Sleep habits,excessive daytime sleepiness and school performance in high school students

A questionnaire survey was carried out to examine the sleep habits and excessive daytime sleepiness (EDS) of 3871 high school students with a mean age of 16.8 years in Korea. The results showed that mean total sleep time was 6.3 h/day for male students and 6.5 h/day for female students, which may be insufficient for adolescence during puberty. The overall prevalence of EDS (defined as an Epworth sleepiness scale score of >10) was 15.9% (14.9% for boys and 18.2% for girls). The prevalence of EDS increased significantly (P < 0.001) with a decline in school performance.     

Sleep problems in adolescence A study of senior high school students in Greece

AbstractObjectives The aim of this study was to evaluate sleep habits and sleep-related problems in high school adolescent students in Greece through the Athens Insomnia Scale and to assess the relation of these problems to demographic and other variables.Methods The Athens Insomnia Scale 5-item version (AIS-5) was administered to 713 adolescent senior high school students in the Greater Athens Area. Data such as age, sex, school records, and time spent per week in school-related and extracurricular activities were collected.Results The sample’s mean sleep duration was 7.5 h, mean bedtime 00.20 a.m. and wake-up time 7.15 a.m. Total sleep time was not affected by gender, but was influenced by time spent in various activities. Sleep complaints were related to delayed sleep, onset latency and insufficient total duration of sleep. Of the respondents, 30% estimated that their sleep onset latency was markedly delayed and 30% reported that their total sleep time was markedly insufficient. Girls complained more than boys, while correlations showed that students with lower academic performance and those in second grade were more likely to have higher AIS-5 scores.Conclusions The results show that the sleep time of high school students is dependent on practical matters such as school schedule and other activities, while sleep complaints are related to female gender, bad school performance as well as to the second grade. The difference between actual sleep time and sleep complaints should be considered when studying the sleep of adolescents.     

Sleep habits in adolescents of Saudi Arabia; distinct patterns and extreme sleep schedules

Background and Study ObjectivesThere is a need for comprehensive studies on adolescents' sleep habits in the Middle Eastern region. The aim of this study was to investigate the sleep–wake patterns, prevalence of excessive daytime sleepiness (EDS), and disturbed sleep among adolescents in Saudi Arabia and to identify the associated factors.MethodsThe study was a cross-sectional survey done on a random sample of 1035 high school students, ages 14–23 years, in Jeddah, Saudi Arabia. The response rate was 91%. Students filled a self-reported questionnaire that included sleep–wake questions, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Perceived Stress Scale, academic performance, and personal data.ResultsStudents slept an average of 7.0 hours on school nights, with an average delay of 2.8 and 6.0 hours in weekend sleep and rise times, respectively. Around 1 in 10 students stayed up all night and slept after returning from school (exhibiting a reversed sleep cycle) on weeknights. This pattern was more prevalent among boys and students with lower grade point averages. The prevalence of sleep disturbance was 65%, and EDS was found in 37% of the students. Predictors of EDS were school type, stress, napping and caffeine use, while gender was a predictor of disturbed sleep.ConclusionsAdolescents in Saudi Arabia showed a high percentage of poor sleep quality. Compared with adolescents from other countries, they had a larger delay in weekend sleep and rise times. An alarming reversed sleep cycle on weekdays is present and highlights the need for further assessment.     

Disorders of arousal and sleep-related bruxism among Japanese adolescents: a nationwide representative survey

ObjectiveThe main objective of our study was to clarify the prevalence of disorders of arousal (confusional arousals, sleepwalking, sleep terrors) and sleep-related bruxism (teeth grinding) and their associated factors among Japanese adolescents.MethodsOur study was designed as a cross-sectional sampling survey. The targets were students attending junior and senior high schools throughout Japan. The questionnaire asked for personal data and information on lifestyle, depressive state, and sleep status including the frequency of experiencing disorders of arousal and sleep-related bruxism.ResultsA total of 99,416 adolescents responded. The overall response rate was 63.7%, and 98,411 questionnaires were subjected to analysis. The prevalence of disorders of arousal was 7.1% (95% confidence interval [CI], 6.9–7.3%) among boys and 7.7% (95% CI, 7.5–7.9%) among girls. The prevalence of sleep-related bruxism was 2.3% (95% CI, 2.2–2.4%) among boys and 3.0% (95% CI, 2.8–3.2%) among girls. The factors associated with disorders of arousal were the grade in school, smoking habit, alcohol consumption, naptime (min), breakfast habit, participation in club activities, sleep duration, difficulty initiating sleep, nocturnal awakening, early morning awakening, subjective sleep assessment, snoring, decrease in positive feelings, and depression (all p < .001). The factors associated with sleep-related bruxism were gender, smoking habit, nocturnal awakening, snoring, early morning awakening, decrease in positive feelings, and depressive feelings (all p < .001).ConclusionsIf disorders of arousal or sleep-related bruxism are observed in an adolescent, his or her smoking habit, alcohol consumption, sleep status, and depressive state should be considered.     

