Constructs of poor sleep quality in adolescents: associated factors

A study on sleep quality under the shadow of school bullying: The interwoven effects of depressed mood, low self-esteem, and negative parenting practices

OBJECTIVE

The aim of this study was to reveal the relationship between school bullying and sleep quality in adolescents. It proposes a theoretical model where depressed mood, low self-esteem, and negative parenting practices serve as mediating variables, providing new directions and measures for preventing and treating school bullying and sleep disorders.

METHODS

In this study, a total of 4483 middle school students from Anhui Province in China were selected anonymously to participate in a questionnaire survey. The data analysis was conducted using SPSS 26.0 software. PROCESS model 6 was employed to investigate the mediating role of depressed mood, low self-esteem, and negative parenting styles in the association between school bullying and sleep disorders.

RESULTS

The study results generally lend support to the hypothesis that bullying exerts an influence on sleep disorders through the mediating pathways of depressed mood, low self-esteem, and negative parenting styles. The aforementioned findings may provide an explanation for the correlation between school bullying and sleep disorders, thus offering implications for intervention strategies targeting sleep disorders.

CONCLUSION

This study innovatively integrates the impact of school bullying on adolescent sleep disorders. Depressed mood, low self-esteem, and negative parenting practices have independent and persistent mediating effects on the relationship between school bullying and sleep disorders. The influence pathway of school bullying on sleep disorders offers a novel direction for relevant governmental agencies and educational institutions to develop mental health measures and establish robust mechanisms for regulating emotions.

Exploring the association between sleep quality, internet addiction, and related factors among adolescents in Dakshinkali Municipality, Nepal

BACKGROUND

Poor sleep quality and internet addiction are significant issues affecting adolescents globally, and Nepal is no exception. Several studies have independently assessed the prevalence and associated factors of poor sleep quality and internet addiction among Nepali adolescents and youth, but the relationship between sleep-related attributes and internet addiction remains unexplored. This study aimed to explore the prevalence and contributing factors of poor sleep quality and internet addiction along with the relationship between sleep quality-related attributes and internet addiction.

MATERIAL AND METHODS

A cross-sectional study was conducted among 243 adolescents of Dakshinkali Municipality, Nepal. Pittsburgh Sleep Quality Index and Young's Internet Addiction Test scale were used to measure sleep quality and internet addiction. Pearson's chi-square test and binary logistic regression were performed at a 5% level of significance to examine the associated factors.

RESULTS

The prevalence of poor sleep quality was 27.6% (95% CI: 22.6-33.7) while potential internet addiction was 49.4% (95% CI: 42.0-56.7). Poor sleep quality was associated with internet addiction (aOR: 1.845; 95% CI: 1.344-3.608), poor perceived relation with teachers (aOR: 2.274; 95% CI: 1.149-4.497), and presence of family conflict (aOR: 2.355; 95% CI: 1.040-5.329). Bad subjective sleep quality (aOR: 5.613; 95% CI: 2.007-15.701), sleep disturbance (aOR: 1.781; 95% CI: 1.251-4.872), frequent daytime dysfunction (aOR: 1.902; 95% CI: 1.083-4.638), and poor perceived relation with teachers (aOR: 2.298; 95% CI: 1.233-4.285), and presence of family conflict (aOR: 1.606; 95% CI: 1.202-3.675) were associated with internet addiction.

CONCLUSION

Almost a quarter of adolescents' experience poor sleep quality, while nearly half screened positive for potential internet addiction. Established interrelations between sleep quality and internet usage underscore the importance of integrated intervention approaches combining lifestyle modification and family/school support to protect and promote the mental health and well-being of Nepalese adolescents.

The relationship between the use of screen-based devices and self-reported sleep quality in adolescents aged 13-19 years in Brunei

BACKGROUND

The widespread use of digital devices among adolescents has raised concerns about the potential impact of screen time on sleep quality. This study aimed to investigate the relationship between screen time and self-reported sleep quality in adolescents.

METHODS

A cross-sectional study was conducted on adolescents (13- to 19-year-olds) using multi-stage cluster sampling with probability proportional to the size of public schools. Data were collected in November 2022 through self-administered questionnaires. The questionnaire collected sociodemographic characteristics, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and screen time on weekdays and weekends using the Screen Time Questionnaire (STQ). A scoring system was used in the PSQI and a global score of more than 5 indicates poor sleep quality. The relationship between screen time and sleep quality was analysed using simple and multiple linear regression.

RESULTS

A total of 547 adolescents participated in the study, with a mean (SD) age of 16.66 (1.54) years. The mean (SD) PSQI score was 5.98 (2.70), and 52% of participants had poor sleep quality. The sleep disturbance component had the highest mean (SD) score at 1.35 (0.5) out of a total score of 3.0. The mean (SD) screen time for a weekday was 537.6 (301.5) minutes, and a weekend day was 725.5 (339.2) minutes. The highest median screen time was spent on smartphones during the whole week. A significant linear relationship was observed between age and PSQI global score (p = 0.008), with a 0.2 increase in PSQI global score for each year increase in age (95% CI: 0.05, 0.35). Being female was also significantly associated with a high PSQI global score (p < 0.001). Additionally, a significant linear relationship was observed between screen time on a weekend and PSQI score (p = 0.032).

CONCLUSIONS

The study found that half of the adolescents had poor sleep quality, which was associated with being female, increased screen time on weekends, and older age. Future research endeavours should focus on conducting longitudinal studies to assess the temporal relationship between screen time and sleep quality.

Problematic Use of Smartphones and Social Media on Sleep Quality of High School Students in Mexico City

BACKGROUND

Smartphones, internet access, and social media represent a new form of problematic behavior and can affect how teens sleep.

