there were no significant difference compared to the controls. Significant improvements were found in all sleep quality items within the dance group, between groups only one significant result was found. No conclusive changes in sleep duration were observed. School satisfaction increased significantly in the dance intervention group; however, its significance compared to that of the control group faded after adjustment for differences between groups at baseline. CONCLUSIONS This study suggests that a dance intervention focusing on enjoyment can be effective in decreasing daytime tiredness. This study also adds to the growing body of evidence for the benefits of using nonpharmacological interventions to decrease stress-related problems among adolescents.
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19
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Impact of sleep disturbances on neurodegeneration: Insight from studies in animal models. Neurobiol Dis 2020; 139:104820. [PMID: 32087293 PMCID: PMC7593848 DOI: 10.1016/j.nbd.2020.104820] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/31/2020] [Accepted: 02/18/2020] [Indexed: 01/18/2023] Open
Abstract
Chronic short sleep or extended wake periods are commonly observed in most industrialized countries. Previously neurobehavioral impairment following sleep loss was considered to be a readily reversible occurrence, normalized upon recovery sleep. Recent clinical studies suggest that chronic short sleep and sleep disruption may be risk factors for neurodegeneration. Animal models have been instrumental in determining whether disturbed sleep can injure the brain. We now understand that repeated periods of extended wakefulness across the typical sleep period and/or sleep fragmentation can have lasting effects on neurogenesis and select populations of neurons and glia. Here we provide a comprehensive overview of the advancements made using animal models of sleep loss to understand the extent and mechanisms of chronic short sleep induced neural injury.
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20
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How Are Adolescents Sleeping? Adolescent Sleep Patterns and Sociodemographic Differences in 24 European and North American Countries. J Adolesc Health 2020; 66:S81-S88. [PMID: 32446613 DOI: 10.1016/j.jadohealth.2020.03.013] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Insufficient and poor sleep patterns are common among adolescents worldwide. Up to now, the evidence on adolescent sleep has been mostly informed by country-specific studies that used different measures and age groups, making direct comparisons difficult. Cross-national data on adolescent sleep that could inform nations and international discussions are lacking. We examined the sleep patterns of adolescents across 24 countries and by gender, age, and affluence groups. METHODS We obtained sleep data on 165,793 adolescents (mean age 13.5 years; 50.5% girls) in 24 European and North American countries from the recent cross-sectional Health Behaviour in School-aged Children surveys (2013-2014 and 2017-2018). For each country, we calculated the age-standardized mean in sleep duration, timing, and consistency and the proportions meeting sleep recommendations on school and nonschool days from self-reported bedtimes and wake times. We conducted stratified analyses by gender, age, and family affluence group. RESULTS Adolescent sleep patterns varied cross-nationally. The average sleep duration ranged between 7:47 and 9:07 hours on school days and between 9:31 and 10:22 hours on nonschool days, and the proportion of adolescents meeting sleep recommendations ranged between 32% and 86% on school days and between 79% and 92% on nonschool days. Sleep patterns by gender and affluence groups were largely similar, but older adolescents slept less and went to bed later on school days than younger adolescents in all countries. CONCLUSIONS The sleep patterns of adolescents vary across countries and sociodemographic groups. Insufficient sleep on school days is common in many countries. Public health and policy efforts to promote healthy adolescent sleep are encouraged.
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21
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Difficulties in Getting to Sleep and their Association with Emotional and Behavioural Problems in Adolescents: Does the Sleeping Duration Influence this Association? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051691. [PMID: 32150909 PMCID: PMC7084249 DOI: 10.3390/ijerph17051691] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 01/22/2023]
Abstract
Sleep problems are common in adolescence with a negative impact on the mental health and functioning of adolescents. However, the roles of different sleep problems in relation to emotional and behavioural problems (EBPs), classified according to the 10th version of the International Classification of Diseases as emotional, conduct, hyperactivity and social functioning disorders, are not clear. The first aim of the study was to investigate the association between difficulties in getting to sleep and EBPs in adolescents. The second aim was to explore the role of sleep duration in this association. We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2018 in Slovakia. Presented are results for specific age groups of 13-year-old (N = 1909) and 15-year-old (N = 1293) adolescents. Subjective measures of sleep variables were used. Binary logistic regression models adjusted for age and gender were used to assess associations between difficulties in getting to sleep, sleep duration and EBPs measured using the Strengths and Difficulties Questionnaire. Modification of the association between difficulties in getting to sleep and EBPs by sleep duration was also explored. We found that difficulties in getting to sleep at least once a week as well as insufficient sleep (less than 8 h) increased the probability of EBPs. Interactions of sleep duration with difficulties in getting to sleep on EBPs were found to be non-significant. The results suggest that caregivers and clinicians should screen and intervene for both sleep quality and quantity problems in adolescents as they might indicate and promote EBPs.
