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Gesoglu Demir T, Havlioğlu S. Determining Adult Dizziness and Sleep Quality After the 2023 Earthquakes in Türkiye. Cureus 2024; 16:e64632. [PMID: 39149661 PMCID: PMC11325212 DOI: 10.7759/cureus.64632] [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] [Accepted: 07/15/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND This study investigated the presence of dizziness and sleep quality in people affected by the earthquake disaster of 2023 in Türkiye and aimed to determine the relationship between dizziness and sleep disorders. METHODS A total of 384 earthquake survivors who had no previous complaints of dizziness or sleep disturbance and who presented to the neurology outpatient clinic with complaints of dizziness or sleep disturbance after the earthquake were included in the study. Demographic information of participants and scales such as the Dizziness Handicap Inventory (DHI) and the Pittsburgh Sleep Quality Index (PSQI) were recorded. RESULTS It was determined that the majority of the patients in the 18-35 age group had poor sleep quality and there was a significant difference in the PSQI score. Additionally, a moderate positive significant relationship was found between the DHI score and the PSQI score. CONCLUSION Exposure to major earthquakes and aftershocks can cause sleep disorders and dizziness complaints, which may emerge as public health problems. Earthquake victims should be followed up and necessary interventions should be made early.
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Affiliation(s)
| | - Suzan Havlioğlu
- Public Health/Nursing, Harran University Faculty of Health Sciences, Sanliurfa, TUR
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Luo M, Dong Y, Fan B, Zhang X, Liu H, Liang C, Rong H, Fei Y. Sleep Duration and Functional Disability Among Chinese Older Adults: Cross-Sectional Study. JMIR Aging 2024; 7:e53548. [PMID: 38771907 PMCID: PMC11196917 DOI: 10.2196/53548] [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: 10/10/2023] [Revised: 02/24/2024] [Accepted: 05/20/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND The duration of sleep plays a crucial role in the development of physiological functions that impact health. However, little is known about the associations between sleep duration and functional disability among older adults in China. OBJECTIVE This study aimed to explore the associations between sleep duration and functional disabilities in the older population (aged≥65 years) in China. METHODS The data for this cross-sectional study were gathered from respondents 65 years and older who participated in the 2018 survey of the China Health and Retirement Longitudinal Study, an ongoing nationwide longitudinal investigation of Chinese adults. The duration of sleep per night was obtained through face-to-face interviews. Functional disability was assessed according to activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. The association between sleep duration and functional disability was assessed by multivariable generalized linear models. A restricted cubic-spline model was used to explore the dose-response relationship between sleep duration and functional disability. RESULTS In total, 5519 participants (n=2471, 44.77% men) were included in this study with a mean age of 73.67 years, including 2800 (50.73%) respondents with a functional disability, 1978 (35.83%) with ADL disability, and 2299 (41.66%) with IADL disability. After adjusting for potential confounders, the older adults reporting shorter (≤4, 5, or 6 hours) or longer (8, 9, or ≥10 hours) sleep durations per night exhibited a notably increased risk of functional disability compared to that of respondents who reported having 7 hours of sleep per night (all P<.05), which revealed a U-shaped association between sleep duration and dysfunction. When the sleep duration fell below 7 hours, increased sleep duration was associated with a significantly lower risk of functional disability (odds ratio [OR] 0.85, 95% CI 0.79-0.91; P<.001). When the sleep duration exceeded 7 hours, the risk of functional disability associated with a prolonged sleep duration increased (OR 1.16, 95% CI 1.05-1.29; P<.001). CONCLUSIONS Sleep durations shorter and longer than 7 hours were associated with a higher risk of functional disability among Chinese adults 65 years and older. Future studies are needed to explore intervention strategies for improving sleep duration with a particular focus on functional disability.
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Affiliation(s)
- Minjing Luo
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Dong
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Bingbing Fan
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xinyue Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hao Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Changhao Liang
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hongguo Rong
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yutong Fei
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing GRADE Centre, Beijing, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Liang Y, Ke Y, Liu Y. The associations of physical activity and sedentary behavior with self-rated health in Chinese children and adolescents. PLoS One 2024; 19:e0304693. [PMID: 38820481 PMCID: PMC11142714 DOI: 10.1371/journal.pone.0304693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/16/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE The study aimed to analyze the independent and joint associations of physical activity (PA) and sedentary behavior (SB) with self-rated health (SRH) among Chinese children and adolescents. METHODS Cross-sectional data on moderate-to-vigorous physical activity (MVPA), school-based PA, extracurricular physical activity (EPA), screen time (ST), homework time, and SRH were assessed through a self-report questionnaire in the sample of 4227 Chinese children and adolescents aged 13.04 ± 2.62 years. Binary logistic regression was used to compare gender differences in PA, SB, and SRH among children and adolescents, and analyses were adjusted for age and ethnicity. RESULTS In independent associations, boys and girls engaging in ≥60 min/day of MVPA and >1 hour/day of EPA reported optimal SRH. Only boys who participated in >1 hour/day of school-based PA were significantly more likely to have optimal SRH (OR = 1.49, 95%CI = 1.19-1.86). Only girls who had ≤2 hours/day of ST were significantly associated with optimal SRH (weekdays: OR = 1.38, 95%CI = 1.10-1.74; weekends: OR = 1.40, 95%CI = 1.14-1.71; whole week: OR = 1.42, 95%CI = 1.16-1.73). In joint associations, regardless of SB recommendation, meeting PA recommendation was significantly associated with optimal SRH in both boys (meet PA and SB recommendations, OR = 1.61, 95%CI = 1.03-2.50; meet PA but not SB recommendations, OR = 2.40, 95%CI = 1.57-3.65) and girls (meet PA and SB recommendations, OR = 3.72, 95%CI = 2.08-6.65; meet PA but not SB recommendation, OR = 4.27, 95%CI = 2.09-8.75). CONCLUSION Increased PA and reduced SB were positively associated with optimal SRH in Chinese children and adolescents. Notably, lower ST positively influenced only girls' SRH. Meeting PA recommendation is more impactful than meeting SB recommendation for improving SRH in Chinese children and adolescents. Future studies could explore these associations using objective measures of PA and SB in China.
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Affiliation(s)
- Yahan Liang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
- Department of Human Movement Studies and Special Education, Darden College of Education & Professional Studies, Old Dominion University, Norfolk, VA, United States of America
| | - Youzhi Ke
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Yang Liu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
- Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai, China
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Liu X, Yang Y, Liu ZZ, Jia CX. Bidirectional associations between sleep problems and suicidal thought/attempt in adolescents: A 3-wave data path analysis. J Affect Disord 2024; 350:983-990. [PMID: 38244795 DOI: 10.1016/j.jad.2024.01.153] [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: 11/11/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE This longitudinal data analysis examined the bidirectional relationships between sleep problems and suicidal thought (ST)/attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 6995 adolescents (mean age = 14.86 years and 51.4% males) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. A self-administered questionnaire and standardized scales were used to assess ST, SA, sleep duration, insomnia, daytime sleepiness, and behavioral/emotional problems in 2015 (T1), 1 year later (T2), and 2 years later (T3). Path analyses were performed without and with adjustment for covariates, including gender, grade level, chronic diseases, cigarette smoking, alcohol use, anxiety/depressive symptoms, paternal education, and family economic status. RESULTS The prevalence rates of short sleep (<7 h/night), insomnia symptoms, and daytime sleepiness were 46.9-58.8%, 16.0-19.4%, and 25.1-25.3% at T1, T2, and T3, respectively. The rates of past-year ST and SA were 9.1-12.4% and 1.6-2.4% at T1, T2, and T3, respectively. Path analyses showed that short sleep, insomnia, and daytime sleepiness predicted subsequent ST, and vice versa. Daytime sleepiness and SA predicted each other 1 year later. Sleep problems and ST/SA in the previous year significantly predicted themselves in the follow-up year. STUDY LIMITATION All data were based on self-report. CONCLUSION Short sleep, insomnia, and daytime sleepiness all had bidirectional relationships with ST. Daytime sleepiness and SA were bidirectionally linked. Our findings suggest that interventions should be taken for both night sleep disturbances and daytime sleepiness to prevent suicide. Adverse sleep outcomes in suicidal adolescents should be assessed, which can in turn increase suicide risk.
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Affiliation(s)
- Xianchen Liu
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China; South China Normal University School of Psychology, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China
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Liu X, Liu ZZ, Yang Y, Jia CX. Starting a Romantic Relationship, Breakups, and Sleep: A Longitudinal Study of Chinese Adolescents. Behav Sleep Med 2024; 22:190-205. [PMID: 37325917 DOI: 10.1080/15402002.2023.2217973] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Epidemiological data on the association between romantic experiences and sleep in adolescents are limited. This study examined the associations of starting a romantic relationship (SRR) and romantic breakups with insomnia symptoms and sleep duration in adolescents. METHODS A total of 7,072 Chinese adolescents were surveyed in November-December 2015 and 1 year later. A self-administered questionnaire was used to assess SRR, romantic breakups, sleep duration, insomnia symptoms, depressive symptoms, substance use, and demographics. RESULTS The mean age of the sample was 14.58 (SD = 1.46) years and half were female. SRR only, breakups only, and both (SRR + breakups) in the past year were reported by 7.0%, 8.4%, and 15.4% of the sample, respectively. At the baseline and 1-year follow-up, 15.2% and 14.7% of the sample had insomnia symptoms and 47.7% and 42.1% reported short sleep duration (<7 h/night), respectively. After adjusting for depressive symptoms, substance use, and demographics, SRR and breakups were significantly associated with 35-45% increased odds of insomnia symptoms at baseline. SRR + breakups were significantly associated with short sleep duration (OR = 1.28, 95%CI = 1.05-1.56). SRR (OR = 1.61, 95%CI = 1.16-2.23) and breakups (OR = 1.43, 95%CI = 1.04-1.96) were significantly associated with increased odds of incident insomnia symptoms at 1-year follow-up. These associations were stronger in younger adolescents (<15 years) than in older adolescents (≥15 years), especially in girls. CONCLUSIONS The findings suggest that SRR and breakups are associated with insomnia symptoms and short sleep duration, underscoring the importance of romantic relationships education and management of romantic stress for healthy sleep especially in early adolescent girls.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun, China
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan, China
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Zhang Y, Wang D, Ma Z, Liu W, Su Y, Wang W, You Z, Fan F. Problematic internet use and suicide ideation among Chinese adolescents: The indirect effects of insomnia, nightmares, and social jetlag. J Affect Disord 2024; 344:347-355. [PMID: 37838270 DOI: 10.1016/j.jad.2023.10.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/12/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Problematic Internet use (PIU) is related to suicide ideation (SI) in adolescents, but little is known about the potential mechanisms between them. This study aimed to examine the mediation roles of insomnia, nightmares, and social jetlag in the association of PIU with SI in adolescents. METHODS A total of 39,731 adolescents (mean age = 13.49 ± 0.76 years, 54.4 % males) from Shenzhen, China, participated in a cross-sectional survey. SI was assessed using the ninth item of the Patient Health Questionnaire-9. PIU was measured by the Revised Chinese Internet Addiction Scale. A self-administered questionnaire was used to assess insomnia symptoms, nightmare frequency, social jetlag, sleep duration, psychological distress, and social-demographical characteristics. Logistic regression and path analyses were performed to examine the associations between PIU, insomnia symptoms, nightmares, social jetlag, and SI. RESULTS The prevalence of PIU and SI were 14.9 % and 18.6 %, respectively. PIU, insomnia symptoms, frequent nightmares, and social jetlag were significantly associated with SI. Path analyses showed that the indirect effects of PIU on SI through insomnia symptoms, frequent nightmares, and social jetlag were significant. Conversely, social jetlag significantly mediated the pathway from SI to PIU. The mediation effect sizes of these sleep and circadian problems were slightly larger in females than in males. LIMITATIONS Cross-sectional design limited the capacity to infer causal relationships. CONCLUSIONS The associations between PIU and SI were mediated by sleep and circadian problems. These findings underscore the importance of assessing and intervening in sleep and circadian problems among adolescents with PIU or SI.
