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Sleeping through a Lockdown: How Adolescents and Young Adults Struggle with Lifestyle and Sleep Habits Upheaval during a Pandemic
Abstract
Objectives
The objective of the present study was to investigate the relationship between chronotype, lifestyle habits during the pandemic, and changes in sleep timing during the first wave of the COVID-19 pandemic in youth.
Method
An online survey of adolescents and young adults (N = 449) was conducted in June 2020. Multivariate hierarchical regressions assessed the contribution of chronotype and changes in lifestyle habits to sleep timing during the COVID-19 pandemic in two age groups (12 to 17 years old and 18 to 25 years old).
Results
Chronotype was a significant predictor of changes in sleep habits during the pandemic in both age groups. In adolescents, electronic device usage during the pandemic was a significant predictor of bedtimes and wake times on weekdays, and caffeine during the pandemic was a predictor of weekday wake times. The number of hours worked during the pandemic was a significant predictor of weekday wake times in both age groups. In young adults, cannabis consumption during the pandemic was a predictor of weekend bedtimes. A later chronotype, along with higher usage of electronic devices, fewer hours worked, as well as higher caffeine and cannabis consumption during the pandemic were associated with delayed sleep timing during the pandemic in youth.
Conclusion
These results highlight the importance of assessing lifestyle habits when exploring changes in sleep habits in youth.
... Para los adolescentes el apoyo de compañeros y padres y la calidad del sueño son factores positivos, mientras que el conflicto entre padres e hijos y el estrés por la salud ante la pandemia son factores de riesgo; sin embargo, los adolescentes de bajos ingresos experimentaron más conflictos con los padres, más estrés por la salud de la covid-19, menos apoyo de los compañeros y una calidad de sueño más baja en comparación con los adolescentes de mayores ingresos. Mientras que Potvin et al. (2022) investigaron la relación entre cronotipos (matutino, vespertino e intermedio) y los hábitos para dormir en adolescentes y adultos jóvenes. El cronotipo vespertino fue un predictor significativo de los cambios en los hábitos de sueño en ambos grupos. ...
... Respecto al sueño, la calidad de éste tuvo una relación negativa con el uso compulsivo de Internet, uso de medios sociales, adicción a los juegos y sentimiento de soledad. Esta relación negativa entre el uso aumentado de los dispositivos electrónicos y una disminución en la cantidad y calidad del sueño es un resultado confirmado por varios estudios (Moitra y Madan, 2022;Ali et al., 2021;Zhang et al., 2021;Potvin et al., 2022). ...
La pandemia por COVID-19 originó emociones y sentimientos negativos que afectan la salud en general y el sueño en específico. Este problema se agudiza en los adolescentes en tanto el confinamiento les ha privado de interacciones sociales con sus pares, las cuales son esenciales para el desarrollo psicológico. El objetivo de la presente revisión fue analizar las investigaciones que han explorado los cambios en el dormir de los adolescentes durante la pandemia de COVID-19, para explorar la magnitud y naturaleza de esos efectos, además de detectar los factores asociados. Se realizó una búsqueda en EBSCO con los siguientes términos “adolescents or teenagers or teens”, “sleep” y “COVID-19”, encontrándose 158 trabajos. Después del análisis se seleccionaron 59 estudios empíricos, principalmente de carácter cuantitativo (89.8%). Durante los confinamientos asociados a la pandemia se reportó un aumento en la duración del sueño y un retraso en la hora de irse a dormir y de levantarse. Al mismo tiempo se evidenció un aumento del insomnio de los adolescentes o de otras alteraciones del dormir, las cuales se asociaron a la presencia de estrés y ansiedad. La dieta, la actividad física y el uso de pantallas son factores que afectan la duración y calidad del sueño. Intervenciones para la mejora del sueño sólo se encontraron dos y éstas obtuvieron efectos positivos. El conocimiento recabado proporciona apoyo para la atención integral de adolescente en búsqueda de la salud física y mental, en la cual el sueño es un componente relevante.
... In this study, the scores of some dimensions were utilized individually as dependent variables in order to describe the characteristics of athletes' sleep in detail, with reference to the methods of previous studies [9,24]. Thus, we have the following indicators in this study: (1) global PSQI score, the total score (0-21) of PSQI, with higher scores indicating poorer sleep quality overall; (2) subjectively rated sleep quality, score on the subjective sleep quality dimension of the PSQI (0-3), with higher scores indicating worse subjective perceived sleep quality; (3) Sleep time, the time when participant go to bed (in minutes since 0:00, if later than 24:00, 1440 minutes are superimposed), the bigger the value, the later the bedtime; (4) Wake time, the time participant wake up after going to bed (in minutes since 0:00), the greater the value, the later the morning wake time; (5) Sleep latency, the time between going to bed and falling asleep, with larger values indicating that it takes more time to fall asleep; (6) hours of sleep, the total number of hours slept, with higher values indicating longer sleep duration; (7) calculated sleep efficiency, the proportion of total sleep time actually spent asleep after falling asleep, with higher values indicating higher sleep efficiency; (8) total sleep disorder score, the total score for the sleep disorder dimension of the PSQI (0-30), with higher scores indicating more severe sleep disorder symptoms (symptoms such as difficulty falling asleep, waking up at night, excessive dreaming, etc.); and (9) total daytime dysfunction score, the total score for the daytime dysfunction dimension of the PSQI (0-6), with higher values indicating more pronounced daytime dysfunction (feelings like sleepiness, problem in keep up enough enthusiasm, etc.). ...
Closed-loop management of athletes at the training base is a compromise approach that balanced epidemic prevention and sports training during the COVID-19 pandemic. This study investigated the impact of prolonged closed-loop management on athletes' sleep and mood during the 2022 Shanghai Omicron wave. The Pittsburgh Sleep Quality Index and the Profile of Mood States were used to assess the sleep and mood states of 110 professional athletes in "closed-loop management" at the training base after 1 and 2 months of closed-loop management, respectively, to characterize changes in sleep and mood with prolonged closed-loop management. After two months of control, the sleep and mood of 69 athletes and students of the same age were measured using the Pittsburgh Sleep Quality Index and Perceptual Stress Scale, as well as the Warwick-Edinburgh Mental Well-being Scale, to compare the differences in sleep and mood between athletes undergoing closed-loop management and the general population who were managed in the community. Paired sample t-tests and independent sample t-tests were used for comparisons across different time intervals and different management approaches. Results showed that with the time of closed-loop management increased, athletes woke up earlier (p = 0.002), slept less (p = 0.024), and became angrier (p = 0.014); athletes had poorer overall sleep quality (p < 0.001) but lower stress level (p = 0.004) than those who were outside the base. In closed-loop management, the athletes were able to maintain a stable sleep and mood state. Sports team administrators must be aware of the need to improve athletes' sleep quality and help athletes to agree with this approach of management.
