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Abstract

During adolescence, changes in sleep patterns due to biological and environmental factors are well documented. Later bedtimes and inadequate sleep, i.e., short and disrupted sleep patterns, insomnia and daytime sleepiness, have become increasingly common. Accumulating evidence suggests that sleep plays a crucial role in healthy adolescent development. This review systematically explores descriptive evidence, based on prospective and cross sectional investigations, indicating that inadequate sleep is associated with negative outcomes in several areas of health and functioning, including somatic and psychosocial health, school performance and risk taking behavior. Findings highlight the need for longitudinal investigations aimed at establishing the underpinnings of these associations and for developing and implementing interventions designed to achieve healthier and more balanced sleep patterns in the adolescent population.

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... Adequate sleep is pivotal to achieving optimal human growth and development and essential to the health and well-being of adolescents, affecting their physical health, academic performance, and emotional regulation [6,7]. Poor sleep is linked to physical health problems such as headaches and obesity [8,9], anxiety, depression [8,10], risky behaviors [11], and poor academic performance [8,12]. All this underscores the need to learn more about adolescent sleep. ...
... Adequate sleep is pivotal to achieving optimal human growth and development and essential to the health and well-being of adolescents, affecting their physical health, academic performance, and emotional regulation [6,7]. Poor sleep is linked to physical health problems such as headaches and obesity [8,9], anxiety, depression [8,10], risky behaviors [11], and poor academic performance [8,12]. All this underscores the need to learn more about adolescent sleep. ...
... Adequate sleep is pivotal to achieving optimal human growth and development and essential to the health and well-being of adolescents, affecting their physical health, academic performance, and emotional regulation [6,7]. Poor sleep is linked to physical health problems such as headaches and obesity [8,9], anxiety, depression [8,10], risky behaviors [11], and poor academic performance [8,12]. All this underscores the need to learn more about adolescent sleep. ...
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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.
... This is particularly evident in Asian countries, where academic performance is a top priority for families, and young people are engaged in extracurricular studies in favour of sleep [19]. Several additional factors have been associated with delayed time to bed and shorter sleep duration, including engagement in social media [20][21][22]. Adolescents are often regarded as "digital natives" because part of their daily life involves the heavy use of technology, such as mobiles, TV, online gaming and computers at schools. In recent years, studies have found evidence of the negative association between social media use and sleep quality (e.g., [23][24][25][26]). ...
... They also correlated factors such as stimulants, including coffee and electronic media, before bedtime as having a negative impact on sleep. Another study reported that shorter sleep duration was associated with lower academic achievement, increased risk-taking behaviour, and a negative impact on mental and physical health [21,34,35]. Shorter sleep duration was also associated with increased daytime sleepiness [36]. ...
... Arora et al. [38] reported similar findings, as adolescents who frequently use social network sites were more likely to lose one hour's sleep from their overall sleep duration. The current findings showed even larger sleep restrictions in these groups, which cannot be fully explained from the data collected, although findings provide further support that social media has a negative effect on adolescent sleep duration, as it is associated with a reduction in the overall sleep duration in both countries (e.g., [21]). There are a number of mechanisms that may be at play in the association between media exposure and sleep [54]. ...
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There are concerns regarding sleep deprivation among adolescents, especially with mount- ing evidence for the importance of sleep during puberty, and its effects on health and families. The present study aimed to characterise sleep in typical development (TD) adolescents in Saudi Arabia, and compare their sleep profiles to TD adolescents in the UK, to evaluate sleep patterns in adolescents in Saudi Arabia, and to examine the relationship between sleep patterns and the use of social media in both groups. Findings from the current study reported a shorter sleep duration for the Saudi Arabia group than in previous studies and the UK group, which may be attributed to the lack of sleep hygiene practised in Saudi Arabia. Multiple analysis of variance results found significant differences in daytime sleepiness (p < 0.001) and a preference for morningness/eveningness (p < 0.001) between Saudia Arabia and UK adolescents. Statistically significant negative correlations (p > 0.05) between the duration of social media usage and sleep duration were found in both the Saudi Arabia and UK adolescents, where a lower number of sleep hours was observed with a higher duration of social media use. This study fills a gap in the research of sleep in Saudi Arabia in adolescents, and offers important insights on the comparison in sleep habits between Saudi Arabia and UK adolescents.
... One of the most important pivotal factors in human health and life is sleep, which plays a direct role in learning, practice, and physical and mental health [1]. Insufficient sleep has adverse health and behavior consequences such as daytime sleepiness, feeling irritable during the day, and depressed mood [2,3]. Reduced attention, psychomotor vigilance, and increased variability in behavioral responses are the most consistent effect of sleep deprivation [4]. ...
... Generally, it has been reported that sleep and learning are two poles of dynamic interaction, which can mutually affect each other [18]. A systematic review study reported that sleep disturbance adversely affected academic performance, general health, and social status of the students [3]. Although there is a possibility of sleep disorders in dental students, there is no certainty about the relationship between poor sleep quality and the lack of academic achievement [1,19,20]. ...
... However, most of the students with high levels of dental environment stress experienced poor sleep quality. is finding was in line with findings of a previous study, which showed a significant association between stress and sleep quality among medical students [33]. Inadequate sleep may be correlated with poor perceived mental health and depression or depressive symptoms [3]. On the other hand, stress may result in many sleep difficulties, such as midsleep awakening, waking up too early, and restless sleep [34]. ...
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Background: Quality of sleep and stress level can affect the health, capacity of learning, and academic performance of the students. This study aimed to investigate the association between stress and sleep quality with academic performance among undergraduate clinical dental students in Shiraz, Iran. Methods: This cross-sectional study was conducted during the second semester of the academic year 2020-2021 among clinical dental students at Shiraz Dental School, Iran. A total of 138 students completed Pittsburgh Sleep Quality Index (PSQI) and dental environment stress (DES) questionnaire. The grade point averages (GPAs) of the previous terms of the participants were also collected. Data analysis was performed using Kolmogorov-Smirnov test, the one-way ANOVA, post hoc Duncan's test, nonparametric Kruskal-Wallis H test, Wilcoxon-Mann-Whitney test, and the chi-squared test. The p values of less than 0.05 were considered statistically significant. Results: Clinical dental students participated in this study experienced moderate levels of stress and poor sleep quality. Mean total DES and PSGI scores did not differ by sex, year of study, marital status, and place of residence (p values >0.05). Most of the students (52.9%) had moderate GPAs. A significant relationship was observed between sex and GPA as well as between place of residence and GPA (p values <0.05). No significant differences were found between DES total score or PSQI score and GPA categories (p values >0.05). A significant direct relationship between DES total score and PSQI score was observed (p < 0.05). Conclusion: Dental undergraduates in Shiraz, Iran, experienced moderate levels of stress and poor sleep quality. The results showed no significant difference between sleep quality or DES and academic achievement. However, a significant direct correlation was observed between sleep quality and dental environment stress.
... The epidemic of children's deficient sleep is pervasive and multiply-determined, with influences ranging from biological to social to psychological factors. [1][2][3][4] Approximately half of school-aged children (ages [5][6][7][8][9][10][11][12][13][14][15][16][17][18] get either insufficient sleep during school nights or barely meet the required amount of sleep expected for healthy functioning (National Sleep Foundation, 2014). 5 This percentage only increases as children develop into adolescents (National Sleep Foundation, 2006). ...
... 6 To make matters worse, the adverse consequences of deficient sleep on children's mental and physical health are extensive. 1,2,7 As the emerging literature in this area highlights, children's and adolescents' sleep environments are fundamental to their sleep health. 8,9 Despite their importance, however, there remains a noticeable absence of valid and reliable assessments of this construct. ...
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Study objectives: To develop a measure of children's sleep environments and to assess its initial reliability and validity. Methods: This cross-sectional study consisted of an online survey for parents of 5-18-year-old children across the United States. A total of 840 parents/caregivers (Mage=40.6 years, SD=8.6; 72.0% female) completed surveys regarding a target child (Mage=10.4 years, SD=3.8). The scale's items were evaluated with exploratory and confirmatory factor analyses in separate random sample halves of the dataset. Cronbach's alpha coefficients were calculated to assess internal consistency across multiple demographic groups. We explored convergent and discriminant validity by examining associations with measures from the nomological net of constructs surrounding the child sleep environment. Finally, we examined incremental/unique predictive validity of the full scale and its subscales through regression analyses. Results: The Children's and Adolescents' Sleep Environment Scale (CASES; 13 items) produced three factors: general environmental hazards (7 items), availability of bedding materials (2 items), and the presence of electronics (4 items). The full scale and its subscales demonstrated strong discriminant validity, and analyses suggested that the CASES and its subscales were generalizable across diverse demographic groups. Finally, after controlling for children's sleep hygiene, sleep disturbances, behavioral problems, and family functioning, the full-scale CASES significantly predicted children's sleepiness, as did the general environmental hazards and presence of electronics subscales in a separate regression analysis. Conclusions: The CASES demonstrates strong psychometric properties and has emerged as both a reliable and valid indicator of children's and adolescents' sleep environments and their potential impact on children's sleep and sleep-related behavior.
... Short sleep duration, insomnia symptoms, and daytime sleepiness are common among adolescents (Shochat et al., 2014). Sleep problems in childhood and adolescence increase the risk for emotional and behavioral difficulties in adulthood (Gregory and Sadeh, 2012;Shochat et al., 2014), so it is important to identify factors in childhood that are predictive of insomnia symptoms in adolescence. ...
... Short sleep duration, insomnia symptoms, and daytime sleepiness are common among adolescents (Shochat et al., 2014). Sleep problems in childhood and adolescence increase the risk for emotional and behavioral difficulties in adulthood (Gregory and Sadeh, 2012;Shochat et al., 2014), so it is important to identify factors in childhood that are predictive of insomnia symptoms in adolescence. There are factors over which adolescents have no influence but may impact their sleep, such as their sex and their family's financial situation. ...
Article
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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.
... Daytime sleepiness is defined as an increased propensity to fall asleep in settings and during times of the day in which it is inappropriate to do so (e.g., at school, while completing homework) (Owens et al., 2020). Daytime sleepiness may lead to reduced academic performance, such as receiving lower grades or being tardy to class (Shochat et al., 2014). Excessive daytime sleepiness has been found to be linked to reduced total sleep time and poorer school achievement in adolescents aged 11-to 15-years-old (Drake et al., 2003). ...
... Similarly, heightened daytime sleepiness at the beginning of treatment was significantly associated with a lower GPA, poorer organizational skills, and increased academic problems, as well as increased homework problems, following the completion of treatment across both groups of participants. These findings are in agreement with studies examining the impact of daytime sleepiness on academic functioning (Becker et al. 2019a;Dewald et al., 2010;Drake et al., 2003;Shochat et al., 2014). Adolescents with ADHD have been found to have exacerbated daytime sleepiness culminating from sleep problems due to organization difficulties postponing bedtime, eveningness chronotype and delayed circadian phase attainment, and the use of stimulant medications throughout the day (Coogan & McGowan, 2017;Langberg et al., 2017;Stein et al., 2012). ...
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Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at heightened risk of experiencing academic difficulties due to organizational deficits. Impairment can be exacerbated through poor sleep hygiene and excessive daytime sleepiness, prevalent sleep challenges for adolescents with ADHD. Given established relationships among sleep, memory consolidation, and executive functioning, sleep hygiene and daytime sleepiness may affect academic and organizational treatment outcomes. The current study examined the influence of pre-treatment daytime sleepiness and sleep hygiene on academic and organizational treatment outcomes in a randomized controlled trial of a multicomponent intervention for 171 high school students with ADHD. Participants were assigned to either the treatment group (n = 85, Mage = 15.0, SD = 0.8, 80% male, 71% White/Non-Hispanic) or the control group (n = 86, Mage = 15.1, SD = 0.9, 78% male, 87% White/Non-Hispanic). Multiple regression analyses with an interaction term were conducted, finding significant main effects for poor pre-treatment sleep hygiene and excessive daytime sleepiness predicting worse post-treatment GPA, organizational skills, academic problems, and homework problems. A significant moderation effect was found such that greater pre-treatment daytime sleepiness was associated with more post-treatment homework problems, but only for the control group. Incorporating efforts to improve sleep hygiene and daytime sleepiness in interventions for adolescents with ADHD may enhance treatment-induced improvements. Future studies should utilize objective sleep measures to gain greater understanding of sleep’s impact on adolescents’ response to psychosocial treatment.