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Affiliation(s)
- Yifan Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yunlin Su
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wei Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zhenli You
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Liu X, Zhang B. Is gradual sleep extension effective for social jetlag in adolescents and college students? Sleep Biol Rhythms 2023; 21:263-264. [PMID: 38476313 PMCID: PMC10899984 DOI: 10.1007/s41105-023-00463-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Wang Z, Zhang K, He L, Sun J, Liu J, Hu L. Associations between frequent nightmares, nightmare distress and depressive symptoms in adolescent psychiatric patients. Sleep Med 2023; 106:17-24. [PMID: 37030034 DOI: 10.1016/j.sleep.2023.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/27/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Nightmares are common in patients with psychiatric disorders. Patients with psychiatric disorders often experience depressive symptoms. Nightmares have been associated with depressive symptoms among adolescents. Previous studies have explored the mediating role of nightmare distress in the relationship between frequent nightmares and depressive symptoms in the general adolescent population. We aimed to explore the associations between frequent nightmares, nightmare distress, and depressive symptoms in Chinese adolescent patients with psychiatric disorders. METHODS A total of 408 adolescents participated in this study. A self-administered questionnaire was used to measure nightmare frequency, nightmare distress, depressive symptoms, and covariates. Linear regressions and mediation analyses were performed to examine the associations between nightmare frequency, nightmare distress, and depressive symptoms. RESULTS The mean age of participants was 15.31 ± 1.88 years, and 152 (37.3%) were boys. The prevalence of frequent nightmares in adolescent patients with psychosis was 49.3%. Girls reported more frequent nightmares and had significantly higher scores of depressive symptoms and nightmare distress. Patients with frequent nightmares had higher scores of nightmare distress and depressive symptoms. Frequent nightmares and nightmare distress were significantly associated with depressive symptoms. Nightmare distress had a full mediating effect on the correlation between frequent nightmares and depressive symptoms. CONCLUSIONS In Chinese adolescent patients with psychiatric disorders, frequent nightmares and nightmare distress were associated with depressive symptoms, whereas the association between frequent nightmares and depressive symptoms was mediated by nightmare distress. Interventions for nightmare distress may be more useful in reducing depressive symptoms in adolescent patients with psychiatric disorders.
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Liu X, Yang Y, Liu Z, Jia C. Associations between Insomnia, Daytime Sleepiness, and Depressive Symptoms in Adolescents: A Three-Wave Longitudinal Study. J Clin Med 2022; 11:jcm11236912. [PMID: 36498487 PMCID: PMC9739758 DOI: 10.3390/jcm11236912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Insomnia, daytime sleepiness, and depressive symptoms are prevalent in adolescents. This three-wave prospective study examined the associations between the three symptoms in adolescents. METHODS A total of 6995 schoolchildren in 7th and 10th grades (Mean age = 14.86 years) participated in a longitudinal study of behavior and health in Shandong, China. Standardized rating scales were used to assess symptoms of insomnia, daytime sleepiness, and depression in November-December in 2015, 1 year later, and 2 years later. RESULTS Insomnia was cross-sectionally associated with 10-14-fold increased odds of daytime sleepiness and 5-9-fold increased odds of depression. Daytime sleepiness was associated with 4-5-fold increased odds of depression. Insomnia, daytime sleepiness, or depression at a later time point was significantly predicted by itself at earlier time points. Insomnia was a significant predictor of daytime sleepiness and depression and a mediator between depression and daytime sleepiness. Daytime sleepiness was a significant predictor of insomnia and a mediator between depression and insomnia. Depression was a significant predictor of insomnia and daytime sleepiness and a mediator between insomnia and daytime sleepiness. CONCLUSIONS Insomnia, daytime sleepiness, and depressive symptoms were highly comorbid in adolescents. The associations of insomnia with daytime sleepiness and depression were bidirectional. Depression predicted daytime sleepiness, but not vice versa. Further research is needed to understand the underlying neurobiological mechanisms between insomnia, daytime sleepiness, and depression during adolescence.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104, USA
- Correspondence:
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL 32306, USA
| | - Zhenzhen Liu
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Cunxian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China
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Characteristic Sleep Patterns and Associated Obesity in Adolescents. Life (Basel) 2022; 12:life12091316. [PMID: 36143353 PMCID: PMC9500978 DOI: 10.3390/life12091316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/25/2022] [Accepted: 08/24/2022] [Indexed: 11/20/2022] Open
Abstract
Poor sleep adversely affects health and may cause obesity. Poor sleep includes short sleep duration, low quality of sleep, and sleep discrepancy. Although most studies have focused on the association between sleep duration and obesity, poor sleep is a significant risk factor for obesity. Adolescents have characteristic sleep patterns which correspond to poor sleep. Adolescents sleep late due to various biological and psychosocial factors; also, they wake up early to be on time for school. This causes them to sleep less. To make up for this sleep debt, adolescents sleep more on non-school days, which causes sleep discrepancies. Therefore, since adolescents have characteristic sleep patterns, an in-depth investigation is needed to identify whether poor sleep is a risk for obesity. This article presents an overview of the characteristic sleep patterns of adolescents, and reviews studies on the association of each sleep pattern with obesity.
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A longitudinal study of bidirectional associations between frequent pain and insomnia symptoms in adolescents. Sleep Health 2022; 8:467-474. [PMID: 35872148 DOI: 10.1016/j.sleh.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Chronic pain and insomnia symptoms are prevalent in adolescents. This study examined the prospective associations between pain and insomnia symptoms in a large sample of adolescents. METHODS A total of 7072 adolescents (mean age = 14.6 years) participated in a longitudinal study of behavior and health in Shandong, China. A baseline survey was conducted in November-December of 2015, and a follow-up survey was conducted one year later. A self-administered questionnaire was used to assess headache, stomachache, other nonspecific pain, depression, substance use, and family environment. The Youth Self-Rating Insomnia Scale was used to measure insomnia symptoms. RESULTS At baseline and 1-year follow-up, frequent pain was reported by 8.4% and 7.8% of the sample, respectively; moderate to severe insomnia symptoms were reported by 15.2% and 14.8%, respectively. Logistic regression analyses showed that frequent pain at baseline was significantly associated with increased odds of incident insomnia symptoms at 1-year follow-up (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.23-2.34) while adjusting for adolescent and family covariates. On the other hand, insomnia symptoms at baseline were significantly associated with increased odds of incident frequent pain at 1-year follow-up (OR = 2.00, 95% CI = 1.50-2.68). The 3 types of pain (ie, headache, stomachache, and other nonspecific pain) had similar associations with insomnia symptoms. CONCLUSIONS The findings suggest that the associations between frequent pain and insomnia are bidirectional, independent of multiple adolescent and family covariates. These findings stress the importance of assessment and management of both pain and insomnia symptoms in adolescents in routine clinical practice and school-based intervention programs.
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Rong H, Wang X, Lai X, Yu W, Fei Y. Associations Between Sleep Duration and Sensory Impairments Among Older Adults in China. Front Aging Neurosci 2022; 14:910231. [PMID: 35754970 PMCID: PMC9228799 DOI: 10.3389/fnagi.2022.910231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/10/2022] [Indexed: 11/20/2022] Open
Abstract
Objective Studies of sleep duration in relation to the risk of sensory impairments other than dementia are scarce. Little is known about the associations between sleep duration and sensory impairments in China. This study aims to explore the associations between sleep duration and single or dual sensory impairments (visual and/or hearing). Methods This cross-sectional study used the data from 17,668 respondents were drawn from the 2018 survey of the China Health and Retirement Longitudinal Study (CHARLS), an ongoing national longitudinal study of Chinese adults aged 45 years and above. The duration of sleep per night was obtained from face-to-face interviews. The presence of sensory impairments was measured by self-reported visual and hearing functions. Multivariable generalized linear models (GLM) with binomial family and log link to assess the associations between sleep duration and sensory impairments. Results Of the 17,668 respondents, 8,396 (47.5%) were men. The mean (SD) age was 62.5 (10.0) years old. Respondents with short (≤ 4, 5 h per night) sleep duration had a significantly higher risk of visual, hearing and dual sensory impairments than those who slept for 7 h per night after adjusting for covariates (P < 0.05). Meanwhile, respondents who slept for 6 h per night had a higher risk of hearing impairment (P = 0.005). Further analysis suggested a U-shaped association between sleep duration and sensory impairments. When sleep duration fell below 8 h, increased sleep duration was associated with a significantly lower risk of visual (OR, 0.93; 95%CI, 0.88–0.98; P = 0.006), hearing (OR, 0.89; 95% CI, 0.86–0.93; P < 0.001), and dual (OR, 0.90; 95% CI, 0.87–0.94; P < 0.001) impairments. When sleep duration exceeded 8 h, the risk of visual (OR, 1.09; 95% CI, 1.00–1.19; P = 0.048), hearing (OR, 1.04; 95% CI, 0.97–1.11; P = 0.269), and dual (OR, 1.07; 95% CI, 1.00–1.14; P = 0.044) impairments would increase facing prolonged sleep duration. Women and the elderly aged over 60 years old were more sensitive to short sleep duration and experienced a higher risk of sensory impairments. Conclusion In this study, short sleep duration was associated with a higher risk of visual and hearing impairments. Future studies are needed to examine the mechanisms of the associations between sleep duration and sensory impairments.
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Affiliation(s)
- Hongguo Rong
- Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao Wang
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Anding Hospital, Capital Medical University, Beijing, China
| | - Xiaozhen Lai
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Weijie Yu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yutong Fei
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Zhou SJ, Wang LL, Wang TT, Wang JQ, Chen JX. Associations between experienced aggression, poor sleep, and suicide risk among Chinese adolescents. Sleep 2022; 45:6542305. [PMID: 35244179 DOI: 10.1093/sleep/zsac048] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/10/2022] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES The physical and mental health of adolescents is an important study area. This study aims to examine the occurrence of aggression, sleep disturbances, and suicide risk among Chinese adolescents, along with the relationships between these factors. METHODS This is a cross-sectional study conducted through an online survey. Of the original 7011 Chinese adolescent respondents, the analysis included data from 6122 adolescents, aged between 12 and 18 years, from 23 regions, whose average age was 16.12 (±1.44) years, with 48.8% being male. While the chi-square test and t-test were used for analyzing demographic data and continuous variables, respectively, mediation analysis was used to explore the mechanism of experiencing aggression on suicide risk. The respondents' sleep quality, nightmare distress, daytime sleepiness, fatigue, and suicide risk were assessed using the Pittsburgh Sleep Quality Index (PSQI), Nightmare Distress Questionnaire-Chinese version (NDQ-CV), Chinese Adolescent Daytime Sleepiness Scale (CADSS), Multidimensional Fatigue Inventory (MFI-20), and the suicide risk module of the Mini-International Neuropsychiatric Interview (MINI), respectively. Four items were used to assess adolescents' experiences with aggression. RESULTS Of the respondents, 42% reported experiencing aggression by others, especially parental physical maltreatment. Furthermore, 26.9% of adolescents in school, and in particular, 31.8% in senior high school experienced insomnia symptoms. Adolescents who reported experiences of aggression had more severe insomnia symptoms, nightmare distress, fatigue, and a higher risk of suicide when compared with those who did not (all ps < 0.001). Insomnia symptoms, nightmare distress, and fatigue all mediated the relationship between aggression and suicide risk, and there was a chain of mediating effects between these factors [for total indirect effect β = 1.1512, 95% CI (0.9671 to 1.3426), direct effect β = 0.4934, 95% CI (0.1978 to 0.7891), and total effect β = 1.6446, 95% CI (1.3479 to 1.9414)]. CONCLUSIONS Our findings indicate that among adolescents, experiencing aggression is associated with an increased suicide risk. In addition to the direct effect of aggression on suicide risk, insomnia, nightmare distress, and fatigue mediate the relationship between aggression and suicide risk. More attention should be paid to adolescents experiencing aggression, and interventions should be implemented and strengthened.