Sleep and behavioral/emotional problems in children: a population-based study

BackgroundThe potential relationships between sleep–wake behaviors and emotional/disruptive problems in otherwise healthy school-aged children are unclear.MethodsA parental questionnaire was developed for the epidemiologic survey of children’s sleep and wake behavioral patterns. The questions covered a wide range of features including sleep length (school days, weekends), time to fall asleep, night awakenings, bedtime and nighttime sleep-related behaviors, daytime sleepiness, irritability, and tiredness. To assess psychiatric symptomatology, the Rutter Scale B2 was completed by teachers. In addition to the total score, sub-scores of emotional, hyperactivity, and conduct problems were obtained. The representative population sample comprised 779 children (403 girls), with an age range of 6–11 years.ResultsHyperactivity and conduct problems at school in boys were both associated with parental reports of bedtime resistance. Hyperactivity was also associated with longer sleep duration during weekends. Conduct and emotional problems in girls were associated with earlier bedtime during school days. Emotional problems in girls were also associated with longer sleep durations in school days and weekends.ConclusionBedtime resistance was the only sleep behavior associated with either hyperactivity or conduct problems in children, and longer sleep durations appear to occur more frequently in children with both hyperactive or emotional problems. Information about good sleep hygiene at bedtime may help parents setting sleep limits.     

Effect of daytime light conditions on sleep habits and morningness-eveningness preference of Japanese students aged 12-15 years

The effect of daytime light conditions on the sleep habits and morning-evening preference of Japanese junior high school students (415 girls and 411 boys; age range, 12-15 years old) was studied. Students who were outdoors during the short break between classes or their lunch-time break were more morning-type people than those who remained indoors. Students who shut out the light from outside showed longer subjective sleep latency and appealed more shallow sleep rather than those who did not. Sunlight can be an important factor for the timing of sleep based on the circadian system of Japanese young students.     

Correlates for poor sleepers in a Los Angeles high school

BACKGROUND AND PURPOSE: We explored sleep patterns including morning-evening preference and their associations with other lifestyle determinants among high school students. PARTICIPANTS AND METHODS: We conducted a cross-sectional survey of students grades 9-12 from a private high school in the United States. One hundred and thirty-one students completed an online survey comprising 23 original, investigator-created questions, a mood scale, the Pittsburgh Sleep Quality Index (PSQI), and the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ). RESULTS: We found that 80% of students reported a sleep deficit. As defined by the PSQI, 69% of girls and 58% of boys in this sample were poor sleepers. Eveningness was a strong predictor of poor sleep, particularly among students aged 15 years (odds ratio [OR] 9.92; 95% confidence interval [CI], 1.52-64.8), among whom poor sleep quality was also associated with a higher body mass index (BMI) (OR, 6.97; 95% CI, 1.01-48.2). CONCLUSIONS: Our pilot study suggests that morningness-eveningness is a strong predictor of sleep quality among high school students.     

The influence of school time on sleep patterns of children and adolescents

ObjectiveThis epidemiological study evaluated the impact of school time on sleep parameters of children and adolescents.MethodsThis cross-sectional study involved 639 elementary and high school students (mean age 13.03 years, range 8–18, 58.5% female) from the south of Brazil. Participants answered the Morningness-Eveningness Questionnaire (MEQ), and were asked about their sleeping habits on weekdays and weekends. Sleep deficit was defined as the difference between sleep duration on weekdays and weekends.ResultsThe morning-school-time students presented significantly higher age, bedtime and wake up differences, sleep deficits, and social jetlag. The sleep deficit presented by girls was greater than that observed in boys of the same age. The difference between weekday and weekend waking times was also significantly greater in girls than in boys aged 13–18 years. Sleep deficit was significantly positively correlated with age and differences in wake up times, and significantly negatively correlated with MEQ scores, social jetlag, difference between weekday and weekend bedtimes, midpoint of sleep on weekends, and midpoint of sleep on weekends corrected for sleep deficit. A step-by-step multivariate logistic regression identified social jetlag, the difference between waking times on weekdays and weekends, and the midpoint of sleep on weekends as significant predictors of sleep deficit (Adjusted R² = 0.95; F = 1606.87; p <0.001).ConclusionThe results showed that school time influences the sleep parameters. The association of school schedules and physiological factors influence the sleep/wake cycle.     