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Hedin G, Norell-Clarke A, Hagell P, Tønnesen H, Westergren A, Garmy P. Facilitators and Barriers for a Good Night's Sleep Among Adolescents. Front Neurosci 2020; 14:92. [PMID: 32116531 PMCID: PMC7019014 DOI: 10.3389/fnins.2020.00092] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/22/2020] [Indexed: 11/17/2022] Open
Abstract
Background Sleep deprivation among adolescents is a major public health issue. Although previous studies have described their sleep habits and the consequences thereof, the voices of adolescents themselves are rarely heard. The aim of this study was to investigate adolescents’ experiences regarding what they perceived as facilitators and barriers for a good night’s sleep. Methods A qualitative focus group study with Swedish adolescents (n = 45) aged 16–18 years was performed with seven focus groups and analyzed using qualitative content analysis. Results Three categories were identified in the analysis regarding facilitators and barriers for achieving a good night’s sleep: (1) Striving for a sense of well-being, (2) Tiring yourself out, and (3) Regulating electronic media availability. The adolescents thought that sleep was important in order to be able to cope with everyday life and to allow physical recovery. Overall, the adolescents were knowledgeable regarding commonly recommended strategies for improving sleep, but they had trouble finding a balance between sleep and other activities. Electronic media was used to obtain a sense of belonging and to communicate with others, which in itself was described as important for the adolescents’ well-being. However, communicating with friends and family during the night conflicted with achieving a good night’s sleep. Parental behaviors (late work habits, internet rules) were also perceived as important for adolescents’ sleep habits. Conclusions An understanding of the dilemma of finding a balance between sleep and other activities may aid future sleep-promoting interventions for adolescents, incorporating the impact from social factors’ on the adolescents’ sleep.
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Affiliation(s)
- Gita Hedin
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden.,Faculty of Medicine, Lund University, Lund, Sweden
| | - Annika Norell-Clarke
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden.,Faculty of Health and Science, Kristianstad University, Kristianstad, Sweden
| | - Peter Hagell
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden
| | | | - Albert Westergren
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden.,Faculty of Medicine, Lund University, Lund, Sweden
| | - Pernilla Garmy
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden.,Faculty of Medicine, Lund University, Lund, Sweden
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Malmborg JS, Bremander A, Olsson MC, Bergman AC, Brorsson AS, Bergman S. Worse health status, sleeping problems, and anxiety in 16-year-old students are associated with chronic musculoskeletal pain at three-year follow-up. BMC Public Health 2019; 19:1565. [PMID: 31771551 PMCID: PMC6880415 DOI: 10.1186/s12889-019-7955-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 11/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Chronic musculoskeletal pain is common in adolescents, and it has been shown that adolescents with pain may become young adults with pain. Pain often coincides with psychosomatic symptoms in adults, but little is known about longitudinal associations and predictors of pain in adolescents. The aim was to investigate chronic musculoskeletal pain and its associations with health status, sleeping problems, stress, anxiety, depression, and physical activity in 16-year-old students at baseline, and to identify risk factors using a three-year follow-up. Methods This was a longitudinal study of 256 students attending a Swedish upper secondary school. Questionnaires regarding chronic musculoskeletal pain and distribution of pain (mannequin), health status (EQ-5D-3 L), sleeping problems (Uppsala Sleep Inventory), stress symptoms (single-item question), anxiety and depression (Hospital Anxiety and Depression Scale), and physical activity (International Physical Activity Questionnaire) were issued at baseline and follow-up. Student’s t-test and chi2 test were used for descriptive statistics and logistic regression analyses were used to study associations between chronic pain and independent variables. Results Fifty-two out of 221 students at baseline (23.5%) and 39 out of 154 students at follow-up (25.3%) were categorized as having chronic musculoskeletal pain. Chronic musculoskeletal pain at follow-up was separately associated with reporting of an EQ-5D value below median (OR 4.06, 95% CI 1.83–9.01), severe sleeping problems (OR 3.63, 95% CI 1.69–7.82), and possible anxiety (OR 4.19, 95% CI 1.74–10.11) or probable anxiety (OR 3.82, 95% CI 1.17–12.48) at baseline. Similar results were found for associations between chronic musculoskeletal pain and independent variables at baseline. In multiple logistic regression analysis, chronic musculoskeletal pain at baseline was a predictor of chronic musculoskeletal pain at follow-up (OR 2.99, 95% CI 1.09–8.24, R2 = 0.240). Conclusion Chronic musculoskeletal pain at baseline was the most important predictor for reporting chronic musculoskeletal pain at the three-year follow-up, but a worse health status, severe sleeping problems, and anxiety also predicted persistence or development of chronic musculoskeletal pain over time. Interventions should be introduced early on by the school health services to promote student health.