... Interestingly, sleep problems in adolescents during the pandemic have also been frequently associated with specific daily habits. Specifically, longer screen time [135,136,[147][148][149][150][151][152][153] and lower physical activity [149,154] have been associated with different measures of poor sleep quality. Considering the influence of these variables on sleep habits in adolescents [14,[155][156][157], these findings are consistent with the increased screen time and sedentary behaviors observed in youth during the pandemic [119][120][121][122]141]. ...
Sleep changes significantly throughout the human lifespan. Physiological modifications in sleep regulation, in common with many mammals (especially in the circadian rhythms), predispose adolescents to sleep loss until early adulthood. Adolescents are one-sixth of all human beings and are at high risk for mental diseases (particularly mood disorders) and self-injury. This has been attributed to the incredible number of changes occurring in a limited time window that encompasses rapid biological and psychosocial modifications, which predispose teens to at-risk behaviors. Adolescents' sleep patterns have been investigated as a biunivocal cause for potential damaging conditions, in which insufficient sleep may be both a cause and a consequence of mental health problems. The recent COVID-19 pandemic in particular has made a detrimental contribution to many adolescents' mental health and sleep quality. In this review, we aim to summarize the knowledge in the field and to explore implications for adolescents' (and future adults') mental and physical health, as well as to outline potential strategies of prevention.
... Additionally, although it was out of the scope of our study, other possible behavioral factors related to the bruxism habit should be also controlled in future studies. For instance, the use of tooth wear (for different findings see references [60,61]) and changes in lifestyle observed during the COVID-19 pandemic, such as changes in sleep habits, use of electronic devices, caffeine, and other drugs intake [62]. Although the sample selection (a cohort of university students) favoured the homogeneity of the samples in terms of age, sociological, cultural, and environmental variables, further research including larger and more representative samples of participants, including a similar number of males and females, could enhance the generalizability of the results. ...
There is a broad consensus accepting that psychological variables such as stress, anxiety, or depression play an important role in bruxism. The COVID-19 pandemic has led to an increase in stress, anxiety, and depression levels. The purpose of this study was to evaluate the impact of the COVID-19 pandemic on possible awake and sleep bruxism prevalence and on the psychological factors associated with bruxism, comparing pre-pandemic, pandemic/lockdown, and post-pandemic samples of first-year students. A total of 274 dentistry students from the Complutense University of Madrid participated in the study: 92 from 2018/2019 (pre-pandemic), 90 from 2020/2021 (pandemic), and 92 students from 2021/2022 (post-pandemic) academic years. The participants filled out a thorough battery of validated questionnaires evaluating bruxism and different psychological characteristics, such as anxiety, depression, somatization, personality, and stress coping styles. While sleep bruxism prevalence was significantly higher for the pandemic group, awake bruxism was smaller in comparison to pre-pandemic and post-pandemic groups. The post-pandemic group also presented higher levels of neuroticism and agreeableness personality traits, and positive reappraisal than the pre-pandemic group, with the pandemic group somewhere in between. Additionally, both the pandemic and post-pandemic group showed higher levels of depression and acceptance/resignation coping styles than the pre-pandemic group. Thus, among the three groups of students, the post-pandemic group was the one that showed a larger effect of the pandemic situation in their psychological variables, presenting higher levels of anxiety (state and trait), depression, acceptation/resignation coping style, higher neuroticism (emotional instability trait), and lower agreeableness trait. Nonetheless, the increase of positive reappraisal in the post-pandemic group (an adaptive coping stress style) might be also a sign of recovery. The higher sleep bruxism for the pandemic group might be related to the pandemic situation and lockdown, passively suffered, possibly promoting feelings of impotency, increased levels of depression and acceptance/resignation (normally considered a passive/maladaptive coping style), while acute stressful situations derived from daily personal social interactions might have increased anxiety levels and induced higher levels of awake bruxism observed in both the pre-pandemic and post-pandemic groups. However, further research, including larger and more representative samples, is needed to confirm this possible relationship.
Keywords: bruxism; stress; anxiety; depression; neuroticism; coping; dental students; COVID-19
Later circadian timing during adolescence is linked to worse sleep, more severe depression and greater alcohol involvement, perhaps due to circadian misalignment imposed by early school schedules. School schedules shifted later during the COVID-19 pandemic, ostensibly reducing circadian misalignment and potentially mitigating problems with depression and alcohol. We used the pandemic as a natural experiment to test whether adolescent drinkers with later circadian timing showed improvements in sleep, depression and alcohol involvement. Participants were 42 adolescents reporting alcohol use. We assessed circadian phase via dim light melatonin onset prior to the pandemic, then conducted remote assessments of sleep, depressive symptoms and alcohol use during the pandemic. Mixed-effects models were used to test for pandemic effects, covarying for age, sex, time since baseline evaluation, and current school/work status. Adolescents with later circadian timing reported less sleep than other teens on school nights, both before and during the pandemic. Although school night sleep increased during the pandemic (F = 28.36, p < 0.001), those increases were not greater for individuals with later circadian timing. Individuals with later circadian timing reported larger increases in alcohol use than other teens during the pandemic (X2 = 36.03, p < 0.001). Depressive symptoms increased during the pandemic (X2 = 46.51, p < 0.001) but did not differ based on circadian timing. Consistent with prior reports, adolescents with later circadian timing obtained less sleep, and later school schedules facilitated increased sleep duration. Nonetheless, individuals with later circadian timing reported the sharpest increases in alcohol use, suggesting that circadian timing contributes to risk for alcohol use beyond the effects of insufficient sleep.
Biological clocks set the timing for a large number of essential processes in the living human organism. After death, scientific evidence is required in forensic investigations in order to collect as much information as possible on the death circumstances and personal identifiers of the deceased victim. We summarize the associations between the molecular mechanisms of biological rhythms and forensically relevant aspects, including post-mortem interval and cause of death, entomological findings, sex, age, ethnicity and development. Given their importance during lifetime, biological rhythms could be potential tools to draw conclusions on the death circumstances and the identity of a deceased person by mechanistic investigations of the different biological clocks in a forensic context. This review puts the known effects of biological rhythms on the functions of the human organism in context with potential applications in forensic fields of interest, such as personal identification, entomology as well as the determination of the post-mortem interval and cause of death.
