Sleep Quality and Associated Factors among Adolescents
DOI:
https://doi.org/10.14306/renhyd.24.3.1017Keywords:
Adolescent, Feeding Behavior, Sleep, Sleep Hygiene, AnthropometryAbstract
Introduction: This study aimed to investigate sleep quality and sleep patterns in adolescents. The second aim was to find out whether there was an association between sleep quality, sleep patterns, dietary habits, food consumptions, and anthropometric measurements in an adolescent population.Material and methods: This cross-sectional study was conducted on 346 adolescents. Data was recorded with a questionnaire form. The questionnaire form included items on adolescents’ characteristics, sleep patterns, dietary habits, food consumptions, and anthropometric measurements. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).
Results: Sleep duration of >8 hours (67.6%) and sleep latency of 15 minutes (53.8%) were the most commonly identified sleeping patterns. The mean PSQI score was 3.07±2.54. PSQI scores revealed poor sleep quality in 13.6% of participants. A significant difference was observed between age, disease diagnosed by physician, skipping main meals, having regular breakfast, and PSQI score (p<0.05). PSQI score was found to be significantly associated with spending time in front of the computer and regular sleep. The amount of daily saturated fatty acid was statistically significantly lower (p=0.040) in individuals in the good PSQI.
Conclusions: The vast majority of adolescents had good sleep quality. Sleep duration of adolescents was consistent with the recommended need. Individual factors, dietary habits, food consumption, and screen times were factors associated with sleep quality. This current study results support the development of interventions to help adolescents improve sleep quality. We recommend further investigation to clarify this finding.
References
(1) Benedict C, Byberg L, Cedernaes J, Hogenkamp PS, Giedratis V, Kilander L, et al. Self-reported sleep disturbance is associated with Alzheimer's disease risk in men. Alzheimers Dement. 2015;11(9):1090-7.
(2) Kronholm E, Laatikainen T, Peltonen M, Sippola R, Partonen T. Self-reported sleep duration, all-cause mortality, cardiovascular mortality and morbidity in Finland. Sleep Med. 2011;12(3):215-21.
(3) Ramos AR, Jin Z, Rundek T, Russo C, Homma S, Elkind MS, et al. Relation between long sleep and left ventricular mass (from a multiethnic elderly cohort). Am J Cardiol. 2013;112(4):599-603.
(4) Bayon V, Leger D, Gomez-Merino D, Vecchierini MF, Chennaoui M. Sleep dept and obesity. Ann Med. 2014;46(5):264-72.
(5) Schmid SM, Hallschmid M, Schultes B. The metabolic burden of sleep loss. Lancet Diabetes Endocrinol. 2015; 3(1):52-62.
(6) Grandner MA, Chakravorty S, Perlis ML, Oliver L, Gurubhagavatula I. Habitual sleep duration associated with self-report and objectively determined cardiometabolic risk factors. Sleep Med. 2014;15(1):42-50.
(7) Guo X, Zheng L, Wang J, Zhang X, Li J, Sun Y. Epidemiological evidence for the link between sleep duration and high blood pressure: a systematic review and meta-analysis. Sleep Med. 2013;14(4):324-32.
(8) Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. Malow BA, Consensus statement of the American Academy of Sleep Medicine on the recommended amount of sleep for healthy children: methodology and discussion. J Clin Sleep Med. 2016;12(11):1549-61.
(9) National Sleep Foundation. Teens and Sleep. (Access date 24 April 2020). Available at: https://www.sleepfoundation.org/articles/teens-and-sleep
(10) Leger D, Bayon V, Sanctis A. The role of sleep in the regulation of body weight. Mol Cell Endocrinol. 2015;418:101-7.
(11) 11.Lytle LA, Pasch KE, Farbakhsh K. The relationship between sleep and weight in a sample of adolescents. Obesity (Silver Spring). 2011;19(2):324–31.
(12) Miller MA, Kruisbrink M, Wallece J, Ji C, Cappuccio FP. Sleep duration and incidence of obesity in infants, children, and adolescents: a systematic review and meta-analysis of prospective studies. Sleep. 2018;41(4):1-19.
(13) Koyuncuoğlu Güngör N. Overweight and Obesity in Children and Adolescents. J Clin Res Pediatr Endocrinol. 2014;6(3):129-43.
(14) Chaput JP, Dutil C. Lack of sleep as a contributor to obesity in adolescents: impacts on eating and activity behaviors. Int J Behav Nutr Phys Act. 2016;13(1):103.