Correlates for poor sleepers in a Los Angeles high school

Background and purposeWe explored sleep patterns including morning–evening preference and their associations with other lifestyle determinants among high school students.Particpants and methodsWe conducted a cross-sectional survey of students grades 9–12 from a private high school in the United States. One hundred and thirty-one students completed an online survey comprising 23 original, investigator-created questions, a mood scale, the Pittsburgh Sleep Quality Index (PSQI), and the Horne–Ostberg Morningness–Eveningness Questionnaire (MEQ).ResultsWe found that 80% of students reported a sleep deficit. As defined by the PSQI, 69% of girls and 58% of boys in this sample were poor sleepers. Eveningness was a strong predictor of poor sleep, particularly among students aged ⩽15 years (odds ratio [OR] 9.92; 95% confidence interval [CI], 1.52–64.8), among whom poor sleep quality was also associated with a higher body mass index (BMI) (OR, 6.97; 95% CI, 1.01–48.2).ConclusionsOur pilot study suggests that morningness–eveningness is a strong predictor of sleep quality among high school students.     

Routine evening naps and night-time sleep patterns in junior high and high school students

This study investigated the relationship between napping and night-time sleep patterns in junior high and high school students. A questionnaire concerning sleep-related lifestyle was given to about 10,000 junior high and high school students. Approximately 50% of the junior high and high school students take at least one nap per week. More than 30% of students take naps later than 17.00 hours. The late naps delayed students' bedtime; that is, onset of night-time sleep. The bedtime of students of university-bound high schools was later than that of students of vocation-bound high schools. The more frequently students took naps, the later they went to bed. Frequent late naps delayed bedtime and, hence, shortened the length of night-time sleep.     

Internet overuse and excessive daytime sleepiness in adolescents

Aim:  The purpose of this study was to examine the association of Internet overuse with excessive daytime sleepiness (EDS).
Methods:  A total of 2336 high school students in South Korea (boys, 57.5%; girls, 42.5%) completed the structured questionnaire. The severity of Internet addiction was evaluated using Young's Internet addiction test.
Results:  The proportions of boys who were classified as Internet addicts and possible Internet addicts were 2.5% and 53.7%, respectively. For girls, the corresponding proportions were 1.9% and 38.9%, respectively. The prevalence of EDS was 11.2% (boys, 11.2%; girls, 11.1%). When Internet addicts were compared with non-addicts, they consisted of more boys, drank alcohol more, and considered their own health condition as poor. But smoking was not related with Internet addiction. The prevalence rate of EDS for Internet addicts was 37.7%, whereas that for possible Internet addicts and non-addicts was 13.9% and 7.4%, respectively. The prevalence of insomnia, witnessed snoring, apnea, teeth grinding, and nightmares was highest in Internet addicts, middle in possible addicts, and lowest in non-addicts. With adjustment for duration of Internet use, duration of sleep time, age, gender, smoking, taking painkillers due to headache, insomnia symptoms, witnessed apnea, and nightmares, the odds of EDS were 5.2-fold greater (95% confidence interval [CI]: 2.7–10.2) in Internet addicts and 1.9-fold greater (95%CI: 1.4–2.6) in possible Internet addicts compared to non-addicts.
Conclusion:  Internet addiction is strongly associated with EDS in adolescents. Clinicians should consider examining Internet addiction in adolescent cases of EDS.     

Prevalence and correlates of delayed sleep phase in high school students

PurposeTo investigate prevalence and correlates of delayed sleep phase, characterized by problems falling asleep in the evening and rising at adequate times in the morning, in a large sample of Norwegian high school students.MethodsA randomized sample of 1285 high school students (aged 16–19 years) participated in an internet based study answering questions about sleep habits, height, weight, smoking, alcohol use, school grades, and anxiety and depression symptoms. Delayed sleep phase was operationalized as difficulties falling asleep before 2 a.m. at least three nights per week together with much or very much difficulty waking up in the morning.ResultsThe results show a prevalence of delayed sleep phase of 8.4%. In all, 68% of these students (5.7% of the total sample) also reported problems advancing their sleep period as well as one daytime consequence (oversleeping at least two days a week or experiencing much/very much sleepiness at school). Delayed sleep phase was associated with lower average school grades, smoking, alcohol usage, and elevated anxiety and depression scores.ConclusionsDelayed sleep phase appears to be common amongst Norwegian adolescents and is associated with negative outcomes such as lower average school grades, smoking, alcohol usage, and elevated anxiety and depression scores.     