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Affiliation(s)
- Shuang-Jiang Zhou
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Lei-Lei Wang
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Ting-Ting Wang
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Jing-Qi Wang
- Binhai Eco-City School-Tianjin Nankai High School, Tianjin, China
| | - Jing-Xu Chen
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
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Chen H, Wang LJ, Xin F, Liang G, Chen Y. Associations between sleep duration, sleep quality, and weight status in Chinese children and adolescents. BMC Public Health 2022; 22:1136. [PMID: 35668374 PMCID: PMC9172025 DOI: 10.1186/s12889-022-13534-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background and objective
The high prevalence of obesity is a serious problem, and sleep is considered to be a factor for obesity. This study aimed to examine the relationship between sleep duration, sleep quality, and weight status among children and adolescents in China and to explore whether the relationship between sleep duration and weight status is independent of sleep quality. Sex and age differences were also explored. Methods A cross-sectional research was conducted among 2019 children and adolescents (1029 boys and 990 girls) aged 8–16 years in Shanghai. An open-question was used to obtain data on sleep duration, which was categorized into the following four groups based on the age-specific National Sleep Foundation Sleep Duration Recommendations: 1) very short, 2) short, 3) recommended, and 4) long. The Pittsburgh Sleep Quality Index was used to assess sleep quality. Weight and height were measured for all participants. The variable weight status was estimated with the Chinese children and adolescent age- and sex-specific body mass index (BMI) and was categorized into overweight/obesity and normal weight. Results Short sleep duration (7–8 and 6–7 h for 6–13 and 14–16 years old, respectively) significantly increased odds of overweight/obesity (OR = 1.32, 95% CI: 1.06–1.64) compared with that of the recommended sleep duration (9–11 and 8–10 h for 6–13 and 14–16 years old, respectively). The relationship between the two variables existed independent of sleep quality. No significant relationship was found between sleep quality and overweight/obesity of children and adolescents. Sleep quality (OR = 1.07, 95% CI: 1.01–1.14) and short sleep duration (OR = 1.51, 95% CI: 1.06–2.13) increased the risk for overweight/obesity among girls, whereas no significant relationships between sleep duration, sleep quality, and overweight/obesity were found among boys. Short sleep duration increased the risk of overweight/obesity in children aged 8–13 years (OR = 1.34, 95% CI: 1.05–1.71), independent of sleep quality, but no significant relationships between these two variables existed for adolescents aged 14–16 years. Conclusions Overall, short sleep duration increased the risks of overweight/obesity in children and adolescents in China, independent of sleep quality. This relationship is significant for girls and children aged 8–13 years instead of boys and adolescents aged 14–16 years. Interventions to extend the sleep duration of children and adolescents, especially girls and children aged 8–13 years in China, are necessary to improve their weight status. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13534-w.
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Affiliation(s)
- Huan Chen
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China
| | - Li-Juan Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China.
| | - Fei Xin
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China
| | - Guo Liang
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China
| | - Yuan Chen
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China
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15
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Liu X, Liu ZZ, Liu BP, Jia CX. Nightmare frequency and psychopathological problems in a large sample of Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 2022; 57:805-816. [PMID: 35064282 DOI: 10.1007/s00127-022-02224-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Nightmares are common, especially in pediatric populations and psychiatric patients. Nightmares are associated with daytime distress and negative health outcomes. The data on the prevalence and psychopathological profiles of nightmares in Chinese adolescents are limited. This study examined age and gender differences in nightmare frequency and associated psychopathological problems in a large sample of Chinese adolescents. METHODS A total of 11,831 adolescent students (mean age = 14.9, 12-18 years) participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort. Participants completed a self-administered questionnaire to report their nightmare frequency, trait anger, hopelessness, and multiple domains of behavioral/emotional problems. Univariate and multivariate analyses were performed to examine psychopathological problems in relation to nightmare frequency. RESULTS Of the sample, 45.2% reported having nightmares at least once in the past month and 7.9% at least once/week. Girls reported more frequent nightmares than boys. Nightmare frequency significantly declined with age for both boys and girls. Mean scores on trait anger, hopelessness, attention, internalizing problems, and externalizing problems significantly increased with nightmare frequency. Frequent nightmares (at least once/week) were significantly associated with 2-4-fold increased likelihood of behavioral/emotional problems after adjusting for adolescent and family covariates. CONCLUSION Nightmares are prevalent in Chinese adolescents. Frequent nightmares are associated with multiple domains of psychopathological problems. Assessment and intervention of frequent nightmares should be incorporated into routine clinical practice and mental health services in adolescents.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Association of sleep duration and sleep quality with overweight/obesity among adolescents of Bangladesh: a multilevel analysis. BMC Public Health 2022; 22:374. [PMID: 35189883 PMCID: PMC8862335 DOI: 10.1186/s12889-022-12774-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/02/2022] [Indexed: 11/25/2022] Open
Abstract
Background Sleep deprivation is widely recognized as a potential contributor to childhood obesity. However, few studies have addressed this issue in low-income settings. The aim of this study was to determine the association of both sleep duration and sleep quality with overweight/obesity among adolescents of Bangladesh. Methods A cross-sectional study was conducted in four randomly selected schools in Gazipur, Bangladesh, from May to August 2019. Using a self-administered semi-structured questionnaire, data on sleep duration and sleep quality were collected from 1,044 adolescents between 13 and 17 years of age. The body mass indices of the study participants were evaluated using their objectively-assessed anthropometric measurements (weight and height). Multilevel logistic regression was used for data analysis. Results The prevalence of underweight, overweight and obesity in adolescents in this study were 14.9, 18 and 7.1%, respectively. More than 15% of the students reported sleep disturbance and poor sleep quality. After adjusting for confounders, reduced (<7 h/day) total sleep duration (OR=1.73, 95% CI=1.21-2.47), weekend sleep duration (OR=1.46, 95% CI=1.00-2.12), and night sleep duration (OR=1.55, 95% CI=1.06-2.28) were found to be significantly associated with overweight or obesity in Bangladeshi adolescents. Similarly, significant positive associations were evident between short duration of total sleep (OR=0.33, 95% CI=0.20-0.54), weekday sleep (OR=0.55, 95% CI=0.35-0.84), weekend sleep (OR=0.53, 95% CI=0.31-0.89), and night sleep (OR=0.56, 95% CI=0.36-0.87), and underweight in study participants. Adolescents with short sleep duration were found less likely to be underweight and more likely to be overweight/obese. Conclusions Study findings denoted short sleep duration to be associated with overweight/obesity and underweight among adolescents of Bangladesh. Adequate sleep may therefore serve as an effective obesity prevention strategy in the growing stages. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12774-0.
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17
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An epidemiologic study of sleep-disordered breathing in a large sample of Chinese adolescents. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01302-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Hamdan S, Apter A, Levi-Belz Y. Non-suicidal Self-Injury Among Adolescents From Diverse Ethnocultural Groups in Israel: The Association With Sleep Problems and Internet Addiction. Front Psychiatry 2022; 13:899956. [PMID: 35633814 PMCID: PMC9136052 DOI: 10.3389/fpsyt.2022.899956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Although Non-suicidal Self-Injury (NSSI) has received more attention in recent years, most of these studies focused on samples from North American and European countries; consequently, little is known about its patterns and frequency in other cultures as well as its relation to sleep problems and internet addiction. As one of the few studies that aim to fill this gap, the current study examined the prevalence, characteristics, and types of NSSI behaviors among adolescents from diverse ethnocultural groups. METHODS A sample of 642 adolescents, aged 12-18 years, were randomly recruited from different middle and high schools in Israel, employing a snowball sampling technique. The sample included the following: 50% Jews and 34.7% Muslims born in Israel, 9.7% immigrants from the former Soviet Union (FSU), and 4.4% immigrants from Ethiopia. The participants completed self-report questionnaires that assessed their NSSI, sleep problems, internet addictions, and depressive symptoms. RESULTS Almost one-third of the sample had engaged in NSSI, while 6% frequently injured themselves. More than half of the FSU immigrants and one-third of the Muslim participants indicated that they engaged in NSSI. These two population groups also exhibited severe depressive symptoms, sleep problems, and internet addictions. The most parsimonious correlations with NSSI included being male, an immigrant/Muslim minority who exhibited severe depressive symptoms and internet addictions. CONCLUSIONS These results emphasize the need for routine NSSI assessments to prevent long-term sequelae, including any forms of suicidal thoughts and behaviors and adult borderline personality disorder (BPD). Primary preventive programs that include adaptive coping skills may eliminate the social contagion effect of NSSI.
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Affiliation(s)
- Sami Hamdan
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo (MTA), Tel Aviv, Israel
| | - Alan Apter
- Fienberg Child Study Center, Schneider Children' Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Hadera, Israel
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Cai Z, Xian J, Araujo C, Zhang Z, Zhou H, Peng H, Sharma M, Zhao Y. Independent and combined associations between multiple lifestyle behaviours and academic grades of inner urban and peri-urban high school students: a cross-sectional study in Chongqing, China. BMJ Open 2021; 11:e049508. [PMID: 34836896 PMCID: PMC8628331 DOI: 10.1136/bmjopen-2021-049508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aims to assess the independent and combined associations between multiple lifestyle behaviours and academic grades of inner urban high school students (IUHSSs) and peri-urban high school students (PUHSSs). DESIGN A cross-sectional study was conducted. PARTICIPANTS There are 1481 high school students (49.9% boys) in this study, who were enrolled from one inner urban and two peri-urban schools in Chongqing, China. OUTCOME MEASURES Academic grades were assessed based on the students' self-reported grade ranking in the last cumulative examination. RESULTS In IUHSSs and PUHSSs, high frequency of sugar-sweetened beverage consumption was unlikely to obtain high academic grades (OR 0.56, 95% CI 0.32 to 0.99 and 0.63, 95% CI 0.42 to 0.96), respectively). Among IUHSSs, meeting the recommendations for weekday screen time and egg consumption (OR 1.57, 95% CI 1.06 to 2.34 and 1.60, 95% CI 1.04 to 2.47, respectively) and high frequency of fruit consumption (1.67, 95% CI 1.11 to 2.50) were significantly associated with high academic grades; meeting the recommendation for weekday sleep duration was unlikely to obtain high academic grades (0.46, 95% CI 0.21 to 0.98). Among PUHSSs, meeting the recommendations for weekend sleep duration (1.40, 95% CI 1.02 to 1.93) and eating dinner regularly (1.55, 95% CI 1.01 to 2.37) had significant associations with high academic grades. No significant associations were found between physical activity and academic grades in both IUHSSs and PUHSSs (p>0.05). Moreover, IUHSSs with 9-13 healthy lifestyle behaviours were 3.25 times more likely to achieve high academic grades than IUHSSs with 1-6 healthy lifestyle behaviours (3.25, 95% CI 1.96 to 5.40). No significant associations were found in the combined associations between multiple lifestyle behaviours and academic grades among PUHSSs (p>0.05). CONCLUSIONS Correlations were observed between lifestyle behaviours and academic grades among high school students, and cumulative associations between multiple healthy lifestyle behaviours and academic outcomes appear to be stronger than the independent associations. These findings are particularly applicable to IUHSSs.
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Affiliation(s)
- Zhengjie Cai
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Jinli Xian
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Camila Araujo
- California University of Science and Medicine, Colton, California, USA
| | - Ziwei Zhang
- The Second Clinical College, Chongqing Medical University, Chongqing, China
| | - Hongyu Zhou
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Huan Peng
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Manoj Sharma
- Environmental & Occupational Health, School of Public Health, University of Nevada, Las Vegas, Nevada, USA
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, Chongqing, China
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Li S, Fong DYT, Xu Y, Wilkinson K, Shapiro C, Wong JYH. Measurement properties of the simplified Chinese version of Nonrestorative Sleep Scale in adolescents. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e299-e307. [PMID: 33756024 DOI: 10.1111/hsc.13354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/12/2020] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
This study aimed to assess the measurement properties of a simplified Chinese version of the Nonrestorative Sleep Scale (NRSS) among adolescents. We obtained a simplified Chinese NRSS by the standard forward-backward translation procedures and administered it to 486 students who were attending Grade 7-11 in Nanjing, China. Furthermore, Pittsburgh Sleep Quality Index, Athens Insomnia Scale, Centre for Epidemiological Studies Depression Scale, and Toronto Hospital Alertness Test were also self-completed for measuring sleep quality, insomnia, depression and alertness respectively. The sample was randomly split into two halves, with the first half used to explore the scale structure by exploratory factor analysis (EFA), and the second half used to confirm the identified structure by confirmatory factor analysis (CFA). A total of 481 adolescents (49% male) with a mean age of 16 years (range: 13-18) completed this study. In the other half of 250 adolescents, the root mean square error of approximation (RMSEA), standardised root mean square residual, and comparative fit index (CFI) in CFA, which tested the four-factor structure obtained from EFA, were 0.062, 0.051 and 0.975, respectively. Convergent validity was demonstrated from a significant correlation of the simplified Chinese NRSS with sleep quality (r = -0.62), insomnia (r = -0.71), depression (r = -0.60) and alertness (r = 0.54). The internal consistency and test-retest reliability for the global scale were 0.83 and 0.86 respectively. Measurement invariance was established between males and females with the changes of both CFI and RMSEA < 0.01. The simplified Chinese NRSS is valid and reliable for measuring NRS among Chinese adolescents.