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Affiliation(s)
- Julia S Malmborg
- The Rydberg Laboratory for Applied Sciences, Halmstad University, Box 823, SE-301 18, Halmstad, Sweden. .,Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden.
| | - Ann Bremander
- Department of Regional Health Research, University of Southern Denmark, Winsløvsparken 19.3, DK-5000, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Engelshøjgade 9A, DK-6400, Sønderborg, Denmark.,Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, SE-221 00, Lund, Sweden
| | - M Charlotte Olsson
- The Rydberg Laboratory for Applied Sciences, Halmstad University, Box 823, SE-301 18, Halmstad, Sweden
| | - Anna-Carin Bergman
- Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden
| | - A Sofia Brorsson
- Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden
| | - Stefan Bergman
- Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Box 117, SE-221 00, Lund, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 454, SE-405 30, Gothenburg, Sweden
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Holstein BE, Ammitzbøll J, Damsgaard MT, Pant SW, Pedersen TP, Skovgaard AM. Difficulties falling asleep among adolescents: Social inequality and time trends 1991-2018. J Sleep Res 2019; 29:e12941. [PMID: 31692162 DOI: 10.1111/jsr.12941] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/24/2019] [Accepted: 10/08/2019] [Indexed: 11/26/2022]
Abstract
Sleep problems in adolescence are increasingly common, and associated with adverse health and psychological outcomes. Adolescents' sleep problems may be related to the family's socioeconomic status, but studies are few and no study has examined whether social inequality in sleep problems changes as sleep problems become increasingly common. This study examined trends in difficulties falling asleep among adolescents in Denmark, whether this sleep problem was associated with socioeconomic status, and whether this association changed from 1991 to 2018. The study applied data from eight comparable surveys among 11-15 year olds in Denmark 1991-2018, the Danish arm of the international Health Behaviour in School-aged Children study, N = 30,002. The prevalence of daily difficulties falling asleep increased from 7.0% to 13.4% in 1991-2018 with higher frequencies among girls and younger adolescents. The odds ratio (95% confidence interval) for daily difficulties was 1.14 (1.05-1.24) in middle and 1.52 (1.37-1.69) in low compared with high socioeconomic status. The absolute social inequality in difficulties falling asleep was persistent in 1991-2018 whereas the relative social inequality may have decreased. The increasing prevalence and the social inequality in difficulties falling asleep among adolescents is a serious public health concern that calls for more attention and efforts.
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Affiliation(s)
- Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Janni Ammitzbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mogens Trab Damsgaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sofie Weber Pant
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Trine Pagh Pedersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Jakobsson M, Josefsson K, Högberg K. Reasons for sleeping difficulties as perceived by adolescents: a content analysis. Scand J Caring Sci 2019; 34:464-473. [PMID: 31487078 PMCID: PMC7328685 DOI: 10.1111/scs.12750] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/09/2019] [Indexed: 01/10/2023]
Abstract
Sleeping difficulties are increasingly prevalent among adolescents worldwide and have negative consequences for adolescent health and education. The aim of this study was to describe the reasons for sleeping difficulties as perceived by adolescents. Sleeping difficulties include insufficient sleep, trouble falling asleep, waking up at night or sleep that does not leave an individual rested. Data were collected in 2015 using an open‐ended question. The sample consisted of n = 475 adolescents from a city in Sweden, aged 15–16 years, with self‐assessed sleeping difficulties. The results described the reasons for the adolescents’ sleeping difficulties, at a general, thematic level, as an imbalance between requirements and preconditions, distributed to stress, technology use, poor sleep habits, existential thoughts, needs and suffering. To find a balance in their daily lives, adolescents may need support from parents, school nurses and school health services to deal with their sleeping difficulties.