Study Objectives
To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD.
Methods
Participants were 122 adolescents (ages 15-17; 61% male; 48% with ADHD). Parents reported on adolescents’ sleep duration and difficulties initiating and maintaining sleep (DIMS); adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019-February 2020) and during (May-June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19.
Results
Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically-elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19.
Conclusions
COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.
Objective
To examine the impact of home confinement during the COVID-19 pandemic on the sleep patterns and sleep disturbances in Italian children and adolescents.
Methods
Participants completed an anonymous online survey, shared via social media and targeting children and adolescents aged 1 to 18 years, subdivided into age groups: 1-3, 4-5, 6-12, and 13-18 years. Caregivers completed a modified version of the Sleep Disturbance Scale for Children (SDSC), along with demographic information.
Results
The final sample consisted of 4,314 subjects: 2,217 males (50.4%) and 2,097 females (49.6%). Age group distribution was: 1-3 years 1,263 (29.3%), 4-5 years 893 (20.7%), 6-12 years 1,848 (42.8%) and 13-18 years 310 (7.2%). We found a significant delay in bedtime and risetime in all age groups. School-age children and adolescents experienced the most significant delay: weekday bedtime ≥23 was reported by 28.4% of 6- to 12-year-old children during lockdown vs. 0.9% before and by 63.5% vs. 12.3% of 13- to 18-year-old adolescents. Risetime was also delayed with most subjects waking up after 8 in all age groups and sleep duration increased in all groups but not in the younger group. The screen time (excluding online lessons) boosted during the lockdown, mainly in older children but also in younger children. Sleep disorders increased in all groups but not in adolescents. Younger groups had an increased prevalence of difficulty falling asleep, anxiety at bedtime, night awakenings, nightmares and sleep terrors.
Conclusion
Our study demonstrates that confinement due to COVID-19 determined a big delay in sleep/wake schedule of children in all age groups as well as an increase of sleep disturbances in all groups but adolescents.
Background:
Exposure to early life stress (ELS) is alarmingly prevalent and has been linked to the high rates of depression documented in adolescence. Researchers have theorized that ELS may increase adolescents' vulnerability or reactivity to the effects of subsequent stressors, placing them at higher risk for developing symptoms of depression.
Methods:
We tested this formulation in a longitudinal study by assessing levels of stress and depression during the COVID-19 pandemic in a sample of adolescents from the San Francisco Bay Area (N = 109; 43 male; ages 13-20 years) who had been characterized 3-7 years earlier (M = 5.06, SD = 0.86 years) with respect to exposure to ELS and symptoms of depression.
Results:
As expected, severity of ELS predicted levels of depressive symptoms during the pandemic [r(107) = 0.26, p = 0.006], which were higher in females than in males [t(107) = -3.56, p < 0.001]. Importantly, the association between ELS and depression was mediated by adolescents' reported levels of stress, even after controlling for demographic variables.
Conclusions:
These findings underscore the importance of monitoring the mental health of vulnerable children and adolescents during this pandemic and targeting perceived stress in high-risk youth.
Objective:
To investigate dietary habits, sleep and psychological well-being of adolescents and medical students during COVID-19 lockdown in Split, Croatia.
Methods:
We surveyed 1326 students during 2018 and 2019, and compared their responses with 531 students enrolled in May 2020. Perceived stress, quality of life (QoL), happiness, anxiety, and optimism were assessed as proxies of psychological well-being, using general linear modelling.
Results:
We found no substantial differences in dietary pattern between pre-lockdown and lockdown periods, including the overall Mediterranean diet (MD) adherence. However, the MD pattern changed, showing increased adherence to the MD pyramid for fruit, legumes, fish, and sweets, while cereals, nuts, and dairy intake decreased during COVID-19 lockdown. A third of students reported weight loss during lockdown, 19% reported weight gain, while physical activity remained rather stable. The most prominent change was feeling refreshed after a night's sleep, reported by 31.5% of students during lockdown vs. 8.5% before; median length of sleep duration increased by 1.5 h. Lockdown significantly affected QoL, happiness, optimism (all p < 0.001), and perceived stress in students (p = 0.005). MD adherence was positively correlated with QoL and study time, and negatively with TV and mobile phone use in pre-lockdown period (all p < 0.001). Interestingly, higher MD adherence was correlated with less perceived hardship and greater happiness and QoL during lockdown.
Conclusion:
These insights provide valuable information for tailored interventions aimed at maintaining healthy lifestyle in young population. Given the numerous beneficial effects associated with MD adherence, modification of lifestyle through application of lifestyle medicine deserves a priority approach.
To understand Wuhan residents’ psychological reactions to the COVID-19 epidemic and offer a reference point for interventions, an online questionnaire survey was conducted. It included the Disorder 7-Item Scale (GAD-7), the Patient Health Questionnaire 9-Item Scale (PHQ-9), Athens Insomnia Scale, and Simplified Coping Style Questionnaire. Categorical data were reported as numbers and percentages. Multivariate logistic regression models were used to evaluate the association between demographic factors and anxiety, depression, sleep disorder, and passive coping style. A total of 1242 Wuhan residents investigated, 27.5% had anxiety, 29.3% had depression, 30.0% had a sleep disorder, and 29.8% had a passive response to COVID-19. Being female was the risk factor for anxiety (OR = 1.62) and sleep disorder (OR = 1.36); being married was associated with anxiety (OR = 1.75); having a monthly income between 1000 and 5000 CNY (OR = 1.44, OR = 1.83, OR = 2.61) or >5000 CNY (OR = 1.47, OR = 1.45, OR = 2.14) was a risk factor for anxiety, depression, and sleep disorder; not exercising (OR = 1.45, OR = 1.71, OR = 1. 85, OR = 1.71) was a common risk factor for anxiety, depression, sleep disorder, and passive coping style; and having a higher education level (bachelor’s degree and above) (OR = 1.40) was associated with having a sleep disorder. Wuhan residents’ psychological status and sleep quality were relatively poorer than they were before the COVID-19 epidemic; however, the rate of passive coping to stress was relatively higher.