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Affiliation(s)
- Sha Li
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Yan Xu
- Jiangsu Luhe High School, Nanjing, China
| | - Kate Wilkinson
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Colin Shapiro
- Department of Psychiatry, University of Toronto, Toronto, Canada
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21
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Liu X, Liu ZZ, Jia CX. Repeat self-harm among Chinese adolescents: 1-year incidence and psychosocial predictors. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1979-1992. [PMID: 33861354 DOI: 10.1007/s00127-021-02085-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/07/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE Self-harm in adolescents is prevalent and is the most significant predictor of future self-harm and suicide. Longitudinal data on the incidence and predictors of repeat self-harm in the general population of adolescents are limited. This study investigated 1-year incidence and psychosocial predictors of repeat self-harm in Chinese adolescents. METHODS Shandong Adolescent Behavior and Health Cohort is a longitudinal study of behavior and health in adolescents in Shandong Province, China. Of 7072 participants who were assessed in 2015 and again 1 year later in 2016, 1879 reported a history of self-harm at the baseline survey and were included for this analysis. A self-administered structured questionnaire was used to assess behavioral and emotional problems, sleep, life stress, previous history of self-harm and suicidal thought, and family factors at baseline and self-harm at 1-year follow-up. RESULTS Mean age of the sample was 14.86 (SD 1.36) years and 54.6% were female. At 1-year follow-up, 22.1% participants engaged in repeat self-harm. Multiple logistic regression analyses showed that female gender (OR 1.45, 95% CI 1.11-1.89), alcohol use (OR 1.95, 95% CI 1.48-2.57), frequent nightmares (OR 1.61, 95% CI 1.14-2.28), elevated depression score (OR 1.59, 95% CI 1.05-2.42), and prior suicidal thought (OR 1.79, 95% CI 1.37-2.34) were independently and significantly associated with an increased risk of repeat self-harm. CONCLUSION More than one in five Chinese adolescents who had a history of self-harm engaged in self-harm at 1-year follow-up. Multiple psychosocial factors including female gender, alcohol use, frequent nightmares, depression, and prior suicidal thought appeared to be significant predictors of repeat self-harm. Our findings highlight the importance of comprehensive psychosocial assessment and intervention of repeat self-harm in adolescents.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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22
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Zhang X, Dimitriou D, Halstead EJ. Sleep, Anxiety, and Academic Performance: A Study of Adolescents From Public High Schools in China. Front Psychol 2021; 12:678839. [PMID: 34276498 PMCID: PMC8281015 DOI: 10.3389/fpsyg.2021.678839] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Sleep is essential for optimal learning across the developmental pathways. This study aimed to (1) explore whether school start and end times and screen time influenced sleep disturbances in adolescents during the lockdown in China and (2) investigate if sleep disturbances at night and sleep-related impairment (daytime fatigue) influenced adolescents' academic performance and anxiety levels. Methods: Ninety-nine adolescents aged 15-17 years old were recruited from two public schools in Baishan City Jilin Province, China. An online questionnaire was distributed including questions on adolescents' demographics, screen time habits, academic performance, anxiety level, sleep disturbances, and sleep-related impairment. Results: Adolescents who started school earlier and ended school later had a greater severity of sleep disturbances and sleep-related impairment compared with students who started school later and finished earlier. Adolescents who engaged in screen time at bedtime were more likely to have a greater severity of sleep-related impairment than students who reported no screen time use at bedtime. Adolescents who had a greater severity of sleep disturbances had higher anxiety and higher academic achievements than adolescents with less sleep disturbances. Finally, 79.7% of adolescents reported their total sleep duration as <8 h. Conclusions: Adolescents are experiencing sleep disturbances to manage academic demands during COVID-19, which in turn is having a wider impact on their mental health. Many schools internationally have continued to provide online education to students, longitudinal studies on how COVID-19 has influenced adolescents sleep and mental health would be beneficial in understanding the impact of the pandemic.
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Affiliation(s)
- Xiaoning Zhang
- Department of Psychology and Human Development, University College London, Institute of Education, London, United Kingdom
| | - Dagmara Dimitriou
- Department of Psychology and Human Development, University College London, Institute of Education, London, United Kingdom
| | - Elizabeth J Halstead
- Department of Psychology and Human Development, University College London, Institute of Education, London, United Kingdom
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Fidancı İ, Aksoy H, Yengil Taci D, Fidancı İ, Ayhan Başer D, Cankurtaran M. Evaluation of the effect of the COVID-19 pandemic on sleep disorders and nutrition in children. Int J Clin Pract 2021; 75:e14170. [PMID: 33759311 PMCID: PMC8250073 DOI: 10.1111/ijcp.14170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/14/2021] [Indexed: 11/18/2022] Open
Abstract
AIMS The aim of the study was to evaluate the possible changes in sleep behavior and nutrition in children during the pandemic period. METHODS One hundred fourteen parents who accepted to participate in the study aged 18 and over and who had children between the ages of 6 and 16 were included in the study. A questionnaire was carried out after written consents were obtained. In the first part of the questionnaire, there were a total of 9 questions including socio-demographic information and nutritional characteristics, and the second part included the "Sleep Disturbance Scale for Children" (SDSC). The data were analyzed with the SPSS 20 statistical program. RESULTS The total number of participants was 114 parents; 64 (56%) of the children were girls and 50 (43.9%) were boys. Among the participants, the number of children who had COVID-19 was 38 (33.3%). There was no statistically significant relationship between going through COVID-19 status and the variables examined in general. The proportion of participants who stated that if the pandemic period was prolonged, COVID-19 would not change their diet was found to be statistically significant (P = .038). The SDSC score was found to be significantly high in girls (P < .05). CONCLUSION Sleep and nutritional disorders affect the quality of life for all ages for both genders, and their importance increases even more in extraordinary periods such as pandemic. Sleep problems increasing especially with an accompanying anxiety state may lead to developmental problems as well as deepening psychological disorders.
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Affiliation(s)
- İzzet Fidancı
- Faculty of MedicineDepartment of Family MedicineHacettepe UniversityAnkaraTurkey
| | - Hilal Aksoy
- Faculty of MedicineDepartment of Family MedicineHacettepe UniversityAnkaraTurkey
| | - Duygu Yengil Taci
- Department of Family MedicineAnkara Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
| | - İlknur Fidancı
- Department of PediatricsDepartment of Pediatric EmergencyAnkara Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
| | - Duygu Ayhan Başer
- Faculty of MedicineDepartment of Family MedicineHacettepe UniversityAnkaraTurkey
| | - Mustafa Cankurtaran
- Faculty of MedicineDepartment of Internal MedicineDivision of Geriatric MedicineHacettepe UniversityAnkaraTurkey
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Liu X, Liu ZZ, Yang Y, Jia CX. Associations of frequent pain symptoms with excessive daytime sleepiness in adolescents: a longitudinal study. J Clin Sleep Med 2021; 17:2415-2423. [PMID: 34170226 DOI: 10.5664/jcsm.9444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Pain symptoms, sleep disturbance, and daytime sleepiness are common in adolescents. This study examined the cross-sectional and prospective associations between pain symptoms and excessive daytime sleepiness (EDS) in a large sample of adolescents. METHODS Participants were 7,072 adolescents (mean age = 14.6 years) in a follow-up study of behavior and health in Shandong, China. A self-administered structured questionnaire was used to assess pain symptoms (headache, stomachache, and other general pain), body weight and height, sleep, anxiety/depression, substance use, and family environment in November-December in 2015 and one year later. The Chinese adolescent daytime sleepiness scale (CADSS) was used to measure daytime sleepiness. RESULTS Of the sample, 19.8% and 23.2% had moderate or severe EDS at baseline and at 1-year follow-up, respectively. The prevalence and 1-year incidence rates of EDS significantly increased with the frequencies of pain symptoms. Frequent pain was significantly associated with increased risk of EDS at baseline (OR=2.01, 95% CI=1.56-2.59), incident EDS (OR=1.41, 95% CI=1.03-1.93), and persistent EDS (OR=2.17, 95% CI=1.52-3.09) while adjusting for adolescent and family covariates, including anxiety/depression, nocturnal sleep duration, insomnia symptoms, frequent snoring, body mass index, and hypnotic use. Similar associations were observed across headache, stomachache, and other pain. CONCLUSIONS Frequent pain is significantly and independently associated with increased risk of EDS. Our findings suggest that assessing and treating pain symptoms is important to improve healthy sleep and reduce risk of EDS in adolescents. Further research is needed to understand the underlying psychological and neurobiological mechanisms between pain and daytime sleepiness in adolescents.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China.,Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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Xu S, Chen C, Ouyang Z, Duan C, Xu Z, Bai T, Hou X. Association between multiple sleep dimensions and functional bowel disorders among Chinese college freshmen. Sleep Med 2021; 98:168-173. [PMID: 34312082 DOI: 10.1016/j.sleep.2021.05.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although sleep disorder is thought as a risk factor for functional bowel disorders, its impact role in adolescents remains unknown and the contribution of different sleep dimensions may deserve further attention. This study aimed to evaluate the relationship between multiple sleep dimensions and functional bowel disorders among Chinese college freshmen. METHODS A cross-sectional survey was conducted in college freshmen from Huazhong University of Science and Technology in Wuhan, China in September 2019 with random cluster sampling method. All participants completed questionnaires about living habits, sleep and digestive symptoms. Diagnosis of irritable bowel syndrome and functional constipation were based on the Rome IV criteria. Univariate and multivariate logistic regression models were applied to assess the association of sleep dimensions with irritable bowel syndrome or functional constipation. RESULTS Based on the 3335 individuals who completed the questionnaire, the overall prevalence of irritable bowel syndrome and functional constipation in college freshmen were 2.5% and 1.7%, respectively. Multivariate analysis revealed that compared with individuals reporting good sleep quality, those reporting poor (OR = 7.269, 95%CI: 2.876-18.370) were associated with increased risk of irritable bowel syndrome. Similarly, those reporting fair (OR = 2.068, 95%CI: 1.010-4.236) and poor (OR = 5.664, 95%CI: 1.864-17.205) were associated with increased risk of functional constipation. There was no statistically significant association between other sleep dimensions (sleep duration, sleep timing, or sleep latency) and irritable bowel syndrome or functional constipation. CONCLUSION Self-reported poor sleep quality was a stronger independent predictor of functional bowel disorders than other sleep dimensions among Chinese college freshmen. Future intervention studies should consider the role of sleep quality for the prevention of FBDs in adolescents.
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Affiliation(s)
- Shu Xu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 1277 Jiefang Avenue, 430022, Hubei Province, China.
| | - Can Chen
- Huazhong University of Science and Technology, 1037 Luoyu road, Wuhan, 430074, Hubei Province, China.
| | - Zhen Ouyang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, China.
| | - Chaofan Duan
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 1277 Jiefang Avenue, 430022, Hubei Province, China.
| | - Zhiyue Xu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 1277 Jiefang Avenue, 430022, Hubei Province, China.
| | - Tao Bai
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 1277 Jiefang Avenue, 430022, Hubei Province, China.
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 1277 Jiefang Avenue, 430022, Hubei Province, China.