... This clash is a major factor leading most adolescents to get less than the medically recommended 8-10 hours of sleep per night (Hirshkowitz et al., 2015). Teen sleep deprivation contributes to many adverse outcomes, including symptoms of anxiety and depression (Shochat et al., 2014), risky behaviors (Shochat et al., 2014), poor grades (Saxvig et al., 2012), and school absenteeism and tardiness (Hysing et al., 2014). Later school start times may help to alleviate many of these problems. ...
... This clash is a major factor leading most adolescents to get less than the medically recommended 8-10 hours of sleep per night (Hirshkowitz et al., 2015). Teen sleep deprivation contributes to many adverse outcomes, including symptoms of anxiety and depression (Shochat et al., 2014), risky behaviors (Shochat et al., 2014), poor grades (Saxvig et al., 2012), and school absenteeism and tardiness (Hysing et al., 2014). Later school start times may help to alleviate many of these problems. ...
Article
Background Few studies have examined the effects of later class start times in college, even though developmentally driven sleep phase changes persist into the mid-20s. Objective We hypothesized that sleepiness would be higher in an 8 a.m. versus 10 a.m. section of Introductory Psychology, and grades, engagement, enjoyment, attendance, assignment completion, ease of waking and staying awake, and student evaluations of teaching (SETs) would be lower. Method Eighty-two students enrolled in an 8 a.m. ( n = 39) or 10 a.m. ( n = 43) section of Introductory Psychology reported their GPA and completed the Stanford Sleepiness Scale, Likert-scale items from the College’s SET form, and other questions. Results Students in the 8 a.m. section reported lower GPA, class grade, and assignments completed; more sleepiness; and a harder time waking up and staying awake for class. Several findings held when controlling for GPA. Conclusion Results extend previous research and suggest the importance of offering later classes in college. Limitations include a small sample size, quasi-experimental design, and use of self-report data. Future researchers should test whether findings replicate with other kinds of classes and in other subjects. Teaching Implications To maximize student success and well-being, later courses should be offered at the college level whenever feasible.
... However, more than 75% of adolescents report falling short of that recommendation (Healthy People, 2020). This is concerning because inadequate sleep in adolescents is linked to a host of negative outcomes, including mental health difficulties (Shochat et al., 2014), obesity, chronic inflammation (Park et al., 2016), violent and criminal activity, and substance use (McGlinchey & Harvey, 2015). Lack of sleep also interferes with attentional focus and can impair adolescents' academic performance (Curcio et al., 2006;Roberts et al., 2009). ...
... Lack of sleep also interferes with attentional focus and can impair adolescents' academic performance (Curcio et al., 2006;Roberts et al., 2009). Furthermore, poor sleep habits formed during adolescence can persist into adulthood, creating a negative health spiral, with significant long-term consequences (Shochat et al., 2014). To advance current understanding of the factors associated with adolescent sleep, this study focuses on the role of parents in promoting adolescent sleep, both directly and indirectly through their effects on adolescent bedtime media use. ...
Article
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Inadequate sleep in adolescents has been linked to an increase in screen-based media use, especially at bedtime. Parents can play a critical role in regulating adolescent media use and promoting healthy sleep, yet few studies have evaluated parental effects on these outcomes. This study examined the effects of general and media-specific parenting behaviors and family conflict on adolescent sleep outcomes, both directly and indirectly through bedtime media use. Data were collected from 345 middle-schoolers (Mage = 12.65 ± 0.67 years; 47% female; 59% White) at two time points, six months apart. The findings revealed that parental involvement had a significant positive effect on sleep duration that was mediated by bedtime media use. Family conflict had a direct positive effect on daytime sleepiness. Adolescent sleep interventions could benefit from a parenting component focused on positive involvement and fostering a family climate conducive to sleep.
... Sleep problems such as insufficient sleep duration, sleep disturbance, and sleep-wake problems are associated with behavioural problems, self-harm behaviours, depressive symptoms, anxiety, and worse health-related quality of life (HRQoL) in adolescents (Bøe et al., 2012;Roeser et al., 2012;Shimizu et al., 2021;Shochat et al., 2014;Sivertsen et al., 2021;Sivertsen et al., 2015). Reversely, behavioural problems and emotional disturbance are associated with difficulties in sleep onset and maintenance (Ivanenko et al., 2005;Meijer et al., 2010), thereby indicating a potential bidirectional relationship between sleep and mental health. ...
... Sleep disturbance, internalising difficulties, and low HRQoL were more prevalent in female adolescents, in accordance with previous research (Shochat et al., 2014). However, we did not observe any gender-specific associations between sleep problems and behavioural difficulties or HRQoL. ...
Article
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Sleep problems show associations with negative outcomes in both physical and mental health in adolescents, but the associations may be reciprocal. We aimed to assess bidirectional associations between sleep problems and mental health symptoms including behavioural difficulties (internalising and externalising difficulties) and low health‐related quality of life (HRQoL). A total of 6616 adolescents (52.4% females) across Greater London completed baseline assessments when they were aged 11–12 years, and 3803 of them (57.2% females) completed follow‐up assessments at aged 13–15 years. Weekday and weekend sleep duration were derived from self‐reported bedtime, sleep onset latency and wake time. Sleep disturbance was assessed using a standardized sleep disturbance scale. Internalising and externalising difficulties were assessed using subscales of the Strength and Difficulties Questionnaire. HRQoL was assessed using the KIDSCREEN‐10 questionnaire. Cross‐lagged structural equation modelling was used with multiple imputation to examine bidirectional associations between sleep problems and mental health symptoms. Females had greater internalising difficulties, worse HRQoL and more sleep disturbance than males. Persistent insufficient weekday and weekend sleep, and sleep disturbance (i.e., at both baseline and follow‐up) were associated with internalising and externalising difficulties and low HRQoL at follow‐up (ORs ranged from 1.53 to 3.63). Persistent externalising difficulties and low HRQoL were also associated with insufficient weekend sleep and sleep disturbance at follow‐up (ORs ranged from 1.68 to 4.25). Using continuous variables, we found bidirectional associations between weekday sleep duration and HRQoL, weekend sleep duration and externalising score, sleep quality and internalising score, and sleep quality and HRQoL. The association magnitudes were mostly similar in the two directions. Our study showed bidirectional associations between sleep problems and mental health symptoms during adolescence, indicating that early intervention and treatment on the first‐occurring symptom may prevent the development of subsequent problems. We assessed bidirectional associations between sleep problems and mental health symptoms including behavioural difficulties (internalising and externalising difficulties) and low health‐related quality of life (HRQoL). Bidirectional associations were found between weekday sleep and HRQoL, weekend sleep and externalising score, as well as sleep quality and internalising score and HRQoL.
... Sleep is critical for cellular and humoral immunity control, and sleep deprivation can impair immunological response. A vicious cycle results when there is inadequate sleep followed by depression and anxiety, which are both significant predictors of inadequate sleep [44]. In addition, lack of sleep may cause changes in the neuroendocrine stress response system, which can lead to stress-related diseases such mood disorders and depression [44]. ...
... A vicious cycle results when there is inadequate sleep followed by depression and anxiety, which are both significant predictors of inadequate sleep [44]. In addition, lack of sleep may cause changes in the neuroendocrine stress response system, which can lead to stress-related diseases such mood disorders and depression [44]. Attention, executive function, emotional reactivity, memory formation, decision making, risk-taking behaviour, and judgement are all affected by sleep disruption. ...
Article
The world has come to a halt as a result of the SARS-CoV-2 pandemic, which has forced most countries to implement lockdown for the maintenance of the spread of infection. This commentary highlights the important role of sleep as a public health problem, especially in stressful life stages such as the COVID-19 pandemic, and is evidence-based and practical for managing sleep disorders during this crisis. People’s routine has changed due to lockdown, including physical activities, eating habits, electronic usage, and sleeping habits. This has caused disruption between the external and internal zeitgebers and have the greatest impact on melatonin hormone. Melatonin is a key regulator of sleep-in body and controls other hormone cycles as endogenous synchroniser. Sleep is influenced by both circadian and homeostatic factors and sleep problems have a wide range of impacts on the body, effecting different physiological system. So, we should maintain a sleep / wake cycle which will benefit the overall health.
... First, short sleep duration causes bad eating habits. Short sleep duration also increases the chance for intake of late-night snacks and food due to long waking times [66,67]. Additionally, short sleep duration is associated with greater responses to external stimuli, such as the sight or smell of food [67]. ...
... In addition, a short sleep duration is linked to decreased energy expenditure and increased leptin levels [68], leading to further weight gain. Lastly, a short sleep duration leads to physical inactivity due to fatigue and increased screen time [66]. ...
Article
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Poor sleep adversely affects health and may cause obesity. Poor sleep includes short sleep duration, low quality of sleep, and sleep discrepancy. Although most studies have focused on the association between sleep duration and obesity, poor sleep is a significant risk factor for obesity. Adolescents have characteristic sleep patterns which correspond to poor sleep. Adolescents sleep late due to various biological and psychosocial factors; also, they wake up early to be on time for school. This causes them to sleep less. To make up for this sleep debt, adolescents sleep more on non-school days, which causes sleep discrepancies. Therefore, since adolescents have characteristic sleep patterns, an in-depth investigation is needed to identify whether poor sleep is a risk for obesity. This article presents an overview of the characteristic sleep patterns of adolescents, and reviews studies on the association of each sleep pattern with obesity.
... A study with 165,739 adolescents throughout Europe and North America showed that, while the proportion varies between countries, only between 32% and 86% of adolescents get their recommended eight hours of sleep (Gariepy et al., 2020). The consequences of sleeping difficulties include negative school performance, increased risk-taking behaviors, psychosocial health problems, somatic health problems (Shochat et al., 2014;Sun et al., 2019), and negative emotional reactivity (Tempesta et al., 2020). To avoid persistent sleeping difficulties, healthrelated problems, and school failures, it is of the utmost importance to promote good sleep among adolescents. ...
... During adolescence, academic and social demands increase, while, at the same time, parental supervision decreases (Becker et al., 2015;Crowley et al., 2018). Adolescents' health conditions such as anxiety, depression, and pain may interfere with their sleep (Orchard, 2020;Shochat et al., 2014), and external circumstances, such as social norms, values, and requirements from family, friend groups, school, social media, and society can make sleep challenging (Jakobsson et al., 2020b). ...
Article
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Sleeping difficulties among adolescents constitute a pressing public health issue, and it is of the utmost importance that these are approached from a health-promotion perspective. This study explores adolescents’ suggestions on how their sleep could be supported. Data were collected via eight focus group interviews with 43 adolescents aged 15–16, in Sweden, and analyzed using qualitative content analysis. The results describe the adolescents’ suggestions on how their sleep could be supported in three themes: being supported by involved parents— routines, engagement, and warmth are vital; being supported to achieve knowledge on the “whys” and “hows” of sleep—increased knowledge gives the ability to make well-grounded sleep choices; and being guided into finding balance—balance in life is difficult to achieve and adolescents desire support. Parents, school nurses, health professionals, and anyone who has the opportunity to improve and promote sleep should consider adolescents’ suggestions.
... Studies of adolescents have found associations between screen usage and shorter sleep duration (Falbe et al., 2015;Lemola et al., 2015). There is increasing evidence of an association between shorter sleep duration and poorer mental wellbeing in adolescents (Royal College of Paediatrics & Child Health, 2018;Shochat et al., 2014). ...
... Contrary to previous research (Royal College of Paediatrics & Child Health, 2018;Shochat et al., 2014) sleep duration was not associated with mental wellbeing. This finding was unexpected given the high levels of social media usage reported in our sample, and existing evidence for a putative link between excessive social media use, particularly when it occurs later in the day, and sleep quality and quantity (Espinoza, 2011;Falbe et al., 2015;Lemola et al., 2015). ...