Italy was the first European country that entered a nationwide lockdown during the COVID-19 pandemic. Since quarantine can impact on mental health, this study aimed to estimate the prevalence of depressive symptoms, anxiety symptoms and sleeping disturbances in the Italian population during lockdown. The factors that might influence such outcomes were explored. A national cross-sectional survey was performed during the last 14 days of the Italian lockdown. Questionnaires assessed socio-demographics characteristic, behaviors and healthcare access. The outcomes were assessed using Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2. Participants with sleep disturbances completed the Insomnia Severity Index. The sample size was 1515. Depression and anxiety symptom prevalence was 24.7% and 23.2%; 42.2% had sleep disturbances and, among them, 17.4% reported moderate/severe insomnia. Being female, an increased time spent on the internet and an avoidance of activities through peer pressure increased the likelihood of at least one mental health outcome. Increasing age, an absence of work-related troubles and being married or being a cohabitant reduced such a probability. Females and participants with chronic conditions were associated with a higher prevalence of sleep disturbances. It is crucial to study effective interventions, specifically planning strategies, for more vulnerable groups and to consider the role of the internet.
Although short total sleep time (TST) is associated with increased anxious symptoms in adolescents, it is unknown whether social jetlag, a misalignment between sleep timing on the weekend and school week, is independently associated with anxious symptoms. In the current study, sleep timing, anxious symptoms, and demographic information were assessed from 3097 adolescents (48% female, mean ± SD age 15.59 ± .77 years) from the age 15 wave of the Fragile Families and Child Wellbeing Study. Social jetlag was calculated as the absolute value of the midpoint of sleep on the weekend minus the midpoint of sleep during the school week. Anxious symptoms were measured through the 6-item anxiety subscale of the Brief Symptom Inventory 18. We assessed associations between sleep variables and anxious symptoms using multiple linear regression. Adjusted analyses controlled for sex, race/ethnicity, age in years, body mass index percentile, number of other children below the age of 18 in the household, and primary caregiver (PCG) married/cohabiting with youth’s biological parent, PCG employment status, PCG household income and PCG education level. In fully adjusted models (R² = .034), school night TST (b = −.04, ∆R² = .005, p < .001) was negatively associated with anxiety symptoms, while social jetlag (b = .04, ∆R² = .009, p < .001) was positively and independently associated with anxiety symptoms. Findings indicate small associations of school night TST and social jetlag with anxious symptoms. Thus, maintenance of optimal emotional health in adolescents may require both sufficient sleep duration and regularity of sleep timing across the week.
Objective
To use theory to design and evaluate an intervention to promote sleep hygiene and health among adolescents.
Methods
The Theory of Planned Behavior (TPB) and the Health Action Process Approach (HAPA) were used to develop an intervention, which was then evaluated in a cluster randomized trial. Participants were high school students (N = 2,841, M age = 15.12, SD = 1.50). Adolescents in the intervention group received four face-to-face sessions providing behavior change techniques targeting the theoretical determinants of sleep hygiene. Adolescents in the control group only received educational material at the end of the study. The primary outcome was sleep hygiene measured at one and six months post intervention. A number of secondary outcomes were also measured, including beliefs about sleep, self-regulatory processes, and outcomes related to health and wellbeing.
Results
Sleep hygiene was improved in the intervention group as compared to the control group at both follow-up points (coefficients = 0.16 and 0.19, 95% CIs = 0.12-0.20 and 0.15-0.23 at one month and six months, respectively, for scores on the Adolescent Sleep Hygiene Scale), as were psychosocial and general aspects of health. Mediation analyses suggested that beliefs about sleep hygiene as specified by the TPB, along with self-regulatory processes from HAPA, both mediated the effect of the intervention on outcomes. In turn, the effects of the intervention on sleep hygiene mediated its impact on general health.
Conclusions
Healthcare practitioners might consider intervention programs based on the TPB and the HAPA to improve sleep among adolescents.
Clinical Trial Registration
Clinicaltrials.gov (NCT02551913) https://clinicaltrials.gov/ct2/show/NCT02551913
Insufficient sleep is common among high school students and has been associated with an increased risk for motor vehicle crashes (1), sports injuries (2), and occupational injuries (3). To evaluate the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among U.S. high school students, CDC analyzed data from 50,370 high school students (grades 9-12) who participated in the national Youth Risk Behavior Surveys (YRBSs) in 2007, 2009, 2011, or 2013. The likelihood of each of the five risk behaviors was significantly higher for students who reported sleeping ≤7 hours on an average school night; infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students who reported sleeping ≥10 hours compared with 9 hours on an average school night. Although insufficient sleep directly contributes to injury risk, some of the increased risk associated with insufficient sleep might be caused by engaging in injury-related risk behaviors. Intervention efforts aimed at these behaviors might help reduce injuries resulting from sleepiness, as well as provide opportunities for increasing awareness of the importance of sleep.
Both scientists and the general public assume that physical activity (PA) is an effective, non-pharmacological approach to improvement in sleep quality. However, objective and reliable data on this relationship are scarce, particularly for adolescents. Therefore, the aims of the present study were to test the relationship by assessing both PA and sleep subjectively and objectively. A total of 56 adolescent vocational school students (Mean age=17.98, SD=1.36; 28 males, 28 females) participated in the study. Sleep and PA were subjectively assessed via questionnaires. Accelerometers objectively assessed PA, while sleep-EEG devices objectively assessed sleep. The data supported our prediction that adolescents with high PA levels would have longer TST, fewer wakening at night (WASO), fewer symptoms of insomnia, and higher sleep quality. However, gender influenced this pattern of results in that significant findings were only found between high self-reported PA levels and shorter perceived sleep onset latency (SOL). Though self-reported PA levels were a better predictor of good sleep than objectively assessed PA levels, gender was associated with sleep complaints; females reported more sleep complaints. Results indicate that among a non-clinical sample of adolescents increased PA is favorably associated with restoring sleep. Therefore, PA seems beneficial not only for physical and mental health, but also for sleep restoration.
This study presents a reduced scale of Horne & Östberg's Morningness-Eveningness questionnaire. The information collected from the questionnaire (adapted a nd standardized for the Spanish population), which was administered to a sample of subjects (N=908) with different work schedules and ages, was analysed according to multiple correspondences and cluster. The total scores and the 5 types considered in the Horne & Östberg questionnaire and the reduced from correlate very closely. The special interest of the reduced questionnaire is twofold. On the one hand, there is its actual make-up: it only contains questions about Morningness, which helps to define this dimension better. On the other hand, it shows how information can be collected more easily for research, especially in the case of using broad samples of subjects. The results obtained from the reduced scale for the variables contemplated in our researches corroborate the primacy of work schedule and age. Extraversion correlates negatively with Morningness scores, while sex and neuroticism show no significant differences.