(15) Kim S, DeRoo LA, Sandler DP. Eating patterns and nutritional characteristics associated with sleep duration. Public Health Nutr. 2011;14(5):889-95.
(16) Buysse DJ, Reynolds CF 3 rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
(17) Agargün YM, Kara H, Anlar Ö. Pittsburg Uyku Kalitesi İndeksi’nin geçerliliği ve güvenirliği. Türk Psikiyatri Dergisi 1996;7(2): 107-15.
(18) Gordon CC, Chumlea WC, Roche AF. Measurement descriptions and techniques Anthropometric Standardization Reference Manual. In: Lohman TG, Roche AF, Martorell R, eds. 1st edition, 3-12. Illinois: Kinetics Books Champaign; 1998.
(19) de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007; 85:660-67.
(20) World Health Organization. WHO Growth reference 5-19 years - application tools. (Access date 24 April 2020). Available at: http://www.who.int/growthref/tools/en/
(21) Merdol Kutluay T. Toplu beslenme yapılan kurumlar icin standart yemek tarifeleri. Ankara: Hatiboglu Yayınevi, Ankara, Turkey, 5th edition, 2015. (in Turkish)
(22) Rakıcıoglu N, Tek Acar, N, Ayaz A, Pekcan G. Photograph catalog of food and dishes: Portion sizes and amounts. Ata Ofset Pub, Ankara, Turkey, 2nd edition, 2009.
(23) Ebispro for Windows, Stuttgart, Germany, BEBİS, Turkish version and Data Bases: Bundeslebenmittelschlüssell, 11.3 and other sources. Nutrition Information Systems, 2004.
(24) IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.
(25) World Health Organization (WHO). Sleep characteristics and sleep deprivation in infants, children and adolescents. WHO Regional Office for Europe, European Centre for Environment and Health Bonn Office: World Health Organization; 2004.
(26) Xu Z, Su H, Zou Y, Chen J, Wu J, Chang W. Sleep quality of Chinese adolescents: distribution and its associated factors. J Paediatr Child Health 2012;48(2):138-45.
(27) Şenol V, Soyuer F, Pekşen Akça R, Argün M. The Sleep Quality in Adolescents and the Factors that Affect It. Kocatepe Med J. 2012;14:93-102.
(28) Şimşek Y, Tekgül N. Sleep quality in adolescents in relation to age and sleep-related habitual and environmental factors. J Pediatr Res. 2019;6(4):307-13.
(29) Gradisar M, Gardner G, Dohnt H. Recent worldwide sleep patterns and problems during adolescence: A review and meta- analysis of age, region, and sleep. Sleep Med. 2011;12:110-8.
(30) Felden ÉP, Filipin D, Barbosa DG, Andrade RD, Meyer C, Louzada FM. Fatores associados à baixa duração do sono em adolescentes. Rev Paul Pediatr. 2015;34:64 70.
(31) Iglowstein I, Jenni OG, Molinari L, Largo RH. Sleep duration from infancy to adolescence: reference values and generational trends. Pediatrics. 2003;111:302 7.
(32) Carskadon MA, Wolfson AR, Acebo C, Tzischinsky O, Seifer R. Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days. Sleep. 1998;21:871 81.
(33) Giannotti F, Cortesi F, Sebastiani T, Ottaviano S. Circadian preference, sleep, and daytime behavior in adolescence. J Sleep Res. 2002;11:191–99.
(34) Tonetti L, Fabbri M, Natale V. Sex differences in sleep-time preference, and sleep need: a crosssectional survey among Italian pre-adolescents, adolescents, and adults. Chronobiol Int. 2008;25:745–59.
(35) Akçay D, Akçay BD. The influence of media on the sleep quality in adolescents. Turk J Pediatr. 2018; 60: 255-63.
(36) Mei X, Zhou Q , Li X , Jing P , Wang X, Hu Z. Sleep problems in excessive technology use among adolescent: a systemic review and meta-analysis. SSP. 2018; 2:9.
(37) Garmy P, Nyberg P, Jakobsson U. Sleep and television and computer habits of Swedish school-age children. J Sch Nurs. 2012; 28:469-76.
(38) Van den Bulck J. Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children. Sleep. 2004; 27: 101-04.
(39) American Academy of Pediatrics Committee on Public Education. Policy statement-Media education. Pediatrics. 2010; 126: 423-26.
(40) Weiss A, Xu F, Storfer-Isser A, Thomas A, Ievers-Landis CE, Redline S. The association of sleep duration with adolescents’ fat and carbohydrate consumption. Sleep. 2010;33:1201–9.