Sleep problems in physically disabled children and burden on caregivers

Aim

The present study was implemented to investigate relationships between sleep problems in physically disabled children and sleep quality and perceived burden of caregivers.

Methods

Subjects comprised 100 caregivers of disabled children, including 96 mothers, 2 fathers and 2 grandmothers. Questionnaires included demographic data for children and caregivers, sleep problems of children, and sleep quality (Pittsburgh sleep quality index (PSQI)) and perceived burden on caregivers (Japanese version of the Zarit Burden Interview (J-ZBI)). The sleep problems of children were evaluated according to the following five categories: “Problems initiating and maintaining sleep”; “Problems with sleep-related breathing”; “Problems with excessive somnolence”; “Problems with circadian rhythm”; and “Problems with sleep-related movement”.

Results

The children comprised 66 boys and 34 girls (age range, 1–17 years). Of these, 65 children could not sit up and 35 could. A total of 88 children were found to have one or more categories of sleep problems. The most common sleep problem was “Problems initiating and maintaining sleep” (64.8%), followed by “Problems with sleep-related movement” (59.1%). J-ZBI was significantly higher in caregivers of children with “Problems initiating and maintaining sleep”. PSQI scores were significantly higher in caregivers of children with “Problems with sleep-related breathing” and “Problems with circadian rhythm”. A significant correlation was identified between perceived J-ZBI and PSQI of the caregiver.

Conclusions

Increased focus on the sleep problems of disabled children is needed, particularly in relation to the sleep quality and perceived burden of caregivers.     

Comprehensive assessment of the impact of life habits on sleep disturbance,chronotype, and daytime sleepiness among high-school students

ObjectiveSleep affects adolescents in various ways. However, the effects of multiple factors on sleep hygiene remain unclear. A comprehensive assessment of the effects of life habits on sleep in high-school students was conducted.MethodsA cross-sectional survey of 344 high school students (age range 15–17; 171 boys, 173 girls) in Tokyo, Japan was conducted in 2015. Complete responses were provided by 294 students. Demographic variables, Pittsburgh Sleep Quality Index (PSQI), diurnal type scale, Pediatric Daytime Sleepiness Scale (PDSS), and life habits such as dinnertime, viewing electronic displays, caffeine intake, sunlight in the morning, and the brightness of the room in the night were asked.ResultsThe mean scores were PSQI: 5.9 (±2.3), PDSS: 19.0 (±5.8), and the diurnal type scale: 16.7 (±3.4). Using an electronic display in bed (OR = 3.01; (95%CI) 1.24–7.30), caffeine intake at night always (OR = 2.22; 1.01–4.90), and waking up before dawn (OR = 3.25; 1.34–7.88) were significantly associated with sleep disturbance. Irregular timing of the evening meal (OR = 2.06; 1.10–3.84) and display viewing within 2 h before bedtime (OR = 2.50; 1.01–6.18) or in bed (OR = 3.60; 1.41–9.21) were significantly associated with excessive daytime sleepiness. Using an electronic display within 2 h before bedtime (OR = 2.64; 1.10–6.38) or in bed (OR = 3.50; 1.40–8.76) and a living room which is bright at night (OR = 1.89; 1.06–3.36) were significantly associated with eveningness.ConclusionEach type of sleep-related problem had its own associated life habit factors.     

Sleep–wake habits in Spanish primary school children

IntroductionSleep deficit in children has been associated with psychological and behavioral health alterations as well as an increased incidence of obesity and accidents. Several studies have assessed the effects of poor sleep patterns on adolescents and young adults; however few studies have been conducted in children and pre-teenagers. The main objective of this study was to examine sleep habits in primary school children.MethodsThe parents of primary school children in Alcoy (Spain) kept a sleep diary for their children for 1 week. Parents were asked to record the time their children went to bed, woke up and got out of bed, as well as sleep latency and total sleep time on schooldays and weekends. The data were analyzed and differences according to grade and gender were noted.ResultsThree hundred twenty-one sleep diaries were studied; 53% were from boys and 47% from girls. As grade increased, children went to bed later and slept less (p < 0.001). Children slept more hours on weekend than during the week. There was a substantial gender difference at the highest grade level: girls slept 23 min more than boys on weekends (p < 0.001). Sleep latency was greater than 20 min in 19% of children, primarily in girls 10–12 years of age. There were a considerable percentage of children in each group who slept less than average for their age.ConclusionSleep patterns in primary school children have been underreported. There appears to be insufficient sleep and delayed sleep-phase patterns among pre-teenagers.     