Previous research has indicated the need to use large samples in different cultural contexts in order to clarify age and gender differences on morningness-eveningness and sleep habits. The goal of our research was to study the relationship between morningness-eveningness and sleep habits in a large sample of 2,649 adolescents between 12 and 16 years. The Morningness- Eveningness Scale for Children and an adaptation of the School Sleep Habits Survey measures were used. Results indicated a greater tendency toward eveningness with age and higher eveningness in 13- and 14-year-old girls. Older adolescents claimed later rising time on weekends, later bedtime and shorter sleep length, and greater social jetlag, weekend rise time delay, and weekend bedtime delay. Girls reported earlier rising time on weekdays, later rising time on weekends, longer sleep length on weekends, and greater social jetlag and weekend rising time delay. Lastly, evening oriented adolescents claimed later rising time and bedtime, shorter sleep length on weekdays but longer sleep duration on weekends, and greater social jetlag, weekend rising time delay, and weekend bedtime delay.
Suicide risk begins to increase during adolescence. Adolescents do not get enough sleep and are also at risk for many sleep disturbances. This study examined the association between sleep patterns and sleep problems and adolescent suicidal behavior.
A questionnaire survey of adolescents attending school was conducted in one prefecture of Shandong Province, People's Republic of China.
A total of 1,362 adolescents attending school (mean age 14.6 years, 60% males) participated in the survey.
Respondents completed a self-administered questionnaire that asked about sleep patterns, sleep problems, suicidal behavior, depressive symptoms, and demographic characteristics of the family and adolescent.
Overall, 19.3% of the sample reported having suicidal ideation, 10.5% having suicide attempts in the past 6 months, 16.9% having insomnia symptoms, 2.3% having taken hypnotic medication, and 48.9% having experience of nightmares in the past month. Mean night sleep duration was 7.6 hours (SD = 0.8). Logistic regression analyses showed that sleeping less than 8 hours at night (OR = 2.89, 95% confidence interval [CI] = 1.07-7.81) and frequent nightmares (OR = 2.43, 95% CI = 1.76-3.35) were significantly associated with increased risk for suicide attempts after adjustment for age, sex, father's occupation, and depressive symptoms and that nightmares (OR = 1.69, 95% CI = 1.20-2.38) were also significantly related to suicidal ideation.
These findings demonstrate the association between short sleep duration and nightmares and suicidal behavior and highlight the potential role of sleep intervention in the prevention of adolescent suicide.
Humans show large differences in the preferred timing of their sleep and activity. This so-called "chronotype" is largely regulated by the circadian clock. Both genetic variations in clock genes and environmental influences contribute to the distribution of chronotypes in a given population, ranging from extreme early types to extreme late types with the majority falling between these extremes. Social (e.g., school and work) schedules interfere considerably with individual sleep preferences in the majority of the population. Late chronotypes show the largest differences in sleep timing between work and free days leading to a considerable sleep debt on work days, for which they compensate on free days. The discrepancy between work and free days, between social and biological time, can be described as 'social jetlag.' Here, we explore how sleep quality and psychological wellbeing are associated with individual chronotype and/or social jetlag. A total of 501 volunteers filled out the Munich ChronoType Questionnaire (MCTQ) as well as additional questionnaires on: (i) sleep quality (SF-A), (ii) current psychological wellbeing (Basler Befindlichkeitsbogen), (iii) retrospective psychological wellbeing over the past week (POMS), and (iv) consumption of stimulants (e.g., caffeine, nicotine, and alcohol). Associations of chronotype, wellbeing, and stimulant consumption are strongest in teenagers and young adults up to age 25 yrs. The most striking correlation exists between chronotype and smoking, which is significantly higher in late chronotypes of all ages (except for those in retirement). We show these correlations are most probably a consequence of social jetlag, i.e., the discrepancies between social and biological timing rather than a simple association to different chronotypes. Our results strongly suggest that work (and school) schedules should be adapted to chronotype whenever possible.
The aim of this study was to evaluate patterns of sleepiness, comparing working and non-working students. The study was conducted on high school students attending evening classes (19:00-22:30 h) at a public school in São Paulo, Brazil. The study group consisted of working (n=51) and non-working (n=41) students, aged 14-21 yrs. The students answered a questionnaire about working and living conditions and reported health symptoms and diseases. For seven consecutive days, actigraphy measurements were recorded, and the students also filled in a sleep diary. Sleepiness ratings were given six times per day, including upon waking and at bedtime, using the Karolinska Sleepiness Scale. Statistical analyses included three-way ANOVA and t-test. The mean sleep duration during weekdays was shorter among workers (7.2 h) than non-workers (8.8 h) (t=4.34; p<.01). The mean duration of night awakenings was longer among workers on Tuesdays and Wednesdays (28.2 min) and shorter on Mondays (24.2 min) (t=2.57; p=.03). Among workers, mean napping duration was longer on Mondays and Tuesdays (89.9 min) (t=2.27; p=.03) but shorter on Fridays and Sundays (31.4 min) (t=3.13; p=.03). Sleep efficiency was lower on Fridays among non-workers. Working students were moderately sleepier than non-workers during the week and also during class on specific days: Mondays (13:00-15:00 h), Wednesdays (19:00-22:00 h), and Fridays (22:00-00:59 h). The study found that daytime sleepiness of workers is moderately higher in the evening. This might be due to a work effect, reducing the available time for sleep and shortening the sleep duration. Sleepiness and shorter sleep duration can have a negative impact on the quality of life and school development of high school students.
Objective
In March 2020, the world experienced a global pandemic, which involved the shutdown of schools or a transposition to remote teaching in most countries. The objective of the present study was to investigate the impact of the COVID-19 pandemic related lockdown on sleep patterns and sleep quality in adolescents and young adults.
Methods
An online survey was conducted in June 2020 with adolescents and young adults (n = 498) aged 12 to 25 years. Participants had to answer questions on sleep, first retrospectively, referring to the time prior to the pandemic, and then referring to the time during the pandemic.
Results
A pronounced shift towards later sleep combined with an increase in sleep duration was found during the pandemic. However, these changes in sleep habits were more pronounced in adolescents than in young adults and seem to occur mostly during weekdays compared to weekends. During the pandemic, teens also reported an improvement in daytime sleepiness and subjective sleep quality, while young adults reported an increase in sleep difficulties associated with sleep onset difficulties, nocturnal and early morning awakenings, and nightmares.
Conclusions
The COVID-19 related lockdown seems to have had a beneficial effect on sleep in adolescents. In young adults, benefits are not as obvious. These results support that later school start times would be beneficial for adolescents. However, in young adults it could be important to investigate the effects of other situational or interindividual factors (stress, lifestyle habits, employment, etc.).
Study objectives:
The COVID-19 pandemic has challenged the population of affected areas in multiple dimensions. Adolescents have been especially affected with school closure and home confinement. The impact of the pandemic on sleep habits and quality of sleep and quality of life among adolescents have not been adequately characterized. We hypothesized that the COVID-19 pandemic induced an evening shift of the daily rhythm among adolescents and adversely affected sleep quality and quality of life of high school students.
Methods:
Students were questioned about their usual bed and wake-up times and answered the Pittsburg Sleep Quality Index Questionnaire (PSQI), the Epworth Sleepiness Scale (ESS), the Morning-Eveningness Questionnaire (MEQ) and the World Health Organization Quality of Life Questionnaire (WHOQOL) before and during the pandemic.
Results:
Ninety-four students (64% females, aged 15+1 years) participated in both phases of the study. Students delayed bed and wake-up times in 1.5[0.5-2.0] and 2.0[1.5-2.5]h, respectively. Chronotype (MEQ) shifted towards eveningness during the pandemic. Sleep duration increased and quality of sleep (PSQI) improved only among those students with shorter sleep duration before the pandemic. During the pandemic, the physical and psychological domains of WHOQOL worsened but the environmental domain improved as compared to the study before the pandemic.
Conclusions:
High school students delayed bed and wake-up times and shifted chronotype towards eveningness during the COVID-19 pandemic. The worsening of the physical and psychological WHOQOL domains and improvement of the environmental domain highlights the conflicting experiences that high school students are facing during the COVID-19 pandemic.
Study Objectives
This study examines the relationship between experimentally manipulated sleep duration and mood in adolescents.
Methods
Thirty-four adolescents (20 male), aged 15 to 17 years, lived in a sleep laboratory for ten days and nine nights. They were allocated to one of three sleep “doses” for five consecutive nights for :5 hours’, 7.5 hours’ or 10 hours’ sleep opportunity per night. Two baseline nights and two recovery nights entailed 10 hours’ sleep opportunity per night. Mood was measured every three hours during wake using unipolar visual analogue scales measuring the mood states “depressed”, “afraid”, “angry”, “confused”, “anxious”, “happy” and “energetic”.
Results
Mixed models analyses with post hoc comparisons revealed that participants in the 5-hour group, but not the 7.5-hour or 10-hour groups, reported being significantly more depressed, angry and confused during sleep restriction than at baseline. Adolescents were significantly less happy and energetic during sleep restricted to 5h and significantly less energetic during sleep restricted to 7.5h. When adolescents had 10h sleep opportunities their happiness significantly increased. No statistically significant effects of sleep restriction were found for fear or anxiety, although small-to-moderate effects of sleep restricted to 5h or 7.5h were found. Two nights of recovery sleep was not sufficient to recover from increased negative mood states for the 5-hour group, although recovery occurred for positive mood states.
Conclusions
Given the prevalence of insufficient sleep and the rising incidence of mood disorders and dysregulation in adolescents, these findings highlight the importance of sufficient sleep to mitigate these risks.
Objective
During the outbreak of the COVID-19 pandemic in 2020, high schools closed or transitioned to remote teaching. The aim of this study was to describe how the COVID-19 related school shutdown impacted the sleep behaviors of typically developing adolescents.
Methods
A qualitative study was conducted between April 28 and June 3, 2020 with 45 adolescents using one-on-one semi-structured phone interviews.
Results
The “natural experiment” caused by the shutdown of schools due to the COVID-19 pandemic led to a 2-h shift in the sleep of typically developing adolescents, longer sleep duration, improved sleep quality, and less daytime sleepiness compared to those experienced under the regular school-time schedule.
Discussion
These findings are consistent with previous studies showing that delaying high school start times could be an effective way to extend sleep duration, improve sleep quality, reduce daytime sleepiness and lower adolescents' stress during the school year. As many countries look for ways to reduce the number of interactions between students in schools so that physical distancing is feasible, following teens’ delayed sleep biology could offer an affordable solution. For example, staggering arrival times by delaying school start time for older adolescents compared with younger adolescents can reduce the total number of students attending school at the same time. This strategy offers a practical means to reduce school density and the number of interactions between students which are needed to reduce the potential transmission of COVID-19 in schools, while improving adolescents sleep health.
Objective
To assess the prevalence and sociodemographic correlates of insomnia symptoms among Chinese adolescents and young adults affected by the outbreak of coronavirus disease-2019 (COVID-19).
Methods
This cross-sectional study included Chinese adolescents and young adults 12–29 years of age during part of the COVID-19 epidemic period. An online survey was used to collect demographic data, and to assess recognition of COVID-19, insomnia, depression, and anxiety symptoms using the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) questionnaires, respectively. The Social Support Rate Scale was used to assess social support.
Results
Among 11,835 adolescents and young adults included in the study, the prevalence of insomnia symptoms during part of the COVID-19 epidemic period was 23.2%. Binomial logistic regression analysis revealed that female sex and residing in the city were greater risk factors for insomnia symptoms. Depression or anxiety were risk factors for insomnia symptoms; however, social support, both subjective and objective, was protective factors against insomnia symptoms. Furthermore, anxiety and depression symptoms were mediators of social support and insomnia symptoms.
Conclusions
Results of this study revealed a high prevalence of sleep problems among adolescents and young adults during the COVID-19 epidemic, especially senior high school and college students, which were negatively associated with students’ projections of trends in COVID-19. The adverse impact of COVID-19 was a risk factor for insomnia symptoms; as such, the government must devote more attention to sleep disorders in this patient population while combating COVID-19.