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JALILOLGHADR SHABNAM, HASHEMI HASSANJAHANI, HASHEMI FATEMEH, NOZARI HOORMEHR, YAZDI ZOHREH. Sleep duration and its relationship with school performance in Iranian adolescents. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E54-E59. [PMID: 34322617 PMCID: PMC8283632 DOI: 10.15167/2421-4248/jpmh2021.62.1.1618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
Background Inadequate or poor sleep quality is common problems in adolescent that affect on their learning, memory and school performance. The present study aimed to determine the association between sleep hours and academic performance in young adults. Methods This cross-sectional study was designed as a descriptive-analytic study. Samples of adolescents of 14-18 years old in Qazvin city were enrolled. The Pediatric sleep questionnaire and BEARS questionnaire used for all students to screen comprehensively major sleeps problems in them. Chi-square test, t-test, analysis of variance (ANOVA), and correlation were performed to determine the relationship between the data (P < 0.001). Results Between 653 adolescents, 40% were male and 60% were female. Sleep duration, sleep onset delay, sleep insufficient, rate of oversleeping and academic performance had a direct relationship with gender (P < 0.001). The sleep duration, rate of oversleeping and academic performance were significantly higher in boys, sleep onset delay and sleep insufficient was significantly higher in girls. Time of falling sleep at weekend nights and weekday nights have positively correlation with age (P < 0.001). Also, a significant relationship between students’ sleep hours with academic performance was shown (P < 0.001). Conclusions The overall result was that sleep duration, sleep onset delay, sleep insufficient and rate of oversleeping of students in this study had a significant influence on academic performance. Students without difficulty in falling asleep had good academic performance in compared to students with difficulty in falling asleep.
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Affiliation(s)
- SHABNAM JALILOLGHADR
- Professor of Pediatric, Sleep Medicine Fellowship, Department of Pediatrics, School of Medicine, Children Growth Research Center Research Institute for Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - HASSAN JAHANI HASHEMI
- Associate Professor of Biostatistics, Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - FATEMEH HASHEMI
- General practitioner, Clinical Research Development Unit, Qods Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - HOORMEHR NOZARI
- Student of Medicine, Gaziantep Medical University, Gaziantep, Turkey
| | - ZOHREH YAZDI
- Associate Professor of Occupational Medicine, Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
- Correspondence: Zohreh Yazdi, Department of Pediatrics, School of Medicine, Children Growth Research Center Research Institute for Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran - Tel. 0098 28 33359503 - Fax: 0098 28 33359503 - E-mail:
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Zhang Y, Folarin AA, Sun S, Cummins N, Bendayan R, Ranjan Y, Rashid Z, Conde P, Stewart C, Laiou P, Matcham F, White KM, Lamers F, Siddi S, Simblett S, Myin-Germeys I, Rintala A, Wykes T, Haro JM, Penninx BW, Narayan VA, Hotopf M, Dobson RJ. Relationship Between Major Depression Symptom Severity and Sleep Collected Using a Wristband Wearable Device: Multicenter Longitudinal Observational Study. JMIR Mhealth Uhealth 2021; 9:e24604. [PMID: 33843591 PMCID: PMC8076992 DOI: 10.2196/24604] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/07/2020] [Accepted: 02/03/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Sleep problems tend to vary according to the course of the disorder in individuals with mental health problems. Research in mental health has associated sleep pathologies with depression. However, the gold standard for sleep assessment, polysomnography (PSG), is not suitable for long-term, continuous monitoring of daily sleep, and methods such as sleep diaries rely on subjective recall, which is qualitative and inaccurate. Wearable devices, on the other hand, provide a low-cost and convenient means to monitor sleep in home settings. OBJECTIVE The main aim of this study was to devise and extract sleep features from data collected using a wearable device and analyze their associations with depressive symptom severity and sleep quality as measured by the self-assessed Patient Health Questionnaire 8-item (PHQ-8). METHODS Daily sleep data were collected passively by Fitbit wristband devices, and depressive symptom severity was self-reported every 2 weeks by the PHQ-8. The data used in this paper included 2812 PHQ-8 records from 368 participants recruited from 3 study sites in the Netherlands, Spain, and the United Kingdom. We extracted 18 sleep features from Fitbit data that describe participant sleep in the following 5 aspects: sleep architecture, sleep stability, sleep quality, insomnia, and hypersomnia. Linear mixed regression models were used to explore associations between sleep features and depressive symptom severity. The z score was used to evaluate the significance of the coefficient of each feature. RESULTS We tested our models on the entire dataset and separately on the data of 3 different study sites. We identified 14 sleep features that were significantly (P<.05) associated with the PHQ-8 score on the entire dataset, among them awake time percentage (z=5.45, P<.001), awakening times (z=5.53, P<.001), insomnia (z=4.55, P<.001), mean sleep offset time (z=6.19, P<.001), and hypersomnia (z=5.30, P<.001) were the top 5 features ranked by z score statistics. Associations between sleep features and PHQ-8 scores varied across different sites, possibly due to differences in the populations. We observed that many of our findings were consistent with previous studies, which used other measurements to assess sleep, such as PSG and sleep questionnaires. CONCLUSIONS We demonstrated that several derived sleep features extracted from consumer wearable devices show potential for the remote measurement of sleep as biomarkers of depression in real-world settings. These findings may provide the basis for the development of clinical tools to passively monitor disease state and trajectory, with minimal burden on the participant.
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Affiliation(s)
- Yuezhou Zhang
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amos A Folarin
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
- South London and Maudsley National Health Services Foundation Trust, London, United Kingdom
| | - Shaoxiong Sun
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Nicholas Cummins
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rebecca Bendayan
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley National Health Services Foundation Trust, London, United Kingdom
| | - Yatharth Ranjan
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Zulqarnain Rashid
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Pauline Conde
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Callum Stewart
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Petroula Laiou
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Faith Matcham
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Katie M White
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam University Medical Centre, Vrije Universiteit and GGZ inGeest, Amsterdam, Netherlands
| | - Sara Siddi
- Teaching Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Sara Simblett
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Aki Rintala
- Center for Contextual Psychiatry, Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - Til Wykes
- South London and Maudsley National Health Services Foundation Trust, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Josep Maria Haro
- Teaching Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Brenda Wjh Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam University Medical Centre, Vrije Universiteit and GGZ inGeest, Amsterdam, Netherlands
| | | | - Matthew Hotopf
- South London and Maudsley National Health Services Foundation Trust, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Richard Jb Dobson
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
- South London and Maudsley National Health Services Foundation Trust, London, United Kingdom
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Putilov AA, Sveshnikov DS, Bakaeva ZB, Yakunina EB, Starshinov YP, Torshin VI, Alipov NN, Sergeeva OV, Trutneva EA, Lapkin MM, Lopatskaya ZN, Budkevich RO, Budkevich EV, Puchkova AN, Dorokhov VB. Differences between male and female university students in sleepiness, weekday sleep loss, and weekend sleep duration. J Adolesc 2021; 88:84-96. [PMID: 33667792 DOI: 10.1016/j.adolescence.2021.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/17/2020] [Accepted: 02/21/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Women and men experience sleep differently and the difference in intrinsic desire for sleep might underlie some of the observed male-female differences. The objective of this cross-sectional questionnaire study of university students was to determine male-female differences in self-reported sleepiness and sleep-wake patterns. METHODS Five questionnaires were completed by 1650 students at four Russian universities. RESULTS Compared to male students, female students reported a lower subjective sleep quality score, had a higher morning sleepability score and lower nighttime and daytime wakeability scores. They more often reported excessive daytime sleepiness and expected to be sleepier at any time of the day with the largest male-female difference around the times of sleep onset and offset. On free days, they reported a longer sleep duration and an earlier sleep onset. Free-weekday difference was larger for sleep duration and smaller for sleep onset. Such male-female differences showed similarity to the differences observed in university and high school students from different countries around the globe. There was no significant male-female difference in weekly averaged sleep duration, weekday sleep duration, hours slept, midpoint of sleep on free days, free-weekday difference in sleep offset, social jetlag, and morningness-eveningness score. Therefore, when studies rely on these self-reports, the most salient male-female differences might not be immediately evident. CONCLUSIONS It seems that the intrinsic desire for longer sleep duration might contribute to a higher susceptibility of female students to weekday sleep loss. Among these students, negative effects of reduced sleep duration might be more common and more detrimental.
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Affiliation(s)
- Arcady A Putilov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia.
| | - Dmitry S Sveshnikov
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Zarina B Bakaeva
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Elena B Yakunina
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Yuri P Starshinov
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Vladimir I Torshin
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Nikolay N Alipov
- Department of Physiology, Pirogov's Russian National Research Medical University, Moscow, Russia
| | - Olga V Sergeeva
- Department of Physiology, Pirogov's Russian National Research Medical University, Moscow, Russia
| | - Elena A Trutneva
- Department of Physiology, Ryazan State Medical University, Ryazan, Russia
| | - Michael M Lapkin
- Department of Physiology, Ryazan State Medical University, Ryazan, Russia
| | - Zhanna N Lopatskaya
- Department of Physiology, Department of Physiology, Medical Institute of the of Surgut State University, Surgut, Russia
| | - Roman O Budkevich
- Laboratory of Nanobiotechnology and Biophysics, the North-Caucasus Federal University, Stavropol, Russia
| | - Elena V Budkevich
- Laboratory of Nanobiotechnology and Biophysics, the North-Caucasus Federal University, Stavropol, Russia
| | - Alexandra N Puchkova
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
| | - Vladimir B Dorokhov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
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Brown GA, Veith S, Sampson JA, Whalan M, Fullagar HHK. Influence of Training Schedules on Objective Measures of Sleep in Adolescent Academy Football Players. J Strength Cond Res 2021; 34:2515-2521. [PMID: 32639380 DOI: 10.1519/jsc.0000000000003724] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Brown, GA, Veith, S, Sampson, JA, Whalan, M, and Fullagar, HHK. Influence of training schedules on objective measures of sleep in adolescent academy football players. J Strength Cond Res 34(9): 2515-2521, 2020-Football academy settings may pose risks to adolescent athletes achieving sufficient sleep because of the contextual challenges these players face (e.g., psychosocial pressure, changes in training, competition, and academic stress). Given the importance of sleep to overall health as well as physical athletic development and injury risk, this study aimed to investigate whether differences in training schedules (morning vs. evening training sessions) affected objective measures of sleep in adolescent academy football (soccer) players. Twelve academy players (mean age 14.18 ± 1.36 years) wore an ActiGraph accelerometer on nights before, and nights of, training days in 2 separate weeks where morning (09:00-11:00 hours) and evening (18:00-20:00 hours) training occurred. Objective sleep parameters and training load data were collected. Night-time sleep periods were categorized as sleep preceding morning training, preceding evening training, or after evening training. One-way univariate and multivariate analyses of variance for repeated measures were performed to determine the impact of the training schedule on sleep. Significance levels were set at p < 0.05. The total sleep time was below the recommended guidelines (<8 hours) across conditions. A large significant effect of the training schedule on time attempted to fall asleep (p = 0.004, effect size [ES] = 0.40) and time of sleep (p = 0.003, ES = 0.41) was present, with post-evening sessions resulting in the latest times. Overall, the players' sleep behavior was resilient to changes in training schedules. However, the low sleep durations (and potential risks to physical performance/injury) suggest that sleep education coupled with practical interventions are required in this cohort.