Article
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Wellbeing declines during adolescence, for which the reasons are unclear. This analysis explored associations between wellbeing and multiple lifestyle, socioeconomic and school-level factors in young people. Data were collected as part of the Wellbeing in School (WiSe) survey of adolescent school children in Northern Ireland at age 13–14 years ( N = 1618; 49% female) and 15–16 years ( N = 1558; 50.5% female). Wellbeing was assessed using the short-form Warwick-Edinburgh Mental Wellbeing Scale (sWEMWBS), where scores declined between time one (13–14 years) and time two (15–16 years) in both sexes and were significantly lower in females at both timepoints. Multilevel, multivariate modelling was therefore undertaken separately for males and females with sWEMWBS scores as the dependent variable. Physical activity, family affluence, fruit and vegetable intake, social media use, sleep duration, school factors (size and type) and religion were independent variables. More frequent physical activity in both sexes at both timepoints was associated with higher sWEMWBS scores. In females, higher sWEMWBS scores were associated with less social media use at time one (and marginally at time two), greater family affluence at time two, and being Catholic at both timepoints. In males, higher sWEMWBS scores were associated with more frequent fruit and vegetable intake at time one. Mental wellbeing was unrelated to sleep duration or school factors in either sex, at both time points. Efforts to maximize mental wellbeing in adolescents should promote engagement in physical activity and implement sex-specific interventions.
... In addition, severe sleep disturbances have been linked to mental and emotional dysfunction in adolescents. For instance, over 50% of adolescents aged 9-19 years old with insomnia have a comorbid psychiatric disorder, such as depression or anxiety [6]. Further, having difficulty in falling asleep measured by self-rated questionnaire is linked to attention problems, withdrawal, anxiety, and depression in adolescents [7]. ...
... Following previous research [4,6], these self-reported confounders were selected: gender (i.e., boy/girls), how close is the cohort member with mother/father, general health level, and alcohol consumption in the last four weeks. We selected each of these confounders based on the impact that each of these variables exert on mental health in adolescence. ...
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(1) Background: There is a growing interest in investigating the relationship between sleep and mental health development in adolescents. This study aims to further investigate this relationship by identifying the specific associations between several sleep problems in adolescents and several mental health areas, and the role of gender in these associations. (2) Methods: Data from the Millennium cohort survey containing 11,553 individuals at 13–14 years old was included. Nighttime sleep duration and bedtime during weekdays and weekends, night awakening frequency, and sleep onset latency were assessed using self-reported questionnaires. Affective symptom and emotional and behavioural problems were examined with self-reported questionnaires. (3) Results: Regression analyses and path analysis models suggested that frequent night awakening was associated with all the outcomes, and hyperactivity/inattention was the outcome that presented a higher number of significant associations with sleep patterns. Long sleep onset latency and late bedtime at school days were associated with higher risk of emotional and behavioural difficulties. Further, poor sleep seems to manifest more externally in males, while more internally in females. (4) Conclusions: Specific sleep problems should be considered when assessing mental health in adolescence, which would allow more targeted prevention and intervention strategies. Further, special attention should be given to gender differences when addressing sleep and mental health.
... The behavioural aspects of substance use can result in relationship difficulties, disciplinary issues at school, and contact with the justice system (Slade et al. 2008;Bax 2021). There are also bi-directional associations between substance use and sleep disturbance in young people, with inadequate sleep impacting on health and functioning (Pasch et al. 2012;Shochat et al. 2014). Young people can find themselves in a vicious circle of life difficulties leading to heavy substance use, which in turn leads to further life difficulties and mental health issues. ...
Article
This narrative review summarises the latest evidence on the causes and consequences of substance use in adolescence and describes long-term trends in adolescent alcohol, tobacco and cannabis use in Aotearoa. Adolescence is a time of rapid brain development when young people are uniquely vulnerable to the risks of substance use. It is a major cause of health and social harm in this age group and can affect adult outcomes and the health of the next generation. Therefore, substance use trends are central to understanding the current and future state of child and youth wellbeing in Aotearoa. Adolescent use of alcohol, tobacco and cannabis peaked in the late 1990s/early 2000s, then declined rapidly, and prevalence is now much lower than 20 years ago. However, levels of adolescent binge drinking remain high by international standards and disparities in tobacco and cannabis use by ethnicity and socioeconomic status are wide. Evidence suggests we may again be at a turning point, with-long term declines stalling or reversing in the past 2–5 years, and vaping emerging as a new risk. Greater investment in primary prevention is indicated, including restrictions on alcohol marketing and availability, and alleviation of poverty, racism and marginalisation. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
... Adolescent insomnia tends to be chronic and frequently coexists with or precedes the onset of psychiatric illnesses [30]. There was a considerable systematic review in 2014 showing that insomnia could lead to a number of negative consequences, including daytime impairments, poor academic performance, pain, cardiovascular and cardiometabolic impairments, and mental/emotional dysfunction [31]. In addition, GD, age (≥ 16 years old), sex (female) and parental absence have also been considered risk factors for insomnia [32][33][34]. ...
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Background The growing popularity and frequency of online game use have resulted in a large number of studies reporting various mental problems associated with game abuse in adolescents. In this article, we examined the prevalence of gaming disorder (GD) and explored the associations of GD with anxiety and insomnia symptoms in minority youth in China. Methods A total of 1494 students completed the Problematic Online Gaming Questionnaire Short-Form (POGQ-SF), the Generalized Anxiety Disorder 7-item questionnaire (GAD-7), and Athens Insomnia Scale (AIS). Chi-square and binary logistic regression analyses were used to explore the associations between gaming disorder and anxiety/insomnia. Results A total of 356 (23.83%) respondents reported that they had gaming disorder. Chi-square analysis showed that gender, grade, marital status of parents and exercise situation were significantly associated with GD. Binary logistic regression analysis showed that those who had GD were at significantly higher risk for anxiety and insomnia than those without GD. Conclusion We found a high incidence of GD and a positive association among anxiety, insomnia and GD. Thus, special attention should be paid to those who have suffered from GD. It is worth addressing the adverse effects of GD on anxiety and insomnia.
... 11 Further adding to their sleep deprivation are psychosocial factors such as academic pressure, and decreased parental supervision regarding bedtime and screen time. 4,11,12 Factors which aid upholding healthy sleep habits, yet which undergo changes during adolescence, are called sleep hygiene practices (eg, having a regular sleep schedule, a supporting environment, sufficient daylight during the day and limited use of electronic screens before bedtime). 9,10 Given the importance of many such changeable determinants, taking preventive action to stimulate adolescents' healthy sleep habits seems promising. ...
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Background: This study evaluated the effect of the school-based intervention Charge Your Brainzzz on adolescents' social-cognitive determinants, sleep hygiene and sleep duration and quality. Methods: A cluster-randomized controlled trial was conducted with 972 students from 10 Dutch high schools. Schools were randomly allocated to the intervention (N = 5) or control condition (N = 5). Outcomes were measured with the digital Consensus Sleep Diary and via a digital questionnaire, based on valid measures. Data were collected at baseline (T0), ±1.5 weeks post-intervention (T1) and ±3 months post-intervention (T2). Mixed model analyses were performed to estimate the effects on social-cognitive determinants, sleep hygiene, and sleep outcomes. Results: The intervention increased sleep knowledge post-intervention (b = 1.91; 95%CI: 1.22-2.60) and at follow up (b = 1.40; 95%CI: 0.70-2.10). The intervention was also effective in changing adolescents' attitudes (b = 0.10; 95%CI: 0.01-0.19) and perceived behavioral control (b = 0.11; 95%CI: 0.01-0.22) post-intervention. No positive changes were found regarding subjective norms, behavioral intentions, sleep hygiene, or sleep outcomes. Conclusions: The intervention improved adolescents' sleep knowledge, attitude, and perceived behavioral control. To significantly impact sleep health, theoretically sound and systematically developed interventions are needed which take into account the interplay between sleep, sleep-related behaviors, and adolescents' social and physical environment. Clinical trial registration: Trial name: Evaluation of the school-based intervention Charge Your Brainzzz promoting sleep in adolescents; URL: https://doi.org/10.1186/ISRCTN36701918; ID: ISRCTN36701918.
... Sleep loss among adults has been associated with lower physiological, emotional, and cognitive functioning [6,7]. Sleep loss among adolescents has been associated with various outcomes: emotion deregulation [8], depressive symptoms [9,10], anxiety [11], risky behavior [12], obesity [13,14], deteriorated cognitive functioning [15], and diminished academic performance [16][17][18][19]. ...
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The current study investigates the impact of sleep loss on neurobehavioral functioning and sleepiness in a natural setting among healthy adolescents. Fifty-nine adolescents (32 females) from grades 7 to 12 (mean age of 16.29 ± 1.86 years) participated in the study. All participants wore the actigraph for a continuous five to seven days, including school and nonschool days. Subjective sleepiness and neurobehavioral performance (using the psychomotor vigilance test and the digit symbol substitution test) were measured three times a day on two school days and one nonschool day. The results presented that sleep loss influenced subjective sleepiness reports, showing higher sleepiness scores following sleep loss than following sufficient night sleep. Neurobehavioral functioning across all measurements was also significantly worse following sleep loss. Furthermore, participants performed worse on weekday morning assessments than on assessments at other times of the day following sleep loss. These findings suggest that sleep loss in natural settings has a significant impact on neurobehavioral performance and subjective sleepiness. Our findings have essential implications for public policy on school schedules.
... Families are helped to develop a strong health culture by promoting healthy family routines and practices. The VFBA emphasizes family activities that have been empirically supported for enhancing emotional and behavioral health, such as mindfulness and music practice, exercise, sleep, healthy nutrition, and positive community connection (social support) [35][36][37][38][39][40][41][42][43][44][45][46]. These areas of health promotion serve as the VFBA pillars of wellness. ...
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This randomized controlled trial tested the Vermont Family Based Approach (VFBA) in primary care pediatrics. The VFBA is a model of healthcare delivery that shifts the focus from the individual to the family, emphasizes emotional and behavioral health, and uses evidence-based health promotion/prevention along with the treatment of emotional and behavioral problems. Participants were 81 families of 3–15-year-olds. For children, the VFBA was associated with greater reductions than the Control condition on the Child Behavior Checklist Emotionally Reactive, Withdrawn, Sleep Problems, Aggressive Behavior and Total Problems scales. For parents, the VFBA was associated with greater reductions than the Control condition on the Adult Self-Report Anxious/Depressed, Rule-Breaking Behavior, Internalizing Problems and Total Problems scales. The VFBA was also associated with greater improvement than the Control condition in the parents’ health-related quality of life, as indicated by all scales of the Medical Outcomes Study Health Survey.
... There is evidence that cognitive processes are heavily influenced by sleep quality, and sleep disturbances may adversely affect attention, learning, and memory [22,23]. Mounting evidence suggests a positive association between sleep loss and poor academic performance [24]. Disrupted sleep has long been associated with attention and learning difficulties [9]. ...
Article
Objective No studies have investigated sleep disturbance in avoidant/restrictive food intake disorder (ARFID). We examined sleep disturbance in ARFID and its association with eating problems, body mass index (BMI), gender, internalizing and externalizing symptoms, cognitive performance, and academic difficulties. Methods Data from 71 ARFID patients from our partial hospitalization program (PHP) for children and adolescents were examined. Sleep data were extracted from measures administered at admission including Achenbach Child Behavior Checklist (CBCL), Children's Depression Inventory (CDI), and Revised Children's Manifest Anxiety Scale (RCMAS). Correlational analyses were conducted to evaluate the convergent validity of parent-reported and participant-reported sleep problems. Association with the severity of eating problems, BMI, percentage of median body weight (% MBW), age, gender, psychotropic medication, psychopathology, and academic difficulties was examined using analysis of variance (ANOVA) and Pearson's correlation. Results Fifty-two percent of parents and 74% of participants reported two or more sleep symptoms. Trouble sleeping was reported by 46.48% and nightmares by 35.21% of parents. Parent-reported trouble sleeping highly correlated with internalizing disorders. Parent-reported trouble sleeping and participant-reported difficulty sleeping positively correlated with attention and attention-deficit/hyperactivity disorder (ADHD) problems. Parent-reported less sleep and feeling tired correlated with sluggish cognitive tempo, while walking/talking in sleep negatively correlated with school performance. Gender differences were noted in parent-reported sleep problems. Sleep disturbances were not associated with lower BMI or median body weight at intake. Parent-reported talking/walking in sleep and participant-reported bad dreams and bedtime worries positively correlated with Children's Eating Attitudes Test (ChEAT) scores at intake and discharge. Discussion Our results provide compelling evidence to screen for sleep disturbance in ARFID patients regardless of median body weight and BMI. Exploration of sleep disturbances in ARFID using objective measures is warranted.