Objectives
Emerging evidence suggests that inconsistent sleep may affect physical and psychological health. Thus, it is important to identify modifiable determinants of sleep variability. Screen time and physical activity are both thought to affect sleep, but studies of their relationship to sleep variability using objective measures are lacking. We examined cross-sectional associations between these variables in mid-teen adolescents using objectively measured sleep and activity.
Methods
Wrist-worn accelerometers were used to measure one week of sleep and activity in 315 tenth grade students (mean age 15.8y) from six Reykjavík compulsory schools. Participants reported their daily hours of screen time. Regression analysis was used to explore associations of screen time and physical activity with variability in duration, quality, and timing of sleep, adjusting for DXA-measured body fat percentage, parental education, and physical activity or screen time.
Results
Screen time, especially game playing, was associated with variability in duration, timing, and quality of sleep, most strongly with variation in bedtime. Physical activity was inversely associated with variability in duration, timing, and quality of sleep, most strongly with variation in the number of awakenings. Boys had less stable sleep patterns and higher screen time than girls, and sex-specific associations of screen time with sleep variability parameters were significant for boys only.
Conclusions
Less screen time and more physical activity were independently associated with less sleep variability among mid-teen adolescents. Our results indicate that encouraging youngsters toward an active lifestyle with limited screen use may be important to achieve more consistent sleep.
The aim of this study was to examine the relationships among excessive daytime sleepiness, family sleep behaviors, sleep quality, and health behaviors, as well as the role of caffeine intake as a moderator. The study included a sample of 272 adolescents that answered a sociodemographic questionnaire, the Family Sleep Questionnaire, the Pittsburgh Sleep Quality Index, the Modified Excessive Sleepiness Scale, and the Health Behavior Questionnaire. The results revealed that higher caffeine intake was associated with worse sleep quality, worse family sleep behaviors, and fewer healthy behaviors. However, caffeine intake was not associated with excessive daytime sleepiness. In addition, worse sleep quality was associated with worse family sleep behaviors, excessive daytime sleepiness, and fewer healthy behaviors. Worse family sleep behaviors were associated with excessive daytime sleepiness and lower health behaviors. Finally, excessive daytime sleepiness was associated with fewer healthy behaviors. Caffeine intake was a moderator in the relationship between daytime sleepiness and health behaviors. Health professionals (i.e., pediatricians, psychologists, and teachers), when intervening on sleep quality and health behaviors, should assess the adolescent’s caffeine intake.
Although sleep is a key element in adolescent development, teens are spending increasing amounts of time online with health risks related to excessive use of electronic media (computers, smartphones, tablets, consoles…) negatively associated with daytime functioning and sleep outcomes. Adolescent sleep becomes irregular, shortened and delayed in relation with later sleep onset and early waking time due to early school starting times on weekdays which results in rhythm desynchronization and sleep loss. In addition, exposure of adolescents to the numerous electronic devices prior to bedtime has become a great concern because LEDs emit much more blue light than white incandescent bulbs and compact fluorescent bulbs and have therefore a greater impact on the biological clock. A large number of adolescents move to evening chronotype and experience a misalignment between biological and social rhythms which, added to sleep loss, results in e.g fatigue, daytime sleepiness, behavioral problems and poor academic achievement. This paper on adolescent circadian disruption will review the sensitivity of adolescents to light including LEDs with the effects on the circadian system, the crosstalk between the clock and the pineal gland, the role of melatonin, and the behavior of some adolescents(media use, alcohol consumption, binge drinking, smoking habits, stimulant use…). Lastly, some practical recommendations and perspectives are put forward. The permanent social jet lag resulting in clock misalignment experienced by a number of adolescents should be considered as a matter of public health.
Background:
Abundant cross-sectional evidence links eveningness (a preference for later sleep-wake timing) and increased alcohol and drug use among adolescents and young adults. However, longitudinal studies are needed to examine whether eveningness is a risk factor for subsequent alcohol and drug use, particularly during adolescence, which is marked by parallel peaks in eveningness and risk for the onset of alcohol use disorders. This study examined whether eveningness and other sleep characteristics were associated with concurrent or subsequent substance involvement in a longitudinal study of adolescents.
Methods:
Participants were 729 adolescents (368 females; age 12 to 21 years) in the National Consortium on Alcohol and Neurodevelopment in Adolescence study. Associations between the sleep variables (circadian preference, sleep quality, daytime sleepiness, sleep timing, and sleep duration) and 3 categorical substance variables (at-risk alcohol use, alcohol bingeing, and past-year marijuana use [y/n]) were examined using ordinal and logistic regression with baseline age, sex, race, ethnicity, socioeconomic status, and psychiatric problems as covariates.
Results:
At baseline, greater eveningness was associated with greater at-risk alcohol use, greater bingeing, and past-year use of marijuana. Later weekday and weekend bedtimes, but not weekday or weekend sleep duration, showed similar associations across the 3 substance outcomes at baseline. Greater baseline eveningness was also prospectively associated with greater bingeing and past-year use of marijuana at the 1-year follow-up, after covarying for baseline bingeing and marijuana use. Later baseline weekday and weekend bedtimes, and shorter baseline weekday sleep duration, were similarly associated with greater bingeing and past-year use of marijuana at the 1-year follow-up after covarying for baseline values.
Conclusions:
Findings suggest that eveningness and sleep timing may be under recognized risk factors and future areas of intervention for adolescent involvement in alcohol and marijuana that should be considered along with other previously identified sleep factors such as insomnia and insufficient sleep.
Background:
Marijuana (MJ) is the most commonly used recreational drug in the US. Research on the relationship between MJ and sleep is still in its infancy. The study examined the differences in sleep characteristics between a community sample of daily users, non-daily MJ users, and non-users.
Methods:
A total of 98 subjects (45M; 53 F) participated. The mean age was 22.3 (SD = 3.0). There were 53 females and 55% of the sample was Caucasian. Recruitment was through online and via print advertisements in the community. Groups were categorized as non-daily users (n = 29), daily users (n = 49), and non-user controls (n = 20). Sleep was characterized by the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and Morningness Scale (MEQ).
Results:
A standard cut off score of >10 for the ISI was found in 38.8% of daily users, 10.3% of non-daily users, and 20% of non-users. PSQI scores in daily users (7.0 +/- 3.8) was higher than non-daily (4.9+/-3.2) and non-user controls (5.0+/- 3.7), p = 0.02. ISI scores in daily users (7.9 +/-6.1) were higher than non-daily (5.1 +/-4.3) and non-user controls (4.3+/-4.8), p = 0.01. Covariate adjusted regression analyses revealed mean PSQI and ISI scores were significantly lower for non-daily users and controls relative to the daily users. When adjusting for depression and anxiety, these unique associations were not significant. There were no differences in ESS or MEQ.