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Affiliation(s)
- Georgia A Brown
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Sydney, Australia; and
| | - Stella Veith
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - John A Sampson
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Matthew Whalan
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Hugh H K Fullagar
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Sydney, Australia; and
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Shi X, Zhu Y, Wang S, Wang A, Chen X, Li Y, Jiang L. The prospective associations between different types of sleep disturbance and suicidal behavior in a large sample of chinese college students. J Affect Disord 2021; 279:380-387. [PMID: 33099053 DOI: 10.1016/j.jad.2020.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sleep disturbance can be an important predictor associated with suicide behaviors. However, to date, few studies have examined the prospective relationships between different types of sleep disturbance and suicidal behaviors. The current study examined which sleep disturbance types were independent risk factors for subsequent suicidal behaviors in a large sample of Chinese college students. METHODS Data came from a large-scale health-related cohort study in Guangdong, China. Participants were 11,740 college students initially assessed in March and April in 2019 and reassessed six month later. Self-administered structured questionnaires were used to assess suicidal behaviors, insomnia, nightmares, sleep disordered breathing (SDB) symptoms, restless legs syndrome (RLS) symptoms, depression, substance abuse and demographic characteristics. A series of logistic regression analyses were conducted to examine the associations between different types of sleep disturbance and suicidal behaviors. RESULTS Overall, 12.2% and 1.2% of college students reported suicidal ideation and attempts at baseline, and 8.6% and 2.4% reported similar behavior at follow-up. After adjustment for key covariates and prior suicidal behaviors, frequent nightmares (AORs = 1.35-1.69) and RLS symptoms (AOR = 1.37) at baseline predicted subsequent suicidal ideation, and only frequent nightmares (AOR = 2.40) at baseline predicted subsequent suicidal attempts. LIMITATIONS All measures were based on self-report instead of objective assessments or clinical diagnostic evaluations. CONCLUSIONS Frequent nightmares and RLS symptoms were independently associated subsequent suicidal ideation or attempts. Screening and managing sleep disturbance may be helpful for reducing the risk of suicidal behaviors among college students.
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Affiliation(s)
- Xuliang Shi
- College of Education, Hebei University, Hebei, China.
| | - Ya Zhu
- Center for Mental Health Education and Counseling, Guangdong University of Science and Technology, Dongguan, China
| | - Shuo Wang
- College of Education, Hebei University, Hebei, China
| | - Anqi Wang
- College of Education, Hebei University, Hebei, China
| | - Xiaoyan Chen
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yuanyuan Li
- School of Psychology, South China Normal University, Guangzhou, China
| | - Lin Jiang
- College of Education, Hebei University, Hebei, China
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Wang L, Liu X, Liu ZZ, Jia CX. Digital media use and subsequent self-harm during a 1-year follow-up of Chinese adolescents. J Affect Disord 2020; 277:279-286. [PMID: 32841829 DOI: 10.1016/j.jad.2020.05.066] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/02/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Excessive digital media use is prevalent and has a negative impact on sleep, daytime functioning, and mental health in adolescents. We examined the prospective associations between digital media use and subsequent suicidal and non-suicidal self-harm. METHODS Shandong Adolescent Behavior & Health Cohort (SABHC) is a longitudinal study of adolescent behavior and health in Shandong, China. Participants included for the analysis were 7,072 SABHC adolescents who were initially assessed in 2015 and were reassessed in 2016. A self-administered structured questionnaire was used to measure digital media use (i.e., television watching, internet use, and mobile phone use) on weekdays and at the weekend, mental health, and self-harm. RESULTS Multivariable logistic regression analyses showed that daily internet use ≥2 h on weekdays (odd ratio (OR) = 1.86, 95% confidence interval(CI) = 1.25-2.76) and ≥3 h at the weekend (OR = 1.46, 95%CI = 1.06-2.00) and daily mobile phone use 2-3 h (OR = 1.46, 95%CI = 1.02-2.10) and ≥4 h (OR = 1.74, 95%CI = 1.20-2.51) at the weekend were significantly associated with increased risk of recurrent self-harm. Daily internet use ≥ 2 h on weekdays (OR = 1.81, 95%CI = 1.20-2.74) and ≥3 h at the weekend (OR = 1.55, 95%CI = 1.12-2.15), daily mobile phone use 1-2 h on weekdays (OR = 1.47, 95%CI = 1.02-2.12) and 2-3 h (OR = 1.49, 95%CI = 1.01-2.19) and ≥4 h (OR = 1.93, 95%CI = 1.31-2.85) at the weekend were significantly associated with increased risk of recurrent non-suicidal self-injury. Daily internet use 1-2 h on weekdays and 2-3 h at the weekend were significantly associated with increased risk of new suicide attempt (OR = 1.80, 95%CI = 1.07- 3.03) and recurrent suicide attempt (OR = 6.26, 95%CI = 1.31-29.88), respectively. LIMITATIONS All data were self-reported. CONCLUSIONS Excessive use of internet or mobile phone appears to be a significant risk factor of self-harm, suggesting that limiting adolescent use of internet and mobile phone may be beneficial to reduce risk of self-harm.
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Affiliation(s)
- Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, 76798, USA
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, 250012, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, 250012, China.
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Morishima R, Yamasaki S, Ando S, Shimodera S, Ojio Y, Okazaki Y, Kasai K, Sasaki T, Nishida A. Long and short sleep duration and psychotic symptoms in adolescents: Findings from a cross-sectional survey of 15 786 Japanese students. Psychiatry Res 2020; 293:113440. [PMID: 32920526 DOI: 10.1016/j.psychres.2020.113440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 01/19/2023]
Abstract
Sleep problems during adolescence affect current and subsequent mental health and are associated with experiences of psychotic symptoms. Recent studies have suggested that short sleep duration increases the risk of experiencing psychotic symptoms in the general adolescent population; however, whether long sleep duration is associated with an increased risk of psychotic symptoms in adolescence remains unclear. The present study aimed to examine the relationships between long sleep duration, short sleep duration, and the risk of experiencing psychotic symptoms in adolescence. Cross-sectional survey data from 15,786 junior and senior high school students (12- to 15-year-olds and 15- to 18-year-olds, respectively) in Japan were collected and analyzed using logistic regression analysis after controlling for covariates, including depressive symptoms. Long sleep duration was associated with a 1.6- to 2.8-fold increased risk of psychotic symptoms in male but not in female adolescents. Short sleep duration was also related with a 1.6- to 2.9-fold increased risk of experiencing psychotic symptoms, except for 15- to 18-year-old female adolescents. The present study suggested that adolescents with long and short sleep duration should be assessed for their risk of experiencing psychotic symptoms regardless of concurrent depressive symptoms.
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Affiliation(s)
- Ryo Morishima
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
| | - Shinji Shimodera
- Department of Neuropsychiatry & Internal Medicine, Ginza Shimodera Clinic, Tokyo, Japan; Department of Health Promotion and Human Behaviour, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Yasutaka Ojio
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Yuji Okazaki
- Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, The University of Tokyo, Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Huang Y, Jiang ZJ, Deng J, Qi YJ. Sleep quality of patients with postoperative glioma at home. World J Clin Cases 2020; 8:4735-4742. [PMID: 33195641 PMCID: PMC7642526 DOI: 10.12998/wjcc.v8.i20.4735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/19/2020] [Accepted: 09/09/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The sleep quality of patients with postoperative glioma at home has not been reported worldwide. In this study, the sleep quality of postoperative glioma patients at home was explored through telephone interviews.
AIM To investigate the sleep quality of patients with postoperative glioma.
METHODS Glioma patients who were treated and operated on at Nanjing Brain Hospital from May 2012 to August 2019 were selected as participants via convenience sampling. A total of 549 patients were recruited by telephone, and 358 of those patients responded to the Pittsburgh Sleep Quality Index (PSQI).
RESULTS The total PSQI score was 5.19 ± 3.39 in all patients with postoperative glioma, which was higher than that of the normal group. There were 135 patients with poor sleep quality (PSQI > 7), which accounted for 37.7% of all respondents. The scores of the seven dimensions of the PSQI were sleep latency (1.22 ± 1.05), sleep disturbance (1.12 ± 0.98), subjective sleep quality (1.03 ± 0.92), habitual sleep efficiency (1.02 ± 0.91), daytime dysfunction (0.95 ± 0.43), sleep persistence (0.83 ± 0.76), and use of sleeping medication (0.25 ± 0.24). The results showed that the subjective sleep quality of the patients who underwent an operation 1-2 years ago was worse than that of the patients who underwent an operation more than 2 years ago (P < 0.05). Older patients had worse sleep latency and sleep duration scores than younger patients (P < 0.05). Sleep disturbance and daytime dysfunction were worse in patients who received postoperative radiotherapy/ chemotherapy (P < 0.05).
CONCLUSION The sleep quality of patients with postoperative glioma at home is worse than that of normal adults. Moreover, difficulty falling asleep and sleep disorders are common complications among these patients, and age, postoperative duration, and postoperative chemoradiotherapy could affect sleep quality.
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Affiliation(s)
- Yang Huang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Zi-Juan Jiang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Juan Deng
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yu-Juan Qi
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
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Akçay D, Akçay BD. The effect of computer game playing habits of university students on their sleep states. Perspect Psychiatr Care 2020; 56:820-826. [PMID: 32163182 DOI: 10.1111/ppc.12497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 03/01/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the effect of computer game playing habits of university students on their sleep states. DESIGN AND METHODS The study was conducted cross-sectionally with the online survey method. FINDING In this study, it was determined that the students who played games for an average of ≥2 hours per day had later bedtime and later wake-up time, poorer sleep quality, and higher daytime sleepiness. It was found that as the level of game addiction increased, sleep quality decreased, the severity of daytime sleepiness increased, and the wake-up time shifted to a later time. PRACTICE IMPLICATIONS Nurses should develop effective intervention strategies involving technology management and sleep hygiene studies to reduce game-playing time of students.
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Affiliation(s)
- Duygu Akçay
- Public Health Nursing, Military of National Defense, Basınevler/Ankara, Turkey
| | - Bülent Devrim Akçay
- Ruh Sağlığı ve Hastalıkları Bölümü, Ministry of Health Gülhane Education Research Hospital, Basınevler/Ankara, Turkey
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Liu X, Luo Y, Liu ZZ, Yang Y, Liu J, Jia CX. Prolonged Mobile Phone Use Is Associated with Poor Academic Performance in Adolescents. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:303-311. [DOI: 10.1089/cyber.2019.0591] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yachen Luo
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Zhen-Zhen Liu
- Shandong University School of Public Health, Jinan, China
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cun-Xian Jia
- Shandong University School of Public Health, Jinan, China
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Ho CY, Lin SH, Tsai MC, Yu T, Strong C. Impact of Cumulative Unhealthy Sleep Practices in Adolescence on Substance Use in Young Adulthood Estimated Using Marginal Structural Modeling. Front Neurosci 2020; 14:339. [PMID: 32327972 PMCID: PMC7161593 DOI: 10.3389/fnins.2020.00339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/20/2020] [Indexed: 11/25/2022] Open
Abstract
Objectives The purpose of this study was to identify the impact of chronic, unhealthy sleep practices in adolescence on substance use in young adulthood. Unhealthy sleep practices in adolescent samples exhibit a bidirectional relationship with substance use. The relationship is further complicated if we consider that confounders such as depression vary over time and are often in response to adolescents’ prior poor sleep practice, which can be addressed by a counterfactual approach using a marginal structural model. Methods Data in this study are from the Taiwan Youth Project, a longitudinal study that started in 2000 and surveyed 2,690 7th grade students at age 13. Outcomes include frequency of cigarette smoking and alcohol drinking at age 21. Three unhealthy sleep practices were included in this study: short sleep, social jetlag, and sleep disturbance. We used a marginal structural model with stabilized inverse probability-of-treatment weights to address time-varying confounders in each wave and a total sample of 1,678 adolescents with complete information for this study. Results Accumulated waves of sleep disturbance and social jetlag in adolescence were significantly associated with cigarette use in young adulthood. Accumulated social jetlag but not sleep disturbance was also associated with alcohol use in adulthood. Accumulated waves of short sleep were not associated with later alcohol use, but were negatively correlated with cigarette use. Conclusion Interventions that aim to reduce the likelihood of substance use in young adulthood should consider confronting unhealthy sleep practices, in particular the discrepancy between bedtimes on school days and weekends and sleep disturbance.