... It is associated with various crucial aspects, including intelligence, socio-economic status, schooling quality, learning motivation, and 2 of 13 health problems [34,35]. In the past two decades, much research has been conducted to examine the associations between sleep and GPA [33,36,37]. There is increasing evidence that GPA can, to some degree, be predicted by certain sleep measures, including sleep duration [38][39][40][41][42][43][44][45] and sleep quality [42,43,[46][47][48][49][50][51]. ...
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Although the relationship between sleep and academic performance has been extensively examined, how sleep predicts future academic performance (e.g., 2–3 years) remains to be further investigated. Using wearable smartwatches and a self-report questionnaire, we tracked sleep activities of 45 college students over a period of approximately half a month to see whether their sleep activities predicted their academic performance, which was estimated by grade point average (GPA). Results showed that both nighttime sleep awakening frequency and its consistency in the tracking period were not significantly correlated with the GPA for the courses taken in the sleep tracking semester (current GPA). However, both nighttime sleep awakening frequency and its consistency inversely predicted the GPA for the rest of the courses taken after that semester (future GPA). Moreover, students with more difficulty staying awake throughout the day obtained lower current and future GPAs, and students with higher inconsistency of sleep quality obtained lower future GPA. Together, these findings highlight the importance of nighttime sleep awakening frequency and consistency in predicting future academic performance, and emphasize the necessity of assessing the consistency of sleep measures in future studies.
... Sufficient sleep is associated with enhanced attention, cognitive functioning, concentration, expansive thinking, creativity, better school performance, and physical and mental well-being in adolescents (de Zambotti et al., 2018). Adolescents with sleep difficulties are at risk for reduced learning ability, memory impairment, hyperactivity, decreased attention, lower grades, increased risk for depression, insulin resistance, and diabetes (Shochat et al., 2014;Yan et al., 2019). ...
Article
The COVID‐19 pandemic had a major impact on people of all ages. Adolescents' exposure to online learning is linked to excessive screen time on digital devices, which leads to poor sleep quality. This study aimed to investigate the association between screen time on different electronic devices and sleep quality among adolescents in the United Arab Emirates. This study was based on a self‐reported questionnaire, which was administered online to school‐aged adolescents (aged 12–19 years). The multicomponent questionnaire collected information on sociodemographic characteristics, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and screen time (minutes) on TV, TV‐connected devices, laptops, smartphones, and tablets on weekdays, weeknight, and weekends using the Screen Time Questionnaire (STQ). Univariate and multivariate analyses were used to identify factors correlated with poor sleep quality. A total of 1720 adolescents were recruited from private and public schools (mean age 14.6 ± 1.97 years). The mean PSQI score was 8.09 ± 3.37, and 74.3% of participants reported poor sleep (cutoff score >5). Mean scores were highest for the sleep latency (1.85 ± 0.97) and sleep disturbance (1.56 ± 0.62) domains. The highest STQ score was observed for smartphones, with a median screen time of 420 min on weekdays and 300 min on weekends. Screen time related to smartphones on weekends (p = 0.003) and increased screen time in bed (p < 0.001) were significantly associated with poor sleep. Our results confirmed the correlation between sleep and screen time in adolescents. The results may inform educational polices that target screen time and sleep among adolescents during and after the COVID‐19 pandemic.
... Research overwhelmingly supports the fundamental role of sleep in adolescents' emotional and cognitive development, which may have important implications for success and wellbeing in adulthood [2][3][4]. Of the many transitions that occur during adolescence, changes to sleep may have the most pervasive impact, with inadequate and ill-timed sleep being linked to poor physical health, including a greater current and future risk of becoming overweight [5,6], poor psychosocial functioning, low academic performance, and risk-taking behaviors [7,8]. ...
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Study Objectives. During adolescence, an interplay between biological and environmental factors leads to constrained sleep duration and timing. The high prevalence of sleep deprivation during this developmental period is a public health concern, given the value of restorative sleep for mental, emotional, and physical health. One of the primary contributing factors is the normative delay of the circadian rhythm. Therefore, the present study aimed to evaluate the effect of a gradually advanced morning exercise schedule (30 min shift each day) completed for 45 minutes on 5 consecutive mornings, on circadian phase and daytime functioning of adolescents with a late chronotype, compared to a sedentary control group. Methods. 18 physically inactive male adolescents aged 15-18 years spent 6 nights at the sleep laboratory. Morning procedure included either 45 min walking on a treadmill or sedentary activities in dim light. Saliva dim light melatonin onset (DLMO), evening sleepiness and daytime functioning were assessed during the first and last night of laboratory attendance. Results. The morning exercise group had significantly advanced (earlier) circadian phase (27.5 min ± 32.0), while sedentary activity resulted in a phase delay (-34.3 min ± 53.2). Morning exercise also led to higher evening sleepiness in the earlier hours of the night, but not at bedtime. Mood measures improved slightly in both study conditions. Conclusions. These findings highlight the phase advancing effect of low-intensity morning exercise among this population. Future studies are needed to test the transference of these laboratory findings to adolescents’ real life.
... Good night's sleep is essential for individuals' effective emotional and cognitive well-being [ [29] , [30] ]. Furthermore, sleep is related to social, physical, and mental health and the overall quality of life [ [29] , [31] ]. Unfortunately, with the rapid development in technology, many people in advanced society might find it challenging to achieve a good sleep [32] . ...
Article
Full-text available
Recently, the use of social media has penetrated many aspects of our daily lives. Therefore, it has stimulated much debate and polarisation regarding its impact on mental well-being. The present study investigated the association between problematic use of social media, subjective well-being, and insomnia's potential mediator. A proportionate random sample was collected from a Univerity in Algeria between March and April 2020.The participants (n=288; mean [SD] age = 20.83 [2.13]) involved 101 (35.1%) males. Nearly three-fourths of the participants (n=214; 74.3%) used up more-than three hours daily surfing on social media. Their mean (SD) score was 15.64 (4.80) on the Bergan Social Media Addiction Scale, 16.19 (9.15) on the Arabic Scale of Insomnia, and 28.13 (7.90) on the overall subjective well-being. Structural equation modeling (SEM) revealed an indirect correlation between problematic use of social media and the overall subjective well-being of users. Similarly, the indirect but not direct effects were found for the overall subjective well-being subdomains. Moreover, all SEM models have a satisfactory fit with the data. Based on the results, it can be concluded that insomnia appears to play an important role in mediating the association between subjective well-being and problematic social media use. This suggests the importance of tackling the issues of insomnia and problematic use of social media for university students. It also has important implications in dealing with the misuse of social media, especially during the covid-19 pandemic.
... The recommended sleep duration for healthy adults (26-64 years) is seven to nine hours daily [1,2]. The deprivation of night sleep is associated with a number of physical and mental health conditions, which include lack of energy, increased fatigue, daytime sleepiness, low mood, and poor functioning capacity [3]. ...
Article
Objectives To evaluate the different personal, environmental, and social factors associated with the impaired sleep of patients who were admitted for treatment in the department of internal medicine in a tertiary care hospital in Azad Kashmir. Material and methods A single-center, exploratory, prospective study was conducted at Abbas Institute of Medical Sciences (AIMS), a public sector teaching hospital of Azad Jammu and Kashmir Medical College, Muzaffarabad, between November 2021 and January 2022. A standard Performa was used to collect and document the demographic information, the duration and quality of sleep at home and after admission to the hospital. The patients were asked to identify and report the most important factors contributing to disturbed sleep in the hospital. Statistical analysis was performed using SPSS version 23.0 (SPSS Inc., Chicago, IL, USA), continuous parametric variables were reported as mean ± standard deviation; nonparametric continuous variables were reported as median; and categorical variables were expressed as percentages. Exploratory factor analysis was performed and principal components were extracted. Results As reported by the patients, the main factors contributing to disturbed sleep were underlying medical conditions, noise, overcrowding and gathering of people, pain, fever, lighting, weather conditions, and medical interventions. Exploratory component factor analysis showed significant loading of overcrowding and lighting in the ward on components 1 and 2. Component 3 was loaded with underlying illness, noise, pain and fever, uncomfortable mattress, and treatment interventions by the medical staff. Conclusions There were many personal and environmental factors, which contributed towards impaired sleep in hospitalized patients. The underlying medical conditions, noise, overcrowding, lighting, pain and fever, are the most commonly reported factors by hospitalized patients.
... When interpreting these findings, it is also worth noting that the puberty transition (when testosterone and estradiol are changing rapidly) is accompanied by other important transitions, including neurocognitive and psychosocial change, that may impact disengagement (Gee et al., 2018). For instance, the impact of physical change (growth spurt, increased size, strength, and sexual interest), inadequate sleep during adolescence (Shochat et al., 2014), and the relatively high prevalence of anxiety and other mental health issues in adolescence (Collishaw, 2015) are also known to be implicated in disengagement. Thus, although puberty hormones themselves are not amenable to educational intervention, there are modifiable factors during these ubiquitous shifts in testosterone and estradiol that may be the focus of intervention to reduce disengagement. ...
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The significant decline in academic engagement through the early stages of adolescence is well known, however, the relative contribution of the key factors explaining these adolescent patterns over time requires further investigation. Motivation has been a dominant research focus in past decades, while less empirical attention has been given to the comparative effects of puberty hormones (specifically, sex steroid hormones: estradiol and testosterone) that are often the subject of popular “storm and stress” stereotyping regarding adolescent development. From a baseline sample of 342 young people (11–13 years of age, 55 % males) assessed annually across 3 years, we examined the role of motivation (self-efficacy and valuing) and key puberty hormones in predicting males' and females' academic engagement and disengagement trajectories, controlling for personal and background attributes. Latent growth modeling demonstrated that: (a) compared to puberty hormones, self-efficacy and valuing were more strongly associated with engagement (positively) and disengagement (negatively) for both males and females, (b) puberty hormones were more strongly linked to students' disengagement than to their engagement, and (c) the significant links between puberty hormones and disengagement were more salient and consistent across time for males—with higher levels of testosterone and estradiol individually associated with higher disengagement. These findings are discussed in the context of psycho-educational and biopsychological perspectives on adolescents' academic development and hold implications for how to motivate and engage them in developmentally appropriate ways at school.
... Various studies confirm the unequivocal significance of sleep during the period of adolescence. Students' adequate sleep is associated with a learning-friendly, disciplined classroom environment, while lack of sleep can affect students' cognitive processes [65], especially memory, attention and emotion processing [66], and promote adolescent opposition behaviour, hyperactivity, risk-taking behaviour [67] and delaying and skipping lessons [68,69]. ...
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This study explored a moderated mediation model, which is based on the assumption about the direct relationship between teachers’ autonomy-supportive behaviours and students’ learning strategies and via perceived classroom management as well as the effect of growth mindset for the relationships between (1) teachers’ autonomy-supportive behaviours and learning strategies applied by students and (2) perceived classroom management and learning strategies applied by students. Data were collected from 23 secondary schools in municipalities in Lithuania with low SES (socioeconomic status) contexts (N = 581 students). The results showed that teachers’ autonomy-supportive behaviours are directly and positively related to the increased use of learning strategies applied by the student. The perceived classroom management mediates the relationship between teachers’ autonomy-supportive behaviours and learning strategies applied by the students. In this case, we have an inconsistent mediation, so the mediator acts as a suppressor (the indirect path through mediator is negative, while the direct is positive). The growth mindset does not moderate the relationship between perceived teachers’ autonomy supportive behaviours and the students’ use of learning strategies, but growth mindset moderates the relationship between perceived classroom management and learning strategies applied by the student. For students with a lower or moderate growth mindset, greater perceived classroom management is related to the lesser use of learning strategies. However, for those with a higher growth mindset, greater perceived classroom management is related to greater use of learning strategies. This study contributes to the understanding of the importance of teachers’ behaviours for students’ learning by focusing on classroom management and growth mindset.