Conclusion:
Daily MJ users endorsed more sleep disturbance than non-daily users. Future studies should consider mood in the relationship between MJ use and sleep.
Many schools have instituted later morning start times to improve sleep, academic, and other outcomes in response to the mismatch between youth circadian rhythms and early morning start times. However, there has been no systematic synthesis of the evidence on the effects of this practice. To examine the impact of delayed school start time on students’ sleep, health, and academic outcomes, electronic databases were systematically searched and data were extracted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six studies satisfied selection criteria and used pre-post, no control (n=3), randomized controlled trial (n=2), and quasi-experimental (n=1) designs. School start times were delayed 25 to 60 minutes, and correspondingly, total sleep time increased from 25 to 77 minutes per weeknight. Some studies revealed reduced daytime sleepiness, depression, caffeine use, tardiness to class, and trouble staying awake. Overall, the evidence supports recent non-experimental study findings and calls for policy that advocates for delayed school start time to improve sleep. This presents a potential long-term solution to chronic sleep restriction during adolescence. However, there is a need for rigorous randomized study designs and reporting of consistent outcomes, including objective sleep measures and consistent measures of health and academic performance.
Electronic media have often been considered to have a negative impact on the sleep of children and adolescents, but there are no comprehensive reviews of research in this area. The present study identified 36 papers that have investigated the relationship between sleep and electronic media in school-aged children and adolescents, including television viewing, use of computers, electronic gaming, and/or the internet, mobile telephones, and music. Many variables have been investigated across these studies, although delayed bedtime and shorter total sleep time have been found to be most consistently related to media use. A model of the mechanisms by which media use may affect sleep is presented and discussed as a vehicle for future research.
Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
A questionnaire concerning sleep-related lifestyle, and physical and mental health was administered to the students of junior high schools (12-15 years), high schools (15-18 years), and universities. While bedtime linearly delayed with age throughout the adolescence (from junior high school to university age), rise time remained constant until high school ages. As a result, total nocturnal sleep time considerably decreased during this period. Rise time then delayed with age in the university sample. Daytime sleepiness increased with age peaking at high school age, then decreased gradually during university age. Several physical and mental health conditions got worse during high school and university ages. Compared with the adolescent samples, daytime sleepiness and mental health complaints were very low in the adult samples.
Obesity has reached epidemic proportions in the U.S. and more developed countries, particularly so among adolescents. A substantial impact on public health could be achieved if other factors causing obesity besides the conventional ones of diet and physical activity could be identified and acted upon. The present study investigates whether there is a link between low sleep quality and obesity in a tri-ethnic, cross-sectional sample (n = 383) of male and female adolescents ages 11-16 years old (Heartfelt Study). Sleep quality was expressed as two variables, total sleep time and sleep disturbance time obtained by 24-hour wrist actigraphy. Percent body fat and body mass index (BMI) were used together to define obesity. The potential influence of demographic and behavioral confounders were considered in models that described the relation of sleep to obesity occurrence. Obese adolescents experienced less sleep than nonobese adolescents (P < 0.01). For each hour of lost sleep, the odds of obesity increased by 80%. Sleep disturbance was not directly related to obesity in the sample, but influenced physical activity level (P < 0.01). Daytime physical activity diminished by 3% for every hour increase in sleep disturbance. The above observations were independent of potential confounding variables. Inadequate and poor sleep quality in adolescents may be important factors to consider in the prevention of childhood obesity.
Between childhood and adulthood, we go through puberty and adolescence. While the end of puberty is defined as the point of cessation of bone growth (epiphyseal closure; girls: 16 y; boys: 17.5 y), the end of adolescence (∼19 y) is defined less clearly, by a mixture of physical, psychological, social, and mental measures [1]. One conspicuous property of adolescence is the apparently unsaturable capacity to stay up late and to sleep in. Investigating ‘chronotypes’ we observed an abrupt change in the timing of sleep at around the age of 20 and propose this change as the first biological marker of the end of adolescence.
Previous studies found students who both work and attend school undergo a partial sleep deprivation that accumulates across the week. The aim of the present study was to obtain information using a questionnaire on a number of variables (e.g., socio-demographics, lifestyle, work timing, and sleep-wake habits) considered to impact on sleep duration of working (n = 51) and non-working (n = 41) high-school students aged 14-21 yrs old attending evening classes (19:00-22:30 h) at a public school in the city of São Paulo, Brazil. Data were collected for working days and days off. Multiple linear regression analyses were performed to assess the factors associated with sleep duration on weekdays and weekends. Work, sex, age, smoking, consumption of alcohol and caffeine, and physical activity were considered control variables. Significant predictors of sleep duration were: work ( p < 0.01), daily work duration (8-10 h/day; p < 0.01), sex ( p = 0.04), age 18-21 yrs (0.01), smoking( p = 0.02) and drinking habits ( p = 0.03), irregular physical exercise (p < 0.01), ease of falling asleep ( p = 0.04), and the sleep-wake cycle variables of napping ( p < 0.01), nocturnal awakenings ( p < 0.01), and mid-sleep regularity ( p < 0.01). The results confirm the hypotheses that young students who work and attend school showed a reduction in night-time sleep duration. Sleep deprivation across the week, particularly in students working 8-10 h/day, is manifested through a sleep rebound (i.e., extended sleep duration) on Saturdays. However, the different roles played by socio-demographic and lifestyle variables have proven to be factors that intervene with nocturnal sleep duration. The variables related to the sleep-wake cycle-naps and night awakenings-proved to be associated with a slight reduction in night-time sleep, while regularity in sleep and wake-up schedules was shown to be associated with more extended sleep duration, with a distinct expression along the week and the weekend. Having to attend school and work, coupled with other sociodemographic and lifestyle factors, creates an unfavorable scenario for satisfactory sleep duration.
Impact of COVID-19 lockdown on dietary and lifestyle behaviours among adolescents in Palestine
- H Allabadi
- J Dabis
- V Aghabekian
- A Khader
- U Khammash
Examining the impact of later high school start times on the health and academic performance of high school students: A multi-site study
- K L Wahlstrom
- B J Dretzke
- M F Gordon
- K Peterson
- K Edwards
- J Gdula