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Magnusdottir S, Magnusdottir I, Gunnlaugsdottir AK, Hilmisson H, Hrolfsdottir L, Paed AEEM. Sleep duration and social jetlag in healthy adolescents. Association with anxiety, depression, and chronotype: a pilot study. Sleep Breath 2024; 28:1541-1551. [PMID: 38546939 DOI: 10.1007/s11325-024-03026-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/23/2024] [Accepted: 03/20/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE Misalignment between sleep opportunity and chronotype preference during adolescence may affect sleep and mental health. The aim of this study was to objectively evaluate sleep duration and social jetlag (SJL) to observe if there is a relationship with anxiety, depression, or chronotype. METHODS Community based cohort study (n = 65) was conducted in Northern Europe. Participants recorded their sleep during the regular school schedule for 3 school nights and 2 free nights with FDA-cleared/EU Medical Device Directive (CE-02862) compliant home sleep test. They also completed validated questionnaires to assess (Morningness Eveningness Questionnaire; MEQ), sleepiness (Epworth Sleepiness Scale; ESS), and insomnia (Insomnia Severity Index; ISI), anxiety (General Anxiety Disorder-7; GAD-7), and depression symptoms (Beck's Depression Inventory-II; BDI-II). Data were collected during the last week of February and the first 2 weeks of March, 2023. RESULTS Average sleep duration on school nights was 7 h, 15 min, with 18% of participants on average sleeping ≥ 8 h. Average sleep onset was significantly later on free nights (1 hour, 47 minutes; p < 0.0001) causing a high prevalence of moderate-severe SJL, in 71% of participants. Evening chronotypes (prevalence 15.4%) fell asleep later on free nights, causing them to have significantly more SJL (2 hours, 58 minutes) than morning chronotypes (1 hour, 32 minutes) and intermediary chronotypes (1 hour, 36 minutes). Evening chronotypes also had more severe insomnia (ISI + 4.4, p = 0.006; + 4.0, p = 0.001) and greater depressive symptoms (BDI-II + 21.6, p < 0.0001; + 17.1, p < 0.0001). A significant negative correlation was observed between MEQ scores and ESS (r = - 0.287; p = 0.001), ISI (r = - 0.343, p < 0.0001), GAD-7 (r = - 0.185, p < 0.0001), BDI-II (r = - 0.501, p = 0.0001), and suicidal thoughts (r = - 0.294, p = 0.017). CONCLUSION Adolescents are sleep-deprived and have a high prevalence of SJL that is positively correlated with depressive symptoms and evening chronotype. That evening chronotypes have shorter sleep duration, more severe SJL, and significantly more sleepiness and insomnia, anxiety, and depressive symptoms may indicate possible benefits in identifying this group with the aim to assist them in improving their sleep habits with potentially positive effects on mental health.
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Affiliation(s)
| | | | - Audur Karen Gunnlaugsdottir
- Akureyri Junior College, Akureyri, Iceland
- University of Akureyri, Akureyri, Iceland
- The Healthcare Institution of North Iceland, Husavik, Iceland
| | - Hugi Hilmisson
- MyCardio LLC, 3200 East Cherry Creek South Drive, Denver, CO, 80209, USA
| | - Laufey Hrolfsdottir
- Institution of Health Science Research, University of Akureyri and Akureyri Hospital, Akureyri, Iceland
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Mathew GM, Reichenberger DA, Master L, Buxton OM, Chang AM, Hale L. Actigraphic sleep dimensions and associations with academic functioning among adolescents. Sleep 2024; 47:zsae062. [PMID: 38442263 PMCID: PMC11236952 DOI: 10.1093/sleep/zsae062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/30/2024] [Indexed: 03/07/2024] Open
Abstract
STUDY OBJECTIVES There is mixed evidence regarding associations of sleep duration with academic functioning in adolescents and a lack of research on other sleep dimensions, particularly using objective sleep measures. We examined associations of multiple actigraphic sleep dimensions with academic functioning among adolescents. METHODS Data were from the sleep sub-study of the age 15 wave of the Future of Families and Child Wellbeing Study (n = 774-782; 52% female), a national, diverse sample of teens. Adolescents wore wrist-actigraphs for ~1 week and completed a survey reporting academic performance and school-related behavioral problems. Regression models assessed whether average sleep duration, timing, maintenance efficiency, and SD-variability were associated with self-reported academic functioning in cross-sectional analyses adjusted for demographic characteristics, depressive symptoms, and anxious symptoms. RESULTS Later sleep timing (hours) and greater sleep variability (SD-hours) were associated with poorer academic outcomes, including sleep onset variability with higher odds of receiving a D or lower (OR = 1.29), sleep onset (β = -.07), sleep offset (β = -.08), and sleep duration variability (β = -.08) with fewer A grades, sleep offset with lower GPA (β = -.07), sleep offset (OR = 1.11), sleep duration variability (OR = 1.31), and sleep onset variability (OR = 1.42) with higher odds of being suspended or expelled in the past 2 years, and sleep duration variability with greater trouble at school (β = .13). Sleep duration, sleep maintenance efficiency, and sleep regularity index were not associated with academic functioning. CONCLUSIONS Later sleep timing and greater sleep variability are risk factors for certain academic problems among adolescents. Promoting sufficient, regular sleep timing across the week may improve adolescent academic functioning.