... Furthermore, adolescence is a particularly vulnerable period for problems in circadian regulation (Hagenauer & Lee, 2012), presenting the most irregular sleep behaviour (Gradisar et al., 2011). Insufficient sleep has been associated with adverse consequences, including mood disturbances (Moore, Slane, Mindell, Burt, & Klump, 2011), other mental and physical health outcomes (Shochat, Cohen-Zion, & Tzischinsky, 2014), increased risk of injuries (Lam & Yang, 2007), and poor school performance (Wolfson, Spaulding, Dandrow, & Baroni, 2007). Moreover, night-time sleep affects daytime mood, emotional reactivity, and the capacity to regulate positive and negative emotions (Gruber & Cassoff, 2014). ...
Article
Insomnia and circadian dysregulation during adolescence represent important risk factors for emotional and psychological problems. Recent studies have shown that the coronavirus disease 2019 (COVID‐19) pandemic has been linked to a high prevalence of behavioural sleep problems in the general population. This study aimed to provide two pictures of two different time points of the pandemic regarding the prevalence of sleep problems in adolescents and their association with psychological health variables. Two different independent large samples of Italian adolescents aged 13–17 years were recruited at two pandemic time points. A total of 1,146 adolescents at Time 1 (T1; April 2020) and 1,406 at Time 2 (T2; April 2021) took part in the study. Measures of insomnia symptoms, sleep hygiene, chronotype, psychological distress and emotion regulation were collected. Prevalence of insomnia was 12.13% at T1 and 23.19% at T2. Furthermore, high levels of poor sleep habits (late bedtime, poor sleep hygiene, use of electronic devices at bedtime) were also detected at both time points. Insomnia symptoms strongly correlated with poor sleep hygiene, higher psychological distress, and emotional suppression at both time points. Results highlighted an alarming picture for two large samples at two different time points of the pandemic that showed a potential negative impact of the COVID‐19 pandemic, in both the first outbreak and in the later phase of the pandemic, on sleep habits, psychological distress and insomnia symptoms in adolescents. This strongly suggests the need for monitoring these variables and their interaction in the post‐pandemic period and to develop and promote interventions for insomnia and circadian disturbances during adolescence.
... Sleep problems were included in the combined behaviour variable, although sleep problems might be a consequence rather than a choice of behaviour. We chose, however, to include it due to a potentially close relationship with the other lifestyle behaviours (Kwon et al., 2019;Lang et al., 2016), and its potential influence on health in youth (Shochat et al., 2014). To capturing an overall lifestyle behaviour, we included fruit/ vegetables consumption, in accordance with previous research (Bohman et al., 2014;Bohman et al., 2019;Pronk et al., 2010;Skillgate et al., 2017). ...
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Background: There is limited knowledge on the association between lifestyle behaviour in adolescence and musculoskeletal pain in young adulthood. This study aimed to investigate whether an accumulation of adverse lifestyle behaviours in adolescents with and without musculoskeletal pain at baseline, was associated with persistent musculoskeletal pain (pain duration ≥3 consecutive months the last year) 11 years later. Methods: Longitudinal data from the Trøndelag Health Study in Norway including 1824 adolescents (13-19 years old) was analysed. The outcome was persistent musculoskeletal pain (≥3 months). The number of adverse lifestyle behaviours (low physical activity level, sleep problems, insufficient fruit/vegetables consumption, smoking, frequent alcohol intoxication [drunkenness] and/or illicit drug use) were summed up to comprise an ordinal variable and analysed with 0 or 1 adverse behaviours as the reference. Multiple logistic regression analyses, stratified by individuals with and without baseline musculoskeletal pain, were conducted. The results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Results: In adolescents with musculoskeletal pain at baseline, reporting ≥ four adverse lifestyle behaviours increased the odds of persistent musculoskeletal pain (OR 2.23, 95% CI 1.36, 3.66) 11 years later. Two and three adverse behaviours were not associated with future persistent musculoskeletal pain. In adolescents without musculoskeletal pain at baseline, an accumulation of adverse lifestyle behaviours was not associated with future persistent musculoskeletal pain. Conclusion: An accumulation of adverse lifestyle behaviours in adolescents with musculoskeletal pain at baseline was associated with persistent musculoskeletal pain 11 years later, but not in adolescents without musculoskeletal pain at baseline. Significance: An accumulation of four or more adverse lifestyle behaviours in adolescents with musculoskeletal pain was associated with persistent musculoskeletal pain in young adulthood. In future health care of adolescents with musculoskeletal pain, lifestyle behaviours should be assessed, with emphasis on accumulation of multiple adverse lifestyle behaviours. Focusing on an accumulation of multiple adverse lifestyle behaviours, rather than each individual behaviour, might provide a potential area for future research and interventions targeting musculoskeletal pain in youth.
... The data reached an all-time high of 9.6% in May 2010. Labour Productivity Growth is to be considered for the construction industry [39]. ...
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The sleep disturbances of laborers at work lead to acute anxiety and stress stemming from the construction workplace. The sleep deprivation study was conducted on construction laborers in Bengaluru, Karnataka. The paper represents sleep immunity and sleep scores, which track productivity at the construction site. The outcome shows the interconnection between sleep patterns and labour productivity, relating to the concentration level and performance at work. There was a comparative study performed on the calculation of the sleep cycle between the application method and the fit-bit method. The decision-making structure has been interpreted as being sleep-related work, which is related to laborers and may result from an effective decision to withhold the work done by laborers. The productivity of labour in the construction industry has been decreased by up to 12% due to a lack of insufficient sleep. The sleep cycle summarizes the practical implementation of the productivity of labour in the construction industry, which has been decreasing gradually due to a lack of sleep. 1.INTRODUCTION The construction sector in India exercises a prioritized role in development, as it generates investment opportunities [1]. The industry is split and occupied by high-ranking companies that are a part of many construction sectors. Construction labour productivity is influenced by factors such as technology, labour organization, management, overtime and turnover, real wage trends, and sleep deprivation [2-4]. The improper sleep of laborers will cause accidents while they are working on-site and reduce the productivity of workers at the construction site [5,6]. The body condition of the mind, which typically recollects for many hours every night, states that the nervous system is inactive; thus, there will be closed eyes, the muscles relax, and practically consciousness is suspended [7-10]. The symptoms of sleep deprivation are droopy eyelids and general discomfort. Sleep is considered periodically as the state of body and mind and can be characterized by altering consciousness, which is inhibited by sensory activity, which reduces the activity of muscles and inhibition of nearly all muscles that are voluntary active during rapid eye movement sleep and can be reduced by surrounding interaction [11]. The suggested sleep time for aged people is 7 to 8 hours a night. Few human beings need 6 hours or 9 hours of sleep in a day. Adults over the age of 75 require 7-8 hours of sleep per day [12].During pregnancy, women require several hours of rest. A human being usually sleeps for eight hours during the night at the age of 50 and more than five and a half hours a night between the ages of 45 and 50. A 75-year-old in good health requires approximately six and a half hours of sleep per night [13-15].The restoration of body powers is performed during natural periodic sleep [16]. Natural periodic sleep time is associated with psychological and subjective nature, with overall life satisfaction [17]. If the quality of sleep is not of sufficient quality, it will impact walking activities and could even affect long-term health [16]. The sleeping hours of individuals are 6 hours or less, contributing 70% to the higher mortality rate than those who sleep 7 or 8 hours during the night [17]. There are five stages of sleep in a human being: awake sleep, deep sleep, light sleep, and REM sleep [18]. Rem sleep is divided into two types: rapid eye movement sleep and nonrapid eye movement sleep [19]. The pattern of sleep that has been recorded provides the sleep score after the calculation of different stages of sleep [20]. Sleep deprivation has an effect on shift workers that will gradually decrease the productivity growth in their daily work. Shift work reduces both the quality and the quantity of sleep. Sleep individuals are less ambitious and less productive [21]. Researchers have found that the amount of sleep required for adults per day will be approximately 7 hours for completely reviving results, but most get less than 7 h, resulting in a sleep deficit. As a result, sleep deprivation occurs. Outcomes are affected by sleep deprivation in several ways [22-24]. The negative effect of sleep deprivation has a greater influence on the brain and cognitive processes [25]. During the years of college, many pupils were speciated about the capital value of human and knowledge capital, which provides jobs, and when pupils flourished in managing techniques that survived their studies [26]. The two management skills are required for cognition and leadership, which have significantly increased knowledge about written works in documents [27-29].The different stages of sleep will help
... Poor sleep quality affects well-being in both psychosocial and physical aspects. Insufficient sleep among adolescents has been associated with mood disturbances (Moore et al., 2011), somatic and psychosocial health, school performance, and risk-taking behavior (Shochat et al., 2014). ...
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Online learning and the lack of social interactions during lockdown pushed numerous college students to live employing the internet and social media. This study investigates students' well-being and its associated factors in relation to smartphone use and sleep quality among Indonesian university students during the pandemic. A sample of 327 undergraduate students (68 males and 259 females) anonymously completed the Smartphone Addiction Scale – Short Version (SAS-SV), WHO-Five Wellbeing Index (WHO-5), and Pittsburgh Sleep Quality Index (PSQI), along with several socio-demographic data via an online survey. The data was then analyzed with hierarchical linear regression. The results indicate that gender, perceived physical health, smartphone use, and sleep quality were associated with well-being in university students. The final model predicted 23.4 percent of the WHO-5 scores with a significant increase in predictive value by adding perceived physical health and sleep quality. Therefore to enhance well-being among Indonesian university students, suitable physical activities, good sleeping habits, and controlled smartphone use is needed.
... Unwanted bed-sharing (i.e., co-sleeping) is also common (McLay et al., 2019a(McLay et al., , 2019b. Without effective treatment, sleep problems in children with NDD are unlikely to resolve, resulting in profound long-term effects on the daytime behavior, adaptive functioning, and well-being of children and their families (Goldman et al., 2012;Kronk et al., 2010;Mörelius & Hemmingsson, 2014;Shochat et al., 2014). ...
Article
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Sleep problems are prevalent among autistic children and children with Rare Genetic Neurodevelopmental Disorders (RGND). Behavioral interventions are commonly used to treat sleep problems, with most involving extinction. While effective, the occurrence of a response burst (i.e., temporary worsening of the behavior) can result in a temporary increase in parent and child distress, and negatively affect treatment adherence. Thus, it is important to develop less restrictive treatment options. This study used a single case multiple baseline design to investigate the effectiveness and acceptability of less restrictive behavioral interventions (i.e., specifically excluding extinction) for sleep problems in ten autistic children and children with RGND ( M = 7.3 years). Results demonstrated a reduction in sleep disturbance including unwanted bed-sharing, night wakings and sleep onset delay for 3/3, 5/5 and 6/7 children respectively, which were maintained at follow-up. Interventions were rated favorably by parents. The clinical implications of these findings are discussed.
... Good night's sleep is essential for individuals' effective emotional and cognitive well-being [ [29] , [30] ]. Furthermore, sleep is related to social, physical, and mental health and the overall quality of life [ [29] , [31] ]. Unfortunately, with the rapid development in technology, many people in advanced society might find it challenging to achieve a good sleep [32] . ...
Article
Full-text available
Recently, the use of social media has penetrated many aspects of our daily lives. Therefore, it has stimulated much debate and polarisation regarding its impact on mental well-being. The present study investigated the association between problematic use of social media, subjective well-being, and insomnia’s potential mediator. A proportionate random sample was collected from a Univerity in Algeria between March and April 2020.The participants (n=288; mean [SD] age = 20.83 [2.13]) involved 101 (35.1%) males. Nearly three-fourths of the participants (n=214; 74.3%) used up more-than three hours daily surfing on social media. Their mean (SD) score was 15.64 (4.80) on the Bergan Social Media Addiction Scale, 16.19 (9.15) on the Arabic Scale of Insomnia, and 28.13 (7.90) on the overall subjective well-being. Structural equation modeling (SEM) revealed an indirect correlation between problematic use of social media and the overall subjective well-being of users. Similarly, the indirect but not direct effects were found for the overall subjective well-being subdomains. Moreover, all SEM models have a satisfactory fit with the data. Based on the results, it can be concluded that insomnia appears to play an important role in mediating the association between subjective well-being and problematic social media use. This suggests the importance of tackling the issues of insomnia and problematic use of social media for university students. It also has important implications in dealing with the misuse of social media, especially during the covid-19 pandemic.
... Many studies have shown the importance of sleep behavior on children and adolescents' mood, behavior and cognitive function (Beebe, 2011;Gregory & Sadeh, 2012;Shochat et al., 2014). The relationship between sleep problems and internalizing symptoms such as depression and anxiety has been reported (Gregory et al., 2005;Roberts & Duong, 2017). ...
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Intra-family conflict had an adverse effect on adolescent mental health problems. However, to date, few studies using the longitudinal-design have examined the underlying mechanism of this relationship. Therefore, the purpose of the current study was to extend previous study from a longitudinal perspective, and further explore the mediating role of sleep quality that were shown to underlie these relationships. Data came from a longitudinal survey of 932 adolescents (54.0% female; mean of age at baseline = 13.25 years, SD = 0.66). The adolescents were recruited from two junior high school in Guangzhou city, China. A battery of standardized measures was used to assess intra-family conflict, sleep quality, internalizing symptoms and externalizing symptoms for three times with an interval of one year. After adjusting for family demographics, sleep quality at T1 and mental health problems at T1, T1 intra-family conflict had significant effects on sleep quality at T2, and T2 sleep quality mediated the association between T1 intra-family and mental health problems at T3. In addition, this mediation of sleep quality was consistent across gender. Sleep quality was an important mediator in explaining the relationship between intra-family conflict and mental health problems in adolescents. Prevention and intervention programs aimed at improving their sleep quality may be critical to prevent mental health problems when adolescents are involved in family conflict.
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Pharmacologic treatment of the most common pediatric sleep disorders lacks evidence, and alternative methods, which have been proved to alleviate the symptoms, are preferred in most cases. The implementation of specific guidelines is of great importance because sleep disorders in children are not rare and they can negatively affect children's development and their cognitive and social skills. This article summarizes the current therapeutic management of sleep disorders in children, bearing in mind the absence of evidence-based guidelines on this topic.
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Background In adolescents, excessive screen time leads to many adverse health outcomes and is associated with a variety of lifestyle behaviors. This study was conducted to investigate the associations between the two types of screen time and a variety of lifestyle behaviors in American adolescents. Methods Based on the Youth Risk Behavior Surveillance System, this cross-sectional study was conducted. With the help of data collectors, participants self-reported screening time, lifestyle behaviors, and demographic data via well-validated tools. Results 19% and 43.4% of the participants spent more than two hours a day watching television and using the computer, respectively, while the prevalence of physical inactivity and insufficient sleep was 75.1 and 74.4% respectively. Furthermore, 11.9, 7.3, 14.3, and 21.3% of the participants reported skipping fruits, vegetables, breakfast and milk, respectively. Moreover, the prevalence of alcohol and tobacco consumption and sexual activity was 26.8, 5.3, and 23.5% respectively. More than two hours of television time was significantly associated with high risks of fewer frequency for eating fruit (OR = 1.605, 95%CI: 1.308–1.970), vegetables (OR = 1.389, 95%CI: 1.029–1.873), and smoking (OR = 1.465, 95%CI: 1.088–1.972). Computer/video time for more than two hours was significantly associated with high risks of physical inactivity (OR = 1.724, 95%CI: 1.531–1.941), insufficient sleep (OR = 1.354, 95%CI: 1.151–1.592), and not eating fruit (OR = 1.434, 95%CI: 1.179–1.745). Conclusion Increased screen time may be associated with specific unhealthy lifestyle behaviors in adolescents. Furthermore, the associations between different types of screen time and various lifestyle behaviors varied.
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One of the most prevalent sleep disorders in children and adolescents is "insomnia," which can be briefly described as problems with initiating and/or maintaining sleep with associated daytime consequences. These are typical insomnia symptoms, and when experienced for long enough and when they interfere with an important area of the young person's life (eg, schooling), then a diagnosis of an insomnia disorder may be warranted. The authors strongly urge the scientific community to conduct further controlled trials, including dismantling trials that evaluate the relative effectiveness of individual cognitive behavioral therapy for insomnia components.
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Background: Maternal diet during gestation has been linked to infant sleep; whether associations persist through adolescence is unknown. Objective: We explored associations between trimester-specific maternal diet patterns with measures of sleep health among adolescent offspring from a Mexico City birth cohort. Methods: Data from 310 mother-adolescent dyads were analyzed. Maternal diet patterns were identified by principal component analysis derived from food frequency questionnaires collected during each trimester of pregnancy. Sleep duration, midpoint, and fragmentation were obtained from seven-day actigraphy data when adolescents were between 12-20 years old. Unstratified and sex-stratified association analyses were conducted using linear regression models, adjusted for potential confounders. Results: Mean (SD) age of offspring was 15.1 (1.9) years, and 52.3% of the sample was female. Three diet patterns were identified during each trimester of pregnancy: the Prudent Diet (PD), high in lean proteins and vegetables; the Transitioning Mexican Diet (TMD) high in Mexican and "Westernized" foods; and the High Meat & Fat Diet (HMFD), high in meats and high-fat dairy products. Mean (SD) sleep duration was 8.5 (1.5) h/night. Most associations were found in the third trimester. Specifically, PD maternal adherence was associated with shorter sleep duration among offspring (0.57 h [95% CI: -0.98, -0.16 h] in highest tertile vs lowest) and earlier sleep midpoint among females (0.77 h ([95% CI: -1.3, -0.26 h]). Adherence to HMFD and TMD was non-linearly associated with less fragmented sleep, with the latter only evident among females. Conclusions: Findings indicate that maternal dietary patterns, especially during the third trimester of pregnancy, may have long-term impacts on offspring sleep.
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Growing evidence suggests sleep plays an important role in the development of healthy adolescents, with increased interest in the associations between sleep and mental health. Higher duration and quality of sleep has been suggested as a mechanism for increased wellbeing in adolescents. Cross sectional data was collected from 5,661 Irish adolescents. 55% of Irish adolescents reported meeting the guidelines for adolescents of 8-10 hours per night. This was found to decrease with age. Higher duration and quality of sleep was positively associated with wellbeing and negatively associated with symptoms of anxiety and depression. A higher frequency of physical activity was associated with longer duration and higher quality of sleep. 9-10 hours of sleep was associated with the highest levels of wellbeing and lowest symptoms of anxiety and depression. The relationship between physical activity and increased wellbeing may be impacted by physical activity leading to higher durations and quality of sleep. Higher frequencies of physical activity may increase sleep quality and quantity thereby improving markers of mental health in adolescents.
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Sleep is a robust predictor of child and adolescent development. Race/ethnicity, socioeconomic status (SES), and related experiences (e.g., discrimination) are associated with sleep, but researchers have just begun to understand the role of sleep in the development of racial/ethnic and SES disparities in broader psychosocial adjustment and cognitive functioning during childhood and adolescence. In this article, we discuss poor sleep as a potential mechanism contributing to the development of such disparities, and better sleep as a potential protective factor that diminishes such disparities. We conclude by offering recommendations for research to advance understanding of sleep as a key bioregulatory system that may underlie or protect against detrimental developmental outcomes related to socioeconomic adversity and belonging to a historically minoritized group.
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Introduction: Cognitive behavior therapy for insomnia (CBTi), delivered face-to-face or digitally, can improve the mental health of adults. Although insomnia is common in adolescents, the effects of digital CBTi on adolescent mental health have seldom been investigated. Objectives: The aims of this study were to explore: (i) the acceptability of a digital CBTi intervention, Sleepio, as a first-step intervention for adolescents referred to specialist mental health services (CAMHS), (ii) the impact on sleep and mental health and (iii) subsequent CAMHS interventions. Method: Sleepio is a computerized CBTi intervention comprised of six sequentially delivered sessions. Digital Sleepio was offered to new referrals to CAMHS with poor sleep and mental health problems. Results. Of the 75 eligible adolescents, 70 (93%; 95% CI: 85% to 98%) accepted Sleepio with 59 starting the programme and consenting to participate in the study. Of these, 37 (63%; 95% CI: 49% to 75%) completed at least half of the programme. There were post-intervention improvements in sleep, mood, and anxiety; the improvement in sleep was greater for those who completed at least half the programme compared to those who did not. Of those who completed all the programme, 55% (15/29) did not need any subsequent specialist CAMHS input. Of the 11 adolescents who accepted but never started Sleepio, none engaged with other CAMHS interventions and were subsequently discharged. Conclusion: Our study has a number of limitations, in particular the absence of a control group and the loss of follow-up data for programme drop-outs. Nonetheless, these results suggest that digital CBTi may offer a novel and acceptable way of improving the sleep and mental health of adolescents with insomnia. A fully powered randomized controlled trial is required to obtain definitive estimates of the effects of the intervention.
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Issue addressed: Insufficient sleep and unhealthy sleep practices in adolescents are associated with significant health risks. Sleep education programs in schools aim to improve sleep behaviour. A new eLearning sleep education program, Healthy Sleep for Healthy Schools (HS4HS), was developed focused on these goals and is distinguishable from other sleep education programs because it is delivered by teachers, making it more sustainable and adaptable for schools. We aimed to evaluate if HS4HS would improve student sleep knowledge, healthy sleep practices, sleep duration and reduce sleepiness. We also aimed to understand if this intervention could be successfully implemented by trained teachers. Methods: Teachers trained in sleep delivered HS4HS to 64 South Australian students in year 9 (aged 13-14 years) over 6 weeks during regular school curriculum. A sleep education survey assessing sleep patterns (such as healthy sleep practices, time in bed and sleepiness), and a sleep knowledge questionnaire was completed pre and post HS4HS delivery. Evaluations were also completed by teachers. Results: Sleep knowledge and healthy sleep practices significantly improved post intervention. Time in bed on both school days and weekends increased slightly and sleepiness decreased slightly but these changes were not statistically significant. Teachers found the program useful, comprehensive and easy to incorporate into their curricula. Conclusions: After short training, teachers can deliver sleep education during class and improve sleep practices in their students. This suggests that this program may offer potential as an effective and useful resource for teachers wanting to include sleep health in their curriculum. SO WHAT?: Sleep is the foundation of good health and teachers can promote and integrate sleep education into their curricula for the first time with this online teacher focussed program which has the potential to be a sustainable sleep health promotion resource.
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Sleep is a behavioral state whose quantity and quality represent a trade-off between the costs and benefits this state provides versus the costs and benefits of wakefulness. Like many species, we humans are particularly vulnerable during sleep because of our reduced ability to monitor the external environment for nighttime predators and other environmental dangers. A number of variations in sleep characteristics may have evolved over the course of human history to reduce this vulnerability, at both the individual and group level. The goals of this interdisciplinary review paper are (1) to explore a number of biological/instinctual features of sleep that may have adaptive utility in terms of enhancing the detection of external threats, and (2) to consider relatively recent cultural developments that improve vigilance and reduce vulnerability during sleep and the nighttime. This paper will also discuss possible benefits of the proposed adaptations beyond vigilance, as well as the potential costs associated with each of these proposed adaptations. Finally, testable hypotheses will be presented to evaluate the validity of these proposed adaptations.
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This study used routine activity theory to examine the relationships between bullying victimization, subjective obesity, gender, sleep duration, and academic achievement in a national sample of high school youth in the United States. Subjective obesity status (OR = 1.54, 95% CI [1.17–2.03]), academic achievement (OR = 0.88 [0.81, 0.95]), and sleep duration (OR = 0.83 [0.78, 0.88] were significant predictors of bullying victimization. Academic achievement, in turn, attenuated the effects of subjective obesity status. Males were less likely to experience bullying victimization (OR = .56 [.49, .65]), less likely to identify as obese, less likely to earn As and Bs in academic achievement, and more likely to obtain adequate amounts of sleep on school nights. Problems in identifying interactions are discussed. The findings indicate that routine activity theory is a viable framework for understanding bullying victimization, and that academic achievement and sleep duration should be understood as protective factors against bullying predation.