Sleep-related problems and eating habits during COVID-19 lockdown in a southern Brazilian youth sample

The pandemic has affected children's behaviors and this fact has an effect on their healthy habits, such as sleep and diet. The aim of the current study was to determinate the prevalence of sleep-related problems and its relationship with eating habits in children from the south of Brazil during the pandemic.Parents/legal guardians of 3–17 years old participants responded to a online survey distributed using the snowball sampling strategy in Brazil. The survey was conducted in April, 2020. Participants were asked for their sleep duration and sleep-related problems, as well as for their eating habits. Logistic regressions were performed to analyze the relationship between sleep-related problems and eating habits.495 participants were included in the analysis. 48.8% of participants reported sleep-related problems with 12.3% not meeting the sleep guidelines. Moreover, participants reported eating fruits or vegetables and sweets over four and three per week, respectively. Different associations were found between varibles of sleep and eating habits.Those participants with healthy eating habits showed a lower prevalence of sleep-related problems.     

Sleep patterns and habits in high school students in Iran

Background  

Sleep patterns and habits in high school students in Iran have not been well studied to date. This paper aims to re-address this balance and analyse sleep patterns and habits in Iranian children of high school age.     

Sleep patterns and sleep deprivation recorded by actigraphy in 4th-grade and 5th-grade students

ObjectiveThis study investigates sleep patterns of fourth- and fifth-grade students using actigraphy.MethodsThe study included 257 students enrolled in a Southwestern US school district who participated in a novel sleep science curriculum during the Spring 2016–17 and Fall 2017-18 semesters and met the study inclusion criteria. As part of this curriculum, participants underwent 5–7 days of continuous wrist actigraphy and completed an online sleep diary.ResultsApproximately two-thirds of the 9-11-year-old fourth- and fifth-grade students slept less than the minimum 9 h per night recommended by both the American Academy of Sleep Medicine/Sleep Research Society and the National Sleep Foundation. The sleep midpoint time on weekends was about 1 h later than on weekdays. There was a significant effect of age on sleep duration. Compared to 9-year old students, a larger proportion of 10-year old students had a sleep duration less than 8.5 h. Boys had shorter sleep duration than girls, and a larger percentage of boys obtained less than 9 h of sleep compared to girls.ConclusionsInsufficient sleep is a highly prevalent condition among 9-11-year-old fourth- and fifth-grade elementary students. Importantly, there is a difference between sleep patterns on weekdays and weekends which may portend greater problems with sleep in adolescence and young adulthood.     

Children’s Perceived Competence Scale: reevaluation in a population of Japanese elementary and junior high school students

Background

It is important for children to maintain high self-perceived competence and self-esteem, and there are few measures to evaluate them through elementary to junior high school days in Japan. To evaluate psychometric properties of the Children’s Perceived Competence Scale (CPCS).

Methods

Data were collected from 697 elementary school and 956 junior high school students. Some of these students completed measures for construct validity, whereas others repeated the CPCS.

Results

The results demonstrated the three-factor structure of the CPCS: cognitive (nine items), social (eight items) and physical (nine items). Factorial invariance was confirmed between elementary and junior high school students, as well as between boys and girls. Construct validity was excellent. Scores on the cognitive, physical and general self-worth domains declined with increasing age. Boys scored significantly higher than girls on physical and general self-worth domains.

Conclusions

The CPCS is a valid and reliable measure of perceived competence in Japanese children aged 6–15 years. The CPCS may be applied to students from elementary through junior high school days as a measure of self-perceived and psychological state in Japan.

     

Sleep habits,circadian preference,and school performance in early adolescents

ObjectiveThis study aimed to cast light on the relationships between sleep habits, perceived sleep problems and school performance in Evening-type (E-type) compared with Morning-type (M-type) early adolescents.MethodsComparison of questionnaire data of E-type and M-type adolescents random-selected from a large sample of eight-grade adolescents who took part in a national survey of competence in mathematics and science.ResultsThe proportions of sleep problems that were observed to occur more than once per week and the frequency of struggling to fall asleep and/or falling asleep in distinct everyday situations were much higher in E-type than in M-type adolescents. Moreover, E-type adolescents showed more disturbed and poorer sleep during both school and weekend days and reported lower grades in mathematics, science and Italian.ConclusionsE-type adolescents showed a partial recovery of sleep debt during weekend days. This finding suggests that they could improve their school performance if tests and classwork would be scheduled on their most alert school days, namely the post-weekend ones.