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Affiliation(s)
- Gina Marie Mathew
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, 101 Nicolls Road, Health Sciences Center, Stony Brook, NY, USA
| | - David A Reichenberger
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, USA
| | - Lindsay Master
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, USA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, 101 Nicolls Road, Health Sciences Center, Stony Brook, NY, USA
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Chen CX, Zhang JH, Li SX, Chan KCC, Li AM, Kong APS, Chan JWY, Wing YK, Chan NY. Secular trends in sleep and circadian problems among adolescents in Hong Kong: From 2011-2012 to 2017-2019. Sleep Med 2024; 117:62-70. [PMID: 38513532 DOI: 10.1016/j.sleep.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE The study aimed to investigate secular trends in sleep and circadian problems in Hong Kong Chinese adolescents. METHODS This study analyzed cross-sectional data from two large-scale school-based sleep surveys conducted in 2011-2012 and 2017-2019. Sleep and circadian problems, including sleep-wake pattern, insomnia, chronotype, social jetlag, daytime sleepiness, and other sleep-related factors, were compared between two survey years. RESULTS A total of 8082 adolescents (5639 students in 2011-2012 [Mean age: 14.4 years, 50.9% boys] and 2443 students in 2017-2019 [Mean age: 14.7 years, 54.0% boys]) were included in this 7-year study. The average time in bed of Hong Kong adolescents decreased from 8.38 hours to 8.08 hours from 2011-2012 to 2017-2019. There was a 0.28-hour delay in weekday bedtime, 0.54-hour advance in weekend wake-up time, and a 0.36-hour decline in average time in bed, resulting in increased trends of sleep loss (Time in bed <8h: OR = 2.06, 95%CI: 1.44-2.93, p < 0.01; Time in bed <7h: OR = 2.73, 95%CI: 1.92-3.89, p < 0.01), daytime sleepiness (OR = 1.70, 95%CI: 1.34-2.16, p < 0.01), and evening chronotype (OR = 1.26, 95%CI: 1.08-1.48, p < 0.01). The increased trend in insomnia disorder, however, was insignificant when covariates were adjusted. CONCLUSION A secular trend of reduced time in bed, delay in weekday bedtime, advance in weekend wake-up time, increase in evening chronotype and daytime sleepiness from 2011-2012 to 2017-2019 were observed. There is a timely need for systematic intervention to promote sleep health in adolescents.
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Affiliation(s)
- Chris Xie Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ji-Hui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
| | - Kate Ching Ching Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Zhao C, He J, Xu H, Zhang J, Zhang G, Yu G. Are "night owls" or "morning larks" more likely to delay sleep due to problematic smartphone use? a cross-lagged study among undergraduates. Addict Behav 2024; 150:107906. [PMID: 37984222 DOI: 10.1016/j.addbeh.2023.107906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/22/2023]
Abstract
Sleep is an important physiological process, but staying up late has become a worldwide problem, particularly among university students. Sleep procrastination has been found to associated with sleep biorhythms and problematic smartphone use ("PSU") in previous studies. This two-wave study examines the longitudinal reciprocal relationship between PSU and sleep procrastination, together with the moderating role of sleep biorhythms. Participants comprised 1,423 Chinese university students. The results revealed that PSU and sleep procrastination are reciprocally related. Additionally, sleep biorhythms moderated this relationship, as PSU at T1 significantly predicted sleep procrastination at T2 for the morning larks group but not the night owls group. Accordingly, both PSU and sleep biorhythms should be considered when developing interventions for sleep procrastination.
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Affiliation(s)
- Chengjia Zhao
- School of Education, Renmin University of China, Beijing 100872, China.
| | - Jiankang He
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou 325035, China.
| | - Huihui Xu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou 325035, China.
| | - Jingjing Zhang
- School of Nursing, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Guohua Zhang
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou 325035, China; Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, 325035, China; Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Guoliang Yu
- Institute of Psychology, Renmin University of China, Beijing 100872, China.