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Affiliation(s)
- Chia-Yi Ho
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Hsuan Lin
- Institute of Statistics, National Chiao Tung University, Hsinchu, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung Yu
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Differences in Lifestyle Behaviours of Students between Inner Urban and Peri-urban High Schools: A Cross-Sectional Study in Chongqing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072282. [PMID: 32231112 PMCID: PMC7177544 DOI: 10.3390/ijerph17072282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/15/2022]
Abstract
Background: Lifestyle behaviours of students from schools in different socioeconomic areas may be different. Few studies have investigated such topics in China. This study aimed to explore the differences in lifestyle behaviours between inner urban high school students (IUHSSs) and peri-urban high school students (PUHSSs). Methods: A cross-sectional survey based on a self-report questionnaire was administered among 1560 high school students (726 from inner urban high schools and 834 from peri-urban high schools) in Chongqing, China. Physical activity, sleep time, screen time and dietary behaviours were assessed according to a series of recommendations of Chinese guidelines. Results: No significant difference was found in meeting the recommendation for daily physical activity between IUHSSs and PUHSSs (7.6% vs. 6.8%, p > 0.05). PUHSSs were more likely to meet the recommendations of weekdays’ sleep time (14.9% vs. 5.4%, p < 0.001), weekdays’ and weekends’ screen time (85.4% vs. 76.7%, p < 0.001; 21.1% vs. 14.3%, p < 0.001), and had higher proportion of high-score group of dietary behaviours (58.6% vs. 36.4%, p < 0.001) than those of IUHSSs. IUHSSs were more likely to meet the recommendation of weekends’ sleep time (75.6% vs. 67.9%, p < 0.001) than that of PUHSSs. Conclusions: A low proportion met the recommendations of physical activity, weekdays’ sleep time and weekends’ screen time among high school students in Chongqing, China. Lifestyle behaviours may differ between inner urban and peri-urban high school students. Additional support or targeted health education should be provided by high schools to improve the lifestyle behaviours of students, especially in inner urban districts.
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Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents. J Affect Disord 2020; 265:595-602. [PMID: 32090782 DOI: 10.1016/j.jad.2019.11.099] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/15/2019] [Accepted: 11/21/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences. METHODS A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively. RESULTS The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys. LIMITATIONS The study only included school students, and the cross-sectional design limited our ability to make causal inferences. CONCLUSIONS The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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Liu BP, Wang XT, Liu ZZ, Wang ZY, An D, Wei YX, Jia CX, Liu X. Depressive symptoms are associated with short and long sleep duration: A longitudinal study of Chinese adolescents. J Affect Disord 2020; 263:267-273. [PMID: 31818788 DOI: 10.1016/j.jad.2019.11.113] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 01/16/2023]
Abstract
AIMS Sleep loss and irregular sleep patterns in adolescents are major public health concerns in the modern society. This study aimed to explore the associations between short and long sleep duration and depressive symptoms among Chinese adolescents. METHODS A total of 7311 adolescents who participated in the baseline survey and were followed up 1 year or 2 years later were included in the analyses. Participants completed a self-administered questionnaire at baseline and follow-up surveys. The Center for Epidemiologic Studies Depression (CES-D) scale was used to assess depressive symptoms. Generalized estimating equation (GEE) and restrictive cubic spline models were used to estimate the association between sleep duration and depressive symptoms. RESULTS After adjusting for adolescent and family covariates, sleep duration <8 h and >=9 h on weekdays and sleep duration <8 h and >=12 h on weekends were significantly associated with depressive symptoms compared with sleep 8 h. Weekend-weekday sleep difference >=3 h or <-1 h (ie. sleeping >1 h on weekdays than weekends) was also associated with depressive symptoms. There were U-shaped relationships between sleep duration on weekdays, weekends, or weekday-weekend sleep difference and depressive symptoms. LIMITATIONS Sleep duration and depression were measured by self-report. CONCLUSIONS Our findings highlight the risk of short and long sleep duration, and weekday-weekend sleep imbalance for depression in adolescents.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Ze-Ying Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Di An
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Yan-Xin Wei
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; Shandong University Center for Suicide Prevention and Research, Jinan, China.
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan, China; School of Psychology, South China Normal University, Shipai, Guangzhou, China; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.
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Liu X, Liu ZZ, Liu BP, Sun SH, Jia CX. Associations between sleep problems and ADHD symptoms among adolescents: findings from the Shandong Adolescent Behavior and Health Cohort (SABHC). Sleep 2019; 43:5650389. [DOI: 10.1093/sleep/zsz294] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/17/2019] [Indexed: 12/11/2022] Open
Abstract
Abstract
Study Objectives
Sleep problems and symptoms of attention-deficit hyperactivity disorder (ADHD) in adolescence are common. Little is known about the prospective the prospective associations between sleep and subsequent ADHD symptoms in adolescents. This study examined the prospective associations between sleep problems and subsequent ADHD symptoms in a large sample of adolescents.
Methods
Participants included 7072 adolescents from the Shandong Adolescent Behavior and Health Cohort (SABHC) study in Shandong, China. Participants were initially assessed in November–December of 2015 and were reassessed 1-year later in 2016. Sleep duration, sleep problems, and psychosocial information were collected using a structured questionnaire. ADHD symptoms were measured by the Achenbach Child Behavior Checklist-Youth Self-Report.
Results
At baseline, 7.6% participants had clinically relevant ADHD symptoms, which were highly comorbid with sleep problems including insomnia symptoms, poor sleep quality, symptoms of restless legs syndrome (RLS), frequent snoring, and short sleep duration. Of the 6531 participants without clinically relevant ADHD symptoms at baseline, 4.5% reported clinically relevant ADHD symptoms at 1-year follow-up. After adolescent and family covariates were adjusted for, insomnia (OR = 2.09, 95% CI = 1.45–3.02), RLS (OR = 1.47, 95% CI = 1.02–2.11), and frequent snoring (OR = 2.30, 95% CI = 1.36–3.90) were all significantly associated with subsequent ADHD symptoms.
Conclusion
ADHD symptoms and sleep problems are highly comorbid. Insomnia, RLS and frequent snoring appear to be significant predictors of subsequent ADHD symptoms. Our study highlights the importance of assessing and managing sleep problems for prevention and clinical treatment of ADHD symptoms in adolescence.
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Affiliation(s)
- Xianchen Liu
- School of Public Health, Shandong University, Jinan, China
- South China Normal University School of Psychology, Guangzhou, China
- University of Tennessee Health Science Center, Memphis
| | - Zhen-Zhen Liu
- School of Public Health, Shandong University, Jinan, China
| | - Bao-Peng Liu
- School of Public Health, Shandong University, Jinan, China
| | - Shi-Hua Sun
- Karolinska Institutet Psychiatry, Stockholm, Sweden
| | - Cun-Xian Jia
- School of Public Health, Shandong University, Jinan, China
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Zhang Y, Zhang J, Ren R, Tang X. Bidirectional associations of insomnia symptoms with somatic complaints and posttraumatic stress disorder in child and adolescent earthquake survivors: a longitudinal study. Sleep Breath 2019; 24:311-320. [DOI: 10.1007/s11325-019-01955-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/18/2019] [Accepted: 09/29/2019] [Indexed: 12/14/2022]
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Tsou MT, Chang BCC. Association of Depression and Excessive Daytime Sleepiness among Sleep-Deprived College Freshmen in Northern Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3148. [PMID: 31470500 PMCID: PMC6747465 DOI: 10.3390/ijerph16173148] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/25/2019] [Accepted: 08/27/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND The aim of this study was to investigate depression and other determinants (sleep-deprived behaviors such as hours spent sleeping, watching television, and on the computer) and their association with excessive daytime sleepiness (EDS) among college freshmen. METHODS Self-administered questionnaires were collected from two colleges in northern Taiwan from July to September 2014. A total of 2643 students (38.7% male; ages ranged 18-23 years; mean age of 18.8 ± 1.2 years) completed an anonymous questionnaire on lifestyle behaviors (including personal habits, sleep duration and quality, and hours spent watching television and on the computer); perception of one's health, a validated depression scale (Brief Symptom Rating Scale, BSRS-5); insomnia symptoms (the Chinese version of the Athens Insomnia Scale, CAIS); and EDS rated with the Chinese Epworth sleepiness scale (CESS). The data were analyzed using the chi-squared test, t-test, multivariate logistic regression, and multiple linear regression. RESULTS The prevalence of EDS among college students was approximately 27.1% (717/2643). The risk of EDS was elevated with increasing severity of depression: odds ratio (OR) = 2.8/3.71/5.01 for female, and OR = 3.29/5.07/5.07 for mild/moderate/severe depression for male, respectively (p < 0.05; marginally higher in male severe depression, p = 0.08). If depression score increased by 1 point, CESS score increased by 0.35 point; if time spent on the computer during non-holidays increased by 1 h, CESS score increased by 0.1 point; and for those whose sleep duration increased by 1 h during non-holidays, CESS score decreased by 0.1 point. CONCLUSIONS EDS significantly predicted depression among college freshmen. Using a computer for a long time and less sleep duration during non-holidays contributed to EDS of college freshmen. Youths who experience EDS are recommended to seek assessment for depression symptoms and sleep-deprived behaviors, thus allowing physicians to offer appropriate screening and treatment.
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Affiliation(s)
- Meng-Ting Tsou
- The Department of Family Medicine, Mackay Memorial Hospital, Taipei City 10449, Taiwan.
| | - Betty Chia-Chen Chang
- The Department of Family Medicine, Mackay Memorial Hospital, Taipei City 10449, Taiwan
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Geng F, Liang Y, Li Y, Fang Y, Pham TS, Liu X, Fan F. Bidirectional associations between insomnia, posttraumatic stress disorder, and depressive symptoms among adolescent earthquake survivors: a longitudinal multiwave cohort study. Sleep 2019; 42:5536745. [DOI: 10.1093/sleep/zsz162] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 05/21/2019] [Indexed: 02/02/2023] Open
Abstract
Abstract
Study Objectives
To assess insomnia symptoms in adolescents with probable posttraumatic stress disorder (PTSD) and to determine whether there are longitudinal and reciprocal associations between insomnia, PTSD, and depressive symptoms.
Methods
Participants were 1,492 adolescent survivors who had been exposed to the 2008 Wenchuan earthquake in China. Insomnia, PTSD, and depressive symptoms were measured at 12 months (T1, n = 1407), 18 months (T2, n = 1335), and 24 months (T3, n = 1361) postearthquake by self-report questionnaires. Generalized estimating equation (GEE) models were used to examine the cross-sectional and longitudinal associations of insomnia with PTSD and depression.
Results
Insomnia, PTSD, and depressive symptoms were common among adolescent survivors. Among participants with probable PTSD, approximately 47% (48.5%, T1; 48.1%, T2; and 44.2%, T3) reported difficulty falling asleep or difficulty maintaining sleep. Cross-sectional analyses showed that insomnia co-occurred with PTSD (odds ratio [OR] = 2.04) and depressive symptoms (OR = 2.10). Longitudinal analyses revealed that probable PTSD (OR = 1.50) and depression (OR = 1.42) predicted the incidence of insomnia; in turn, insomnia predicted the incidence of depression (OR = 1.65) over time. Furthermore, PTSD predicted (OR = 3.11) and was predicted (OR = 3.25) by depressive symptoms.
Conclusions
There is a bidirectional relationship between insomnia, PTSD, and depressive symptoms. This suggests that insomnia, PTSD, and depression are intertwined over time.