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Affiliation(s)
- Malin Jakobsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Karin Josefsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Karin Högberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Cao M, Zhu Y, Sun F, Luo J, Jing J. Short sleep duration is associated with specific food intake increase among school-aged children in China: a national cross-sectional study. BMC Public Health 2019; 19:558. [PMID: 31088522 PMCID: PMC6515588 DOI: 10.1186/s12889-019-6739-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/02/2019] [Indexed: 12/22/2022] Open
Abstract
Background The relationship between sleep duration and food intake is unclear. This study aims to examine the relationship among children aged 6–17 years in China. Methods The sample consisted of 70,519 children aged 6–17 years, which were randomly selected from 7 representative areas from China, from September to November, 2013. In the structured questionnaire, children reported daily sleep hours (less than 7 h, 7–9 h and more than 9 h), weekly food intake amount (including vegetables, fruit, sugar beverages and meat), physical activity and sedentary time. The relationship of sleep duration with vegetable, sugar beverage, fruit and meat intake was evaluated by multi-nominal logistic regression and multi-variable adjusted. Results A total of 62,517 children (51.6% boys) completed the study. Short sleep duration (SSD, < 7 h) was independently associated with increased sugar beverage intake (SBI, Odd Ratio, OR: 1.29, 95% CI: 1.19–1.40) but decreased vegetable (VI, OR: 0.94, 95% CI: 0.90–0.98) & fruit intake (FI, OR: 0.94, 95% CI: 0.88–0.99). Stratified by age and gender, SSD increased SBI for boys of both young (6–12 years) & older (13–17 years) groups and older girls (ORs: 1.25, 1.25, 1.49, 95% CI: 1.08–1.44, 1.04–1.50, 1.22–1.81, respectively), but decreased VI and FI for older girls (ORs: 0.84& 0.81, 95% CI: 0.74–0.96& 0.68–0.96, respectively). Conclusions Among school-aged children in China, short sleep duration was associated with increased risks of more sugar beverage intake among those younger and boys but less vegetable & fruit intake among those older and girls. Longitudinal research is needed to clarify the causation in between.
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Affiliation(s)
- Muqing Cao
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China
| | - Yanna Zhu
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China
| | - Fan Sun
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China
| | - Jingyin Luo
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China
| | - Jin Jing
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China.
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Jakobsson M, Josefsson K, Jutengren G, Sandsjö L, Högberg K. Sleep duration and sleeping difficulties among adolescents: exploring associations with school stress, self‐perception and technology use. Scand J Caring Sci 2018; 33:197-206. [DOI: 10.1111/scs.12621] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 09/11/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Malin Jakobsson
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Karin Josefsson
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Göran Jutengren
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Leif Sandsjö
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Karin Högberg
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
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Norell-Clarke A, Hagquist C. Child and adolescent sleep duration recommendations in relation to psychological and somatic complaints based on data between 1985 and 2013 from 11 to 15 year-olds. J Adolesc 2018; 68:12-21. [PMID: 30007217 DOI: 10.1016/j.adolescence.2018.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 06/23/2018] [Accepted: 07/08/2018] [Indexed: 01/10/2023]
Abstract
PURPOSE To investigate the association between sleep duration, sleep initiation difficulties and psychological and somatic complaints. METHODS We used three cohorts of cross-sectional Swedish questionnaire data, from the Health Behaviours of School aged Children (1985/1986, 2005/2006, 2013/2014, n=>18 000, aged 11-15). Specific complaints (e.g. pain) and total complaint load were used as outcomes of sleep duration, sleep initiation difficulties and the combination of them both. RESULTS Sleeping less than recommended and sleep initiation difficulties were associated with increased odds of specific complaints and belonging to the group with the greatest complaint load. The combination of short sleep duration and sleep initiation difficulties were associated with higher odds than either sleep issue alone. No interaction effects between time and sleep variables were found regarding complaints. CONCLUSIONS The findings support recent sleep duration recommendations. Further, sleep issues warrant a broad health assessment as they indicate a high likelihood of other complaints.
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Affiliation(s)
- Annika Norell-Clarke
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, SE-651 88, Karlstad, Sweden.
| | - Curt Hagquist
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, SE-651 88, Karlstad, Sweden.
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