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Wang W, Han L, Lu Q, Lv X, Liu Y, Wang D. Research on the impact of the socio-educational environment on the academic performance of college students: the mediating role of study motivation. Front Psychol 2024; 14:1289064. [PMID: 38250122 PMCID: PMC10797049 DOI: 10.3389/fpsyg.2023.1289064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Background Enhancing the academic performance (AP) of college students can contribute to the overall scientific literacy among this population, thereby fostering societal progress. Objective The study investigates the correlation between college students' AP and the socio-educational environment (SEE, including family, roommates, and teachers), study motivation (SM, including self-efficacy and study behaviors). Based on the research findings, recommendations are offered to students, educators, and school administrators. Settings Utilizing a stratified sampling approach, data was collected by selecting a sample of 330 first-year computer science students from a specific local university in Hebei Province, China. Methods Data will be collected through a hierarchical sampling method. Using correlation analysis, difference analysis, and structural equation modeling (SEM) as data analysis methods. The data passed reliability and validity analysis (Cronbach's Alpha = 0.88, KMO = 0.88, χ2/df = 1.49RMSEA = 0.04). Results The independent sample T-test results showed that female students had higher academic performance than male students (p < 0.001), and there was no significant difference in academic performance between students from single parent or orphan families and students from normal families (p = 0.14), from non urban areas and from urban areas (p = 0.67). The results of the mediating effect analysis indicate that SM exerts complete mediation in the association between SEE and AP, with a mediating effect value of 0.18. Conclusion The educational disparity between urban and rural areas in China is gradually narrowing. Support policies for students from impoverished families in higher education institutions are showing initial effectiveness. The conducive learning environment and educational atmosphere for students can indirectly influence their psychological state, thus impacting their academic performance during their university years.
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Affiliation(s)
- Weiqin Wang
- College of Science and Technology, Hebei Agricultural University, Huanghua, Hebei, China
| | - Lu Han
- College of Economics and Management, Hebei Agricultural University, Baoding, Hebei, China
| | - Qingjiao Lu
- Department of Basic Courses, Hebei Agricultural University, Huanghua, Hebei, China
| | - Xingjun Lv
- College of Science and Technology, Hebei Agricultural University, Huanghua, Hebei, China
| | - Yu Liu
- College of Science and Technology, Hebei Agricultural University, Huanghua, Hebei, China
| | - Dongxuan Wang
- College of Science and Technology, Hebei Agricultural University, Huanghua, Hebei, China
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Chen SJ, Li SX, Zhang JH, Lam SP, Yu MWM, Tsang CC, Kong APS, Chan KCC, Li AM, Wing YK, Chan NY. School-Based Sleep Education Program for Children: A Cluster Randomized Controlled Trial. Healthcare (Basel) 2023; 11:1853. [PMID: 37444687 DOI: 10.3390/healthcare11131853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/03/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
Insufficient sleep contributes negatively to child developmental processes and neurocognitive abilities, which argues the need for implementing interventions to promote sleep health in children. In this study, we evaluated the effectiveness of a multimodal and multilevel school-based sleep education program in primary school children using a cluster randomized controlled design. Twelve schools were randomly assigned to either the sleep education or nonactive control groups. The sleep education group included a town hall seminar, small class teaching, leaflets, brochures, and a painting competition for children. Parents and teachers were invited to participate in a one-off sleep health workshop. Parental/caregiver-reported questionnaires were collected at baseline and 1-month follow-up. A total of 3769 children were included in the final analysis. There were no significant improvements observed in the sleep-wake patterns, daytime functioning, and insomnia symptoms between the two groups at follow-up, whereas the intervention group had significantly improved parental sleep knowledge than the controls (paternal: adjusted mean difference: 0.95 [95% confidence interval (CI): 0.18 to 1.71]; maternal: adjusted mean difference: 0.87 [95% CI: 0.17 to 1.57]). In addition, children receiving the intervention had a lower persistence rate of excessive beverage intake (adjusted odds ratio: 0.49 [95% CI: 0.33 to 0.73]), and experienced greater reductions in conduct problems (adjusted mean difference: 0.12 [95% CI: 0.01 to 0.24]) compared with the controls at 1-month of follow-up. Moreover, a marginally significant reduction for emotional problems in the intervention group was also observed (adjusted mean difference: 0.16 [95% CI: -0.00 to 0.32]). These findings demonstrated that school-based sleep education was effective in enhancing parental sleep knowledge and improving behavioral outcomes in children, but not sufficient in altering the children's sleep-wake patterns and sleep problems.
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Affiliation(s)
- Si-Jing Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Ji-Hui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510260, China
| | - Siu Ping Lam
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Mandy Wai Man Yu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Ching Tsang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kate Ching Ching Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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