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Objectives Correlational models suggest increased cardiometabolic risk when sleep replaces moderate-to-vigorous (but not sedentary or light) physical activity. This study tested which activity ranges are impacted by experimentally altering adolescents’ bedtime. Method Adolescents completed a 3-week within-subjects crossover experiment with 5 nights of late bedtimes and 5 nights early bedtimes (6.5- and 9.5-hours sleep opportunity, respectively). Experimental condition order was randomized. Waketimes were held constant throughout to mimic school start times. Sleep and physical activity occurred in the natural environments, with lab appointments following each 5-day condition. Waist-worn accelerometers measured physical activity and sedentary behavior. Wrist-worn actigraphs confirmed sleep condition adherence. Wilcoxon tests and linear mixed effects models compared waking activity levels between conditions and across time. Results Ninety healthy adolescents (14-17 years) completed the study. When in the early (vs. late) bedtime condition, adolescents fell asleep 1.96 hours earlier (SD = 1.08, d = 1.82, p < .0001) and slept 1.49 hours more (SD = 1.01, d = 1.74, p < .0001). They spent 1.68 and 0.32 fewer hours in sedentary behavior (SD = 1.67, d = 1.0, p < .0001) and light physical activity (SD = 0.87, d = 0.37, p = .0005), respectively. This pattern was reflected in increased proportion of waking hours spent in sedentary and light activity. Absolute and proportion of moderate-to-vigorous physical activity did not differ between conditions (d = 0.02, p = .89; d = 0.14, p = .05, respectively). Conclusions Inducing earlier bedtimes (allowing for healthy sleep opportunity) did not affect moderate-to-vigorous physical activity. Alternatively, later bedtimes (allowing for ≤ 6.5 hours of sleep opportunity, mimicking common adolescent school night sleep) increased sedentary behavior. Results are reassuring for the benefits of earlier bedtimes.
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It is well-established that sleep and behavior are interrelated. Although studies have investigated this association, not many have evaluated the bidirectional relationship between the two. To our knowledge this is the first systematic review providing a comprehensive analysis of a reciprocal relationship between sleep and externalizing behavior. Five databases (PsycINFO, PubMed, Web of Science, Scopus, and Google Scholar) were utilized to yield a total of 3,762 studies of which 20 eligible studies, empirical articles examining bidirectionality of sleep and externalizing behavior, were selected for analysis. According to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis, the varying methodological approaches used in these studies were analyzed and synthesized, including examining differences and similarities in outcomes between distinct study designs (longitudinal vs cross-sectional), sleep measures (objective vs subjective vs a combination of both), informants (parents, self-report, teachers), and recruited participants (clinical, subclinical and typical populations). The assessment of risk of bias and quality of studies was guided by the instruments employed in research on sleep and behavior in the past. This review establishes that a bidirectional relationship between sleep problems and externalizing behavior clearly exists, and identifies limitations in the existing literature. Furthermore, the importance of early interventions that target both externalizing behaviors and sleep problems is highlighted as a potentially effective way of breaking the sleep-externalizing behavior relationship. Nonetheless, causality cannot be claimed until more trials that manipulate sleep and evaluate changes in externalizing behavior are conducted.
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Study Objectives Major Depressive Disorder (MDD) in adolescence is associated with irregularities in circadian rhythms and sleep. The characterization of such impairment may be critical to design effective interventions to prevent development of depression among adolescents. This study aimed to examine self-reported and actimetry-based circadian rhythms and sleep-wake behavior associated with current MDD and high-risk for MDD among adolescents. Methods Ninety-six adolescents who took part in the IDEA-RiSCo study were recruited using an empirically-developed depression-risk stratification method: 26 classified as low-risk (LR), 31 as high-risk (HR), and 39 as a current depressive episode (MDD). We collected self-report data on insomnia, chronotype, sleep schedule, sleep hygiene as well as objective data on sleep, rest-activity and light exposure rhythms using actimetry for 10 days. Results Adolescents with MDD exhibited more severe insomnia, shorter sleep duration, higher social jetlag (SJL), lower relative amplitude (RA) of activity and higher exposure to artificial light at night (ALAN) compared to the other groups. They also presented poorer sleep hygiene compared to the LR group. The HR group also showed higher insomnia, lower RA, higher exposure to ALAN and higher SJL compared to the LR group. Conclusions High-risk adolescents shared sleep and rhythm alterations with the MDD group, which may constitute early signs of depression, suggesting that preventive strategies targeting sleep should be examined in future studies. Furthermore, we highlight that actimetry-based parameters of motor activity (particularly RA) and light exposure are promising constructs to be explored as tools for assessment of depression in adolescence.
Article
Objectives During adolescence, changes in the circadian and homeostatic systems, combined with psychosocial factors, create a phase delay in the sleep of adolescents. These changes in sleep are associated with increased sleep difficulties and a shortened sleep duration, which has a negative impact on daytime functioning of adolescents. Some studies showed that teenage girls report worse sleep quality and shorter sleep duration than boys during adolescence. The objective of this study was to investigate gender differences in the impact of sleep difficulties and sleepiness on daytime functioning in adolescents and to measure which aspect of sleep may interfere with daytime functioning in boys and girls. Method A total of 731 adolescents (311 boys, 420 girls; age 13 to 17,5 years) completed questionnaires on sleep and daytime functioning. Results Compared to boys, teenage girls reported a significantly greater impact of short sleep duration and sleep difficulties on their school and social activities. Furthermore, our results suggest that the factors predicting the negative interference on daytime functioning seem to be more complex and multifactorial for girls than for boys. Conclusions This study further emphasizes the importance of monitoring insufficient and poor sleep quality in adolescents, as these sleep variables seem to have a significant impact on their daytime functioning. Clinicians should also take into account gender when considering sleep issues in adolescents, as teenage girls and boys have different vulnerabilities and needs.
Article
Study objectives: Sleep disturbances impact over half of older children and teens with acquired brain injury (ABI) following critical care hospitalization, but are under-evaluated in infants and young children. Given the importance of sleep in brain development and healing after injury, we hypothesized sleep disturbances would be associated with worse neurodevelopmental outcomes in infants with ABI. Methods: We performed a retrospective cohort study of 68 children aged 2-32 months following critical care hospitalization for ABI. The Brief Infant Sleep Questionnaire (BISQ) assessed sleep disturbances. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) and Adaptive Behavior Assessment System, 3rd Edition (ABAS-3) assessed developmental and adaptive functioning outcomes, respectively. T-tests compared sleep characteristics in infants with ABI to historical healthy controls. Spearman's correlation (rs) evaluated relationships among sleep and outcomes. Multiple linear regression investigated relationships controlling for demographic and ABI characteristics. Results: Compared to healthy controls, children with ABI had shorter nighttime sleep duration (p=.01), longer daytime sleep duration (p<.001), and longer duration of nighttime awakenings (p<.001). Duration of night awakenings negatively correlated with Bayley Cognitive scores (rs=-.40). Night awakenings negatively correlated with worse ABAS-3 General Adaptive Composite (GAC) scores (rs=-.42). When controlling for demographic and ABI characteristics, ≥3 awakenings was significantly associated with worse ABAS-3 GAC (β=-11.3; 95% confidence interval=-19.2, -3.5). Conclusions: Sleep disturbances are associated with poorer outcomes in infants and toddlers after ABI. Sleep is vital to recovery and a potentially modifiable target to improve outcomes.
Article
Stress and sleep problems are significantly correlated in adolescents. Few longitudinal studies, however, have evaluated possible correlates and predictors of sleep problems at multiple points across adolescence. The current study examined the relation between stress and sleep problems across four years in a sample of adolescents who varied in risk for psychopathology. Participants included 223 adolescents (55% female) and 223 mothers (77% with a history of a mood disorder during their child’s life). Youth were evaluated in grade 7 (M = 12.69 years, SD = 0.61) and again in grades 8, 9, and 11. Sleep problems were assessed as part of a clinical interview, and weekly stressful events were measured with the Life Events Interview for Adolescents. Multi-group latent growth curve analyses were conducted. Among youth whose mothers had a history of depression (high-risk), sleep problems significantly increased over time (p < .001). Second, among high-risk youth, at each time point, higher stress levels during the prior three months significantly predicted higher levels of sleep problems (p < .001). Finally, across the entire sample, at each time point a greater level of sleep problems predicted higher stress ratings a year later (p ≤ .001). Thus, stress was a significant predictor of sleep problems across multiple years of adolescence, particularly among offspring of mothers with a history of depression. Results highlight targets for preventive interventions for sleep problems in youth.
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This paper examines the association between use of protective devices, frequency of acute health problems and health-protection information received by participants engaged in the Prestige oil spill clean-up in Asturias and Cantabria, Spain. We studied 133 seamen, 135 bird cleaners, 266 volunteers and 265 paid workers selected by random sampling, stratified by type of worker and number of working days. Information was collected by telephone interview conducted in June 2003. The association of interest was summarized, using odds ratios (OR) obtained from logistic regression. Health-protection briefing was associated with use of protective devices and clothing. Uninformed subjects registered a significant excess risk of itchy eyes (OR:2.89; 95%CI:1.21-6.90), nausea/vomiting/dizziness (OR:2.25; 95%CI:1.17-4.32) and throat and respiratory problems (OR:2.30; 95%CI:1.15-4.61). There was a noteworthy significant excess risk of headaches (OR:3.86: 95%CI:1.74-8.54) and respiratory problems (OR:2.43; 95%CI:1.02-5.79) among uninformed paid workers. Seamen, the group most exposed to the fuel-oil, were the worst informed and registered the highest frequency of toxicological problems. Proper health-protection briefing was associated with greater use of protective devices and lower frequency of health problems. Among seamen, however, the results indicate poorer dissemination of information and the need of specific guidelines for removing fuel-oil at sea.
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Background Physical activity and fitness are independently associated with cardiometabolic dysfunction, and short sleep duration is an emerging marker of obesity. Few have examined interrelations among these factors in a comprehensive risk model. Purpose Investigate the influence of behavioral and lifestyle risk factors on the metabolic syndrome and inflammation. Methods A sample of 367 15–17-year-olds (73 % boys) from ethnic minority groups (45.8 % Hispanic, 30.8 % Black), most with elevated blood pressure (72 %), underwent aerobic fitness testing, blood sampling, and completed behavioral questionnaires. Results Structural model results are consistent with the notion that short sleep duration, poor sleep quality and fatigue, and decreased physical activity are associated with increased risk of metabolic syndrome and inflammation possibly via effects on reduced cardiorespiratory fitness. Conclusions The combination of negative lifestyle and behavioral factors of physical inactivity, sleep loss, and poor fitness has serious implications for cardiovascular health complications in at-risk youth.
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Background: Evidence suggests that inadequate or disturbed sleep is associated with increased cardiovascular risk in adults. There are limited data on sleep quality and associated cardiovascular risk in children. Methods: We obtained data on adolescents from the 2009/10 cycle of the Healthy Heart Schools' Program, a population-based cross-sectional study in the Niagara region of Ontario. Participants underwent measurements of cardiometabolic risk factors, including body mass index (BMI), lipid profile and blood pressure, and they completed questionnaires measuring sleeping habits and nutritional status. We assessed sleep disturbance using the sleep disturbance score derived from the Pittsburgh Sleep Quality Index. We explored associations between sleeping habits and cardiovascular risk factors. Results: Among 4104 adolescents (51% male), the mean hours of sleep per night (± standard deviation) were 7.9 ± 1.1 on weeknights and 9.4 ± 1.6 on weekends. In total, 19% of participants reported their sleep quality as fairly bad or very bad on weeknights and 10% reported it as fairly bad or very bad on weekends. In the multivariable regression models, a higher sleep disturbance score was associated with increased odds of being at high cardiovascular risk (highest v. lowest tertile odds ratio [OR] 1.43 [95% confidence interval (CI) 1.16-1.77], p < 0.001), increased odds of hypertension (highest v. lowest tertile OR 1.44 [95% CI 1.02-2.05], p = 0.05) and increased odds of elevated non-high density lipoprotein cholesterol (highest v. lowest tertile OR 1.28 [95% CI 1.00-1.64], p = 0.05). The mean duration of sleep was not associated with these outcomes. Interpretation: In healthy adolescents, sleep disturbance is associated with cardiovascular risk factor abnormalities. Intervention strategies to optimize sleep hygiene early in life may be important for the prevention of cardiovascular disease.