(41) Grandner MA, Kripke DF, Naidoo N, Langer RD. Relationships among dietary nutrients and subjective sleep, objective sleep, and napping in women. Sleep Med. 2010;11:180–4.
(42) Chaput JP. Sleep patterns, diet quality and energy balance. Physiol Behav. 2014;134:86–91.
(43) Chaput JP, Katzmarzyk PT, LeBlanc AG, Tremblay MS, Barreira TV, Broyles ST, et al. Associations between sleep patterns and lifestyle behaviors in children: an international comparison. Int J Obes Suppl. 2015;5(Suppl 2):S59-S65.
(44) Ferranti R, Marventano S, Castellano S, Giogianni G, Nolfo F, Rametta S, et al. Sleep quality and duration is related with diet and obesity in young adolescent living in Sicily, Southern Italy. Sleep Sci. 2016;9(2):117–22.
(45) Gong QH, Li H, Zhang XH, Zhang T, Cui J, Xu GZ. Associations between sleep duration and physical activity and dietary behaviors in Chinese adolescents: results from the Youth Behavioral Risk Factor Surveys of 2015. Sleep Med. 2017;37:168–73.
(46) Kruger AK, Reither EN, Peppard PE, Krueger PM, Hale L. Do sleep-deprived adolescents make less-healthy food choices? Br J Nutr. 2014;111(10):1898–904.
(47) Fisher A, McDonald L, van Jaarsveld CHM, Llewellyn C, Fildes A, Schrempft S, et al. Sleep and energy intake in early childhood. Int J Obes. 2014; 38(7): 926–29.
(48) Weiss A, Xu F, Storfer-Isser A, Thomas A, Ievers-Landis CE, Redline S. The association of sleep duration with adolescents’ fat and carbohydrate consumption. Sleep. 2010; 33(9): 1201–09.
(49) Min C, Kim HJ, Park IS, Park B, Kim JH, Sim S, et al. The association between sleep duration, sleep quality, and food consumption in adolescents: A crosssectional study using the Korea Youth Risk Behavior Web-based Survey. BMJ Open. 2018;8:e022848.
(50) Javadi M, Alimoradi F, Avani A, Jalilolghadr S. Association between sleep quality and intake of macronutrients and micronutrients in adolescents. J Mazandaran Univ Med Sci. 2018; 27(156):205-10.
(51) Tambalis KD, Panagiotakos DB, Psarra G, Sidossis LS. Insufficient sleep duration is associated with dietary habits, screen time, and obesity in children. J Clin Sleep Med. 2018; 14: 1689-96.
(52) Agostini A, Lushington K, Kohler M, Dorrian J. Associations between self-reported sleep measures and dietary behaviours in a large sample of Australian school students (n=28,010). J Sleep Res. 2018; 27(5): e12682.
(53) Smith KJ, Breslin MC, McNaughton SA, Gall SL, Blizzard L, Venn AJ. Skipping breakfast among Australian children and adolescents; findings from the 2011-12 National Nutrition and Physical Activity Survey. Aust NZ J Public Health. 2017; 41: 572–78.
(54) Forkert ECO, Moraes ACFD, Carvalho HB, Manios Y, Widhalm K, Gonzales-Gross M, et al. Skipping breakfast is associated with adiposity markers especially when sleep time is adequate in adolescents. Sci Rep. 2019; 9:6380.
(55) Di Renzo L, Tyndall E, Gualtieri P, Carboni C, Valente R, Ciani AS, et al. Association of body composition and eating behavior in the normal weight obese syndrome. Eat Weight Disord. 2016; 21(1):99–106.
(56) Lytle LA, Pasch KE, Farbakhsh K. The relationship between sleep and weight in a sample of adolescents. Obesity (Silver Spring). 2011;19(2):324-31.
(57) Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring, Md). 2008;16(3): 643-53.
(58) S Bruce E, Lunt L, E McDonagh J. Sleep in adolescents and young adults. Clin Med. 2017; 17(5): 424-8.
(59) Garaulet M, Ortega FB, Ruiz JR, Rey-Lopez JP, Beghin L, Manios Y, et al. Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study. Int J Obes. 2011;35(10):1308-17.
(60) Weiss A, Xu F, Storfer-Isser A, Thomas A, Ievers-Landis CE, Redline S. The association of sleep duration with adolescents' fat and carbohydrate consumption. Sleep. 2010; Sep 1;33(9):1201-9.
(61) Babu R, Bahuleyan B. Correlation of sleep quality with anthropometric parameters in young healthy individuals. Int J Res Med Sci 2018;6:613-7.
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