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Affiliation(s)
- Fulei Geng
- School of Psychology, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
| | - Yingxin Liang
- School of Biological Sciences, Faculty of Science, University of Hong Kong, Pokfulam, Hong Kong
| | - Yuanyuan Li
- School of Psychology, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
| | - Yi Fang
- School of Psychology, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
| | - Tien Sy Pham
- School of Psychology, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Department of Social Work, Hue University of Sciences, Hue, Thua Thien Hue, Vietnam
| | - Xianchen Liu
- School of Psychology, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- University of Tennessee Health Science Center, Memphis, TN
| | - Fang Fan
- School of Psychology, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
- Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, Guangdong, People’s Republic of China
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Psychometric properties of Youth Self-Rating Insomnia Scale (YSIS) in Chinese adolescents. Sleep Biol Rhythms 2019. [DOI: 10.1007/s41105-019-00222-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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45
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Liu BP, Wang XT, Liu ZZ, Wang ZY, Liu X, Jia CX. Stressful life events, insomnia and suicidality in a large sample of Chinese adolescents. J Affect Disord 2019; 249:404-409. [PMID: 30822663 DOI: 10.1016/j.jad.2019.02.047] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 12/12/2022]
Abstract
AIMS This study aimed to examine the associations between stressful life events, insomnia, and suicidality including suicidal ideation (SI), suicide plan (SP) and suicide attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 11,831 adolescents who participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort were included for the analysis. Participants were sampled from 8 middle/high schools in 3 counties of Shandong, China. Participants completed a structured behavior and health questionnaire, including suicidality, demographics, depression/anxiety, stressful life events (SLEs), and insomnia in November-December 2015. A series of logistic regression models and mediation analyses were performed to examine the associations between SLEs, insomnia and suicidality. RESULTS The prevalence rates of overall suicidality, SI, SP and SA in the last year were 13.1%, 12.5%, 3.3%, and 1.5%, respectively. SLEs were significantly associated with overall suicidality, SI, and SP. Insomnia was an independent risk factor of suicidality and a mediator of the association between SLEs and suicidality. The total effect of SLEs on overall suicidality was 0.597 (95%CI: 0.534-0.661), including 0.457 (95%CI: 0.391-0.523) for direct effect and 0.158 (95%CI: 0.138-0.178) for indirect effect. Insomnia also mediated the associations of SLEs with SI, SP and SA, respectively. LIMITATIONS Causal relationship could not be concluded because this study is cross-sectional. CONCLUSIONS Stressful life events and insomnia are directly associated with suicidality in adolescents. The association between SLEs and suicidality is partially mediated by insomnia.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Ze-Ying Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China; School of Psychology, South China Normal University, Shipai, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China.
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Wang ZY, Liu ZZ, Jia CX, Liu X. Age at menarche, menstrual problems, and daytime sleepiness in Chinese adolescent girls. Sleep 2019; 42:5373063. [DOI: 10.1093/sleep/zsz061] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/10/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ze-Ying Wang
- School of Public Health, Shandong University, Jinan, China
| | - Zhen-Zhen Liu
- School of Public Health, Shandong University, Jinan, China
| | - Cun-Xian Jia
- School of Public Health, Shandong University, Jinan, China
| | - Xianchen Liu
- School of Public Health, Shandong University, Jinan, China
- School of Psychology, South China Normal University, Guangzhou, China
- University of Tennessee Health Science Center, Memphis, TN
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The relationship between insomnia symptoms and school performance among 4966 adolescents in Shanghai, China. Sleep Health 2019; 5:273-279. [PMID: 31208710 DOI: 10.1016/j.sleh.2018.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 10/27/2018] [Accepted: 12/15/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE Insomnia symptoms are common in adolescents. This study examined the associations of insomnia symptoms with school performance among adolescents in Shanghai, China. METHODS A total of 4966 adolescents aged 11-20 years participated in a cross-sectional survey during November of 2009. The Adolescent Sleep Disturbance Questionnaire was used to examine insomnia symptoms, and the Teacher School Achievement Form was applied to evaluate adolescents' school performance. RESULTS The results demonstrated that, after adjusting for possible confounders, all 3 dimensions of insomnia symptoms were associated with adolescents' school performance. Difficulty falling asleep problem was associated with poor attention and concentration (odds ratio [OR] = 1.30, 95% confidence interval [CI] 1.11-1.52, P = .001), academic frustration (OR = 1.24, 95% CI: 1.06-1.45, P = .007), and poor school relationships (OR = 1.26, 95% CI: 1.08-1.48, P = .003); maintaining sleep problem was associated with poor attention and concentration (OR = 1.25, 95% CI: 1.06-1.46, P = .007) and poor interest and motivation (OR = 1.22, 95% CI: 1.04-1.44, P = .017); and reinitiating sleep problem was related to poor interest and motivation (OR = 1.20, 95% CI: 1.00-1.45, P = .048). Coexisting insomnia symptoms were associated with poorer school performance, especially in maintaining attention and concentration. CONCLUSIONS The findings of this study highlight the importance of sleep in the social and cognitive development of adolescents.
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Chang LY, Wu CC, Yen LL, Chang HY. The effects of family dysfunction trajectories during childhood and early adolescence on sleep quality during late adolescence: Resilience as a mediator. Soc Sci Med 2019; 222:162-170. [PMID: 30641286 DOI: 10.1016/j.socscimed.2019.01.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/17/2018] [Accepted: 01/04/2019] [Indexed: 01/10/2023]
Abstract
RATIONALE Sleep quality has been linked to several behavioral and psychological problems. No longitudinal study has examined the associations and underlying mechanisms between the trajectories of family characteristics and sleep quality in adolescents. OBJECTIVE This study investigates the effects of heterogeneous trajectories of family dysfunction on sleep quality in adolescents and examines whether resilience mediates these associations. METHOD Data came from 2280 adolescents participating in a longitudinal study across grades 2 through 11 in northern Taiwan. Group-based trajectory modeling was used to identify discrete developmental patterns of family dysfunction. Multiple linear regression was applied to examine the associations between family dysfunction trajectories and sleep quality. Mediation analysis was conducted to test whether resilience mediates the associations examined. RESULTS Four distinct trajectories of family dysfunction were identified: low persistent (26%), escalating dysfunction (21%), moderate stable (25%), and high persistent (28%). Compared to adolescents in the low-persistent trajectory, those in the escalating-dysfunction, moderate-stable, and high-persistent trajectories had significant lower levels of sleep quality (B = -0.19, p < .001, B = -0.14, p < .01, and B = -0.13, p < .05, respectively). Resilience significantly mediated the effects of all family dysfunction trajectories (relative to the low-persistent trajectory) on sleep quality (95% bootstrap confidence intervals are -0.06 to -0.02, -0.05 to -0.02, and -0.08 to -0.03 for escalating-dysfunction, moderate-stable, and high-persistent trajectories, respectively). CONCLUSIONS Family dysfunction conferred risks for poor sleep quality in adolescents and the negative effects, in part, were through decreasing resilience. Interventions to improve sleep quality in adolescents by targeting family function may be more effective when incorporating resilience.
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Affiliation(s)
- Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Chi-Chen Wu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan
| | - Lee-Lan Yen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan
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Li XD, Tai J, Xu ZF, Wang GX, Wu YX, Du JN, Zhang J, Peng XX, Ni X. Sleep Duration and Factors Related to Sleep Loss in 3-14-Year-Old Children in Beijing: A Cross-Sectional Survey. Chin Med J (Engl) 2018; 131:1799-1807. [PMID: 30058576 PMCID: PMC6071462 DOI: 10.4103/0366-6999.237403] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: It is known that short sleep duration adversely affects children's behavior and physical development. This study aimed to investigate the status of sleep duration in 3–14-year-old children in Beijing and explore the related factors of sleep loss with them. Methods: In this study, a cross-sectional study of random stratified cluster sampling was conducted on 3–14-year-old children and adolescents in Beijing. According to the proportion of children in each district and school, the final cohort included a total of 11 kindergartens, 7 primary schools, and 8 junior high schools from 7 districts of Beijing. Children of sampled classes were included, and their parents were invited to fill a series of questionnaires including the simplified Chinese version of Pediatric Sleep Questionnaire, Sleep Questionnaire Scale, and Hong Kong-Children Sleep Questionnaire about the performance of the last 6 months. Results: Out of the total 11,420 questionnaires, 9198 questionnaires were valid and effective with the response rate of 80.54%. The age of the investigated children was 8.8 ± 3.8 years, including 4736 males and 4462 females. The daily sleep duration of children in Beijing was 9.7 ± 0.7 h. The prevalence of sleep loss (<9 h/day) of children in Beijing was 11.8%. The daily sleep duration of children aged <6, 6 ≤ age <11, and ≥11 years was 9.7 ± 0.6 h, 9.6 ± 0.6 h, and 9.5 ± 0.8 h, respectively. The sleep duration reduced significantly in children aged ≥11 years as compared to younger children in Beijing which was mainly contributed by the variation tendency of sleep duration on weekdays. The multivariate logistic regression analysis identified factors associated with sleep loss (P < 0.05): male (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.15–1.51), age ≥11 years (OR = 2.37, 95% CI: 1.92–2.93), overweight (OR = 1.34, 95% CI: 1.17–1.54), family history of snoring (OR = 1.35, 95% CI: 1.13–1.61) and activities before bedtime with watching TV (OR = 1.24, 95% CI: 1.08–1.43), sports (OR = 1.22, 95% CI: 1.01–1.48), playing cellphone (OR = 1.91, 95% CI: 1.31–2.73) and surfing the Internet (OR = 1.27, 95% CI: 1.06–1.52) and among them age ≥11 years and playing cellphone before bedtime had greater impact on children's short sleep duration than that of other factors. Conclusions: Sleep loss was common among 3–14-year-old children in Beijing. Sleep duration decreased with age, especially among children over 11 years old. Factors associated with sleep loss covered sociodemographic characteristics, family sleep habits and routine activities before bedtime, and among those variables, age ≥11 years and playing with cellphones before bedtime had a greater impact on sleep duration, indicating that existing sleep loss in 3–14-year-old children could be, at least partly, improved by paying more attention to children aged of 11 years or entering Grade 5 and Grade 6 and to children with a family history of snoring; by reducing the use of electronic products before bedtime, especially cellphones; by managing weight and keeping fit; and by improving the bedtime routine.
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Affiliation(s)
- Xiao-Dan Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Jun Tai
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Zhi-Fei Xu
- Department of Respiratory, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Gui-Xiang Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Yun-Xiao Wu
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Jiang-Nan Du
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Jie Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Xiao-Xia Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing children's Hospital, Capital Medical University, Beijing 100045, China
| | - Xin Ni
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
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Abstract
AIMS Suicidal behaviours in adolescents are prevalent and multifactorial. This study was conducted to examine the associations between exposure to suicide attempt (ESA) or suicide death (ESD) and suicidal behaviours in a large sample of Chinese adolescents. METHODS Participants included for the analysis were 11 831 adolescent students who participated in the baseline survey of the Shandong Adolescent Behavior and Health Cohort (SABHC). Participants were sampled from five middle and three high schools in three counties of Shandong province, China. A self-administered structured questionnaire was used to collect data on demographics, behavioural and emotional problems, family environment, suicidal behaviours (suicidal thought, plan and attempt), and history of ESA or death of a family member, relative, friend or close acquaintance. Based on the sources of exposure, the participants were divided into four groups: non-exposure, exposure from relatives only, exposure from friends/close acquaintances only (EFO) and exposure from both relatives and friends (ERF). Logistic regressions were used to examine the associations between ESA or ESD and suicidal behaviours. RESULTS Mean age of the participants was 14.97 ± 1.46 years and 50.9% were boys. Of the participants, 9.4% reported having ESA, and 6.6% reported having ESD. The prevalence rates of suicidal behaviours were significantly higher in adolescents who had been exposed to suicide attempt or death than those who had not. Multivariate logistic regressions showed that ESA and ESD were both significantly associated with increased risks of suicidal thought (ESA: OR = 1.96, 95% CI = 1.66-2.31; ESD: OR = 1.59, 95% CI = 1.31-1.94), plan (ESA: OR = 2.37, 95% CI = 1.84-3.05; ESD: OR = 1.62, 95% CI = 1.18-2.23) and attempt (ESA: OR = 2.73, 95% CI = 1.92-3.89; ESD: OR = 1.82, 95% CI = 1.18-2.82), respectively. When participants were exposed to suicide attempt, ERF and EFO groups had significantly higher risks of suicidal thought (ERF: OR = 2.61, 95% CI = 1.28-1.64; EFO: OR = 1.96, 95% CI = 1.64-2.36), plan (ERF: OR = 3.72, 95% CI = 2.04-6.78; EFO: OR = 2.31, 95% CI = 1.74-3.01) and attempt (ERF: OR = 4.83, 95% CI = 2.30-10.17; EFO: OR = 2.57, 95% CI = 1.73-3.81), respectively. CONCLUSIONS ESA or ESD was associated with increased risks of suicidal behaviours in adolescents. Exposure to suicidal behaviours of relatives and friends/close acquaintances appeared to have different influence on adolescent suicidal behaviours. Further research is warranted to examine the biological and psychosocial mechanisms between suicidal exposure and subsequent suicidal behaviours in adolescents.
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