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Poor sleep may play a role in insulin resistance and diabetes risk. Yet few studies of sleep and insulin resistance have focused on the important developmental period of adolescence. To address this gap, we examined the association of sleep and insulin resistance in healthy adolescents. Cross-sectional. Community setting in one high school. 245 (137 African Americans, 116 males) high school students. Participants provided a fasting blood draw and kept a sleep log and wore a wrist actigraph for one week during the school year. Participants' families were from low to middle class based on family Hollingshead scores. Total sleep time across the week averaged 7.4 h by diary and 6.4 h by actigraph; homeostatic model assessment of insulin resistance ([HOMA-IR] unadjusted) averaged 4.13. Linear regression analyses adjusted for age, race, gender, body mass index, and waist circumference showed that the shorter the sleep, the higher the HOMA-IR, primarily due to sleep duration during the week. No evidence was found for long sleep being associated with elevated HOMA-IR. Fragmented sleep was not associated with HOMA-IR but was associated with glucose levels. Reduced sleep duration is associated with HOMA-IR in adolescence. Long sleep duration is not associated. Interventions to extend sleep duration may reduce diabetes risk in youth. CITATION: Matthews KA; Dahl RE; Owens JF; Lee L; Hall M. Sleep duration and insulin resistance in healthy black and white adolescents. SLEEP 2012;35(10):1353-1358.
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Adequate sleep has been considered important for the adolescent's health and well being. On the other hand, self-imposed sleep curtailment is now recognized as a potentially important and novel risk factor for obesity. The present study aimed to assess the prevalence of short sleep duration and its association with obesity among Saudi adolescents. This is a school-based cross-sectional study with self-reported sleep questionnaires. It was conducted during the years 2009/2010 in three cities in Saudi Arabia; Al-Khobar, Jeddah, and Riyadh. Participants were 2868 secondary-school males (1379) and females (1389) aged 15 to 19 years, randomly selected using a multistage stratified sampling technique. Measurements included weight, height, waist circumference, BMI, and sleeping duration. Logistic regression analysis while adjusted for age, gender, and location was used to examine the associations between sleep duration and obesity measures. The mean (SD) of sleep duration was 7.2 (1.6) hours/day with no significant differences between males and females. About 31% of the participants obtain less than 7 hours of sleep per day, while approximately 50% of the sample gets less than 8 hours of daily sleep. Two-way ANCOVA results while controlling for the effect of age revealed a significant gender by school-type interaction (P<0.001). In addition, adequate sleep duration increased the odds of having normal weight (adjusted odds ratios = 1.28, 95% CI = 1.08-1.50, P = 0.003). The present study observed a high prevalence of short sleep duration among Saudi adolescents 15- to 19-year olds and that short sleep duration was significantly associated with increased risk of overweight and obesity. Future interventions should investigate whether adopting a healthy lifestyle by adolescents with short sleep duration would improve their sleeping habits or not.
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To assess the effects of early and late bedtimes and wake up times on use of time and weight status in Australian school-aged children. Observational cross-sectional study involving use of time interviews and pedometers. Free-living Australian adolescents. 2200 9- to 16-year-olds from all states of Australia NA. Bedtimes and wake times were adjusted for age and sex and classified as early or late using median splits. Adolescents were allocated into 4 sleep-wake pattern groups: Early-bed/Early-rise; Early-bed/Late-rise; Late-bed/Early-rise; Late-bed/Late-rise. The groups were compared for use of time (screen time, physical activity, and study-related time), sociodemographic characteristics, and weight status. Adolescents in the Late-bed/Late-rise category experienced 48 min/d more screen time and 27 min less moderate-to-vigorous physical activity (MVPA) (P<0.0001) than adolescents in the Early-bed/Early-rise category, in spite of similar sleep durations. Late-bed/Late-rise adolescents had a higher BMI z-score (0.66 vs. 0.45, P=0.0015). Late-bed/Late-rise adolescents were 1.47 times more likely to be overweight or obese than Early-bed/Early-rise adolescents, 2.16 times more likely to be obese, 1.77 times more likely to have low MVPA, and 2.92 times more likely to have high screen time. Late-bed/Late-rise adolescents were more likely to come from poorer households, to live in major cities, and have fewer siblings. Late bedtimes and late wake up times are associated with an unfavorable activity and weight status profile, independent of age, sex, household income, geographical remoteness, and sleep duration.
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To examine associations between insufficient sleep (<8h on average school nights) and health-risk behaviors. 2007 national Youth Risk Behavior Survey data of U.S. high school students (n=12,154) were analyzed. Associations were examined on weighted data using multivariate logistic regression. Insufficient sleep on an average school night was reported by 68.9% of students. Insufficient sleep was associated with higher odds of current use of cigarettes (age-adjusted odds ratio [AOR], 1.67; 95% confidence interval [CI], 1.45-1.93), marijuana (AOR, 1.52; 95% CI, 1.31-1.76), and alcohol (AOR, 1.64; 95% CI, 1.46-1.84); current sexual activity (AOR, 1.41; 95% CI, 1.25-1.59); seriously considered attempting suicide (AOR, 1.86; 95% CI, 1.60-2.16); feeling sad or hopeless (AOR, 1.62; 95% CI, 1.43-1.84); physical fighting (AOR, 1.40; 95% CI, 1.24-1.60), not being physically active at least 60min ≥ 5days in the past 7days (AOR, 1.16; 95% CI, 1.04-1.29), using the computer ≥3h/day (AOR, 1.58; 95% CI, 1.38-1.80), and drinking soda/pop > 1time/day (AOR, 1.14; 95% CI, 1.03-1.28). Two-thirds of adolescent students reported insufficient sleep, which was associated with many health-risk behaviors. Greater awareness of the impact of sleep insufficiency is vital.
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Adequate sleep is a critical factor for adolescent's health and health-related behaviors. (a) to describe sleep duration in European adolescents from nine countries, (b) to assess the association of short sleep duration with excess adiposity and (c) to elucidate if physical activity (PA), sedentary behaviors and/or inadequate food habits underlie this association. A sample of 3311 adolescents (1748 girls) aged 12.5-17.49 years from 10 European cities in Austria, Belgium, France, Germany, Greece, Hungary, Italy, Spain and Sweden was assessed in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study between 2006 and 2008. We measured anthropometric data, sleep duration, PA (accelerometers and questionnaire), television watching and food habits (Food Frequency Questionnaire). Average duration of daily sleep was 8 h. Shorter sleepers showed higher values of BMI, body fat, waist and hip circumferences and fat mass index (P<0.05), particularly in females. Adolescents who slept <8 h per day were more sedentary, as assessed by accelerometry, and spent more time watching TV (P<0.05). The proportion of adolescents who eat adequate amounts of fruits, vegetables and fish was lower in shorter sleepers than in adolescents who slept ≥8 h per day, and so was the probability of having adequate food habits (P<0.05). Correlation analysis indicated that short sleep is associated with higher obesity parameters. In European adolescents, short sleep duration is associated with higher adiposity markers, particularly in female adolescents. This association seems to be related to both sides of the energy balance equation due to a combination of increased food intake and more sedentary habits.
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Restoring sleep is strongly associated with a better physical, cognitive, and psychological well-being. By contrast, poor or disordered sleep is related to impairment of cognitive and psychological functioning and worsened physical health. These associations are well documented not only in adults but also in children and adolescents. Importantly, adolescence is hallmarked by dramatic maturational changes in sleep and its neurobiological regulation, hormonal status, and many psychosocial and physical processes. Thus, the role of sleep in mental and physical health during adolescence and in adolescent patients is complex. However, it has so far received little attention. This review first presents contemporary views about the complex neurobiology of sleep and its functions with important implications for adolescence. Second, existing complex relationships between common adolescent somatic/organic, sleep-related, and psychiatric disorders and certain sleep alterations are discussed. It is concluded that poor or altered sleep in adolescent patients may trigger and maintain many psychiatric and physical disorders or combinations of these conditions, which presumably hinder recovery and may cross into later stages of life. Therefore, timely diagnosis and management of sleep problems appear critical for growth and development in adolescent patients.
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Adolescents tend to experience more problems with sleep loss as a natural consequence of puberty, whereas teens from impoverished urban areas are likely to witness neighborhood violence and/or engage in risk behaviors that may affect sleep. Data from the Mobile Youth Survey, a longitudinal study of impoverished inner-city African-American adolescents (1998-2005; N = 20,716; age range = 9.75-19.25 years), were used to compare paired years of annual surveys elicited by questions about how sleep was affected when bad things happen to friends or family. Using a cross-lagged panel multivariate approach comparing reports for two sequential years and controlling for age/gender plus exposure to traumatic stress and violence, prior sleep disturbance was associated with carrying a knife/gun, brandishing a knife/gun, using a knife/gun, quick temperedness, warmth toward mother, worry, and belief in the neighborhood street code in the latter year. Conversely, seeing someone cut, stabbed, or shot, using alcohol, worry, and internalized anger were associated with sleep disturbance in a latter year. Although a limited measure of sleep disturbance was used, these findings support further research to examine sleep disturbance and risk behaviors among low-income adolescents.
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BACKGROUND: Sleep problems may have different influences on students' academic performance. We investigated the prevalence of sleep patterns, naps, and sleep disorders, and their associations with academic performance in Hong Kong adolescents. METHODS: In 2007-2008, 22,678 students aged 12-18 (41.6% boys) completed a questionnaire on sociodemographic characteristics, sleep patterns and problems, and lifestyle factors including exercise, smoking, alcohol drinking, and academic performance. RESULTS: The prevalence of having >8 hours of sleep was higher on holiday nights (86.4%) than on school-day nights (27.4%). Sleeping after midnight was more common before holidays (49.3%) than before school days (19.9%). Symptoms of insomnia and obstructive sleep apnea (OSA) were reported by 21.5% and 34.4% of students. Having >2 hours of weekend sleep delay was associated with poor academic performance with an odds ratio (OR) (95% confidence interval) of 1.46 (1.29-1.65). However, having 1-2 hours and >2 hours of weekend wake-up delay were both associated with less likelihood of poor academic performance with ORs of 0.64 (0.56-0.73) and 0.69 (0.59-0.80). Other factors associated with poor academic performance included >2 hours of sleep debt, OR of 1.17 (1.03-1.33); having any insomnia symptoms in the past 30 days, OR of 1.27 (1.17-1.37); and having any OSA symptoms at least weekly, OR of 1.23 (1.14-1.32). Napping in the past 5 school days was only marginally associated with poor school performance with an OR of 1.08 (1.00-1.16). CONCLUSION: Poorer academic performance was associated with sleep debt, and symptoms of insomnia and OSA. Sleep compensation but not naps may be a protective factor of poor academic performance.
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Abstract  The purpose of the present study was to determine the prevalence of excessive daytime sleepiness (EDS) and its associations with sleep habits, sleep problems, and school performance in high school students in South Korea. A total of 3871 students (2703 boys and 1168 girls with a mean age of 16.8 years and 16.9 years, respectively) aged 15–18 years in the 11th grade of high school completed a questionnaire that contained items about individual sociodemographic characteristics, sleep habits, and sleep-related problems. The overall prevalence of EDS was 15.9% (14.9% for boys and 18.2% for girls). Mean reported total sleep time was similar in EDS and non-EDS (6.4 ± 1.6 and 6.4 ± 1.3 h/day, respectively). The increased risk of EDS was related to perceived sleep insufficiency (P < 0.001), teeth grinding ≥ 4 days/week (P < 0.001), witnessed apnea ≥1–3 days/week (P < 0.01), nightmares ≥4 days/week (P < 0.05), low school performance (P < 0.01), and two or more insomnia symptoms (P < 0.05). Students with low school performance had a 60% excess in the odds of EDS compared to those whose school performance was high. These findings suggest that EDS is associated with multiple sleep-related factors in adolescents. Whether interventions to modify associated correlates can alter EDS warrants consideration, especially because it may also improve academic performance in high school students.