METHODS

A cross-sectional design was employed to examine the prevalence and association of problematic internet use and problematic smartphone use with sleep quality in a non-probability sample of 190 high school students in Mexico. The internet-related experiences questionnaire (IREQ), the mobile-related experiences questionnaire (MREQ), and the Pittsburgh Sleep Quality Index (PSQI) were used.

RESULTS

The study revealed that 66% of participants exhibited some form of problematic internet use, primarily in the form of social media use; 68% had some form of problematic smartphone use, and 84% reported poor sleep quality. The PSQI score was most accurately predicted by problematic smartphone use (MREQ), followed by enrollment in the morning school shift, participation in sports, the father's education level, and knowledge that "smartphone use disturbs sleep", which together explained 23% of the variation in sleep quality.

CONCLUSIONS

Excessive smartphone use may negatively affect sleep quality in adolescents. We recommended that interventions be implemented to educate adolescents about appropriate and healthy use of technology, in parallel with the promotion of preventive sleep habits.

Association of parent-child discrepancies in educational aspirations with physical fitness, quality of life and school adaptation among adolescents: a multiple mediation model

BACKGROUND

The global public health issue of diminishing physical fitness among adolescents has gained increasing attention. The impact of parents' negative emotions or pressure regarding adolescents' educational aspirations may have a passive impact on the quality of life and adaptation of adolescents in and out of school, and ultimately harm their physical health. This study aims to explore whether parent-child discrepancies in educational aspirations influence physical fitness in adolescents through school adaptation and quality of life.

METHODS

Participants consisted of 9,768 students, males 4,753(48.7%), females 5,015(51.3%), aged 11-19 years, males 14.3 ± 1.92, females 14.4 ± 1.93. The educational aspirations were gauged using a six-point scale for expectation scores. Physical fitness assessments were based on criteria from the National Student Physical Fitness and Health Survey. School adaptation was evaluated using the School Social Behaviors Scale-2. Quality of life for adolescents was measured using Chinese version of the Quality of Life Scale for Children and Adolescents. To analyze the multiple mediating effects, structural equation models were used, and 95% confidence intervals were determined through bootstrap methods.

RESULTS

The results illustrated that school adaptation and quality of life played a significant mediating role in the effect of parent-child discrepancies in educational aspirations and physical fitness. There were three intermediary paths were confirmed: (1) discrepancies in educational aspirations → school adaptation → physical fitness (β=-0.088 SE = 0.021; p<0.01; 95% CI: -0.135, -0.05); (2) discrepancies in educational aspirations → quality of life → physical fitness (β=-0.025; SE = 0.011; p = 0.010; 95% CI: -0.050, -0.006); (3) discrepancies in educational aspirations → school adaptation→ quality of life → physical fitness (β=-0.032; SE = 0.014; p = 0.011; 95% CI: -0.061, -0.007).

CONCLUSION

This study suggests that parents should reduce negative emotions and pressure regarding adolescents' academic aspirations may help their children get better physical fitness.

Examining the Effects of Strength Training with Load Progression on Sleep Parameters and Mental Health in College Students

Objective  To compare the effects of strength training with load progression after 4 weeks on sleep parameters and mental health in college students. Methods  A total of 17 university students (11 women, 6 men), ranging from 18 to 21 years old, were randomized into a strength training group (STG) and a control group (CG). The Pittsburgh sleep quality index (PSQI), insomnia severity questionnaire, hospital anxiety and depression (HAD) scale, profile of mood states (POMS), and chronotype were used to evaluate the main outcomes. Training consisted of 60 minute·d -1 (2 times/week, for 4-weeks), with 3 sets of 10 to 12 repetitions, and a 1-minute rest interval between sets and exercises. Baseline and postintervention differences were analyzed using generalized estimating equations (GEE). Results  After 4 weeks of ST, a significant time effect on the chronotype (β: 1.33; p  < 0.05) was observed in the STG. Additionally, there was a significant time and group effect in the reduction of tension (β: 5.00; p  < 0.05), depression (β: 15.41; p  < 0.05), anger (β: 8.00; p  < 0.05), and confusion (β: 6.50; p  < 0.05). For fatigue (β: 2.66; p  < 0.05), there was a significant time effect difference in its reduction. Vigor was meaningfully increased in the STG group (β: -1.75; p  < 0.05). Furthermore, a significant positive relationship was observed between sleep quality and anxiety (r = 0.54; p  = 0.03). Finally, insomnia was positively related with an increase in confusion (r = 0.70; p  = 0.04) and anxiety (r = 0.52; p  = 0.04), as well as with a decrease in vigor (r = -0.71; p  = 0.03). Discussion  Short-term strength training for 4 weeks was effective for improving mental health, helping achieve characteristics of a positive mood profile, that is, low values for negative factors and a high value for the positive factor.

Prevalence and correlates of sleep disturbance among adolescents in the eastern seaboard of China

BACKGROUND

Sleep disturbances are serious public health issues that warrant increased attention, especially in adolescents. The aim of this study was to investigate the prevalence and factors associated with sleep disorders among urban adolescents in China.

METHODS

This study utilized an online survey to assess the demographic characteristics and mental health status of secondary school students in Lianyungang City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate sleep disturbances in adolescents. The seven-item Generalized Anxiety Disorder (GAD-7) assessed anxiety symptoms, and the Perceived Social Support Scale (PSSS) was used to measure perceived social support.

RESULTS

Among 3443 adolescents, the prevalence of sleep disorders were 10.8%, with significantly higher proportions of sleep disorders (13.7% VS 8.3%, P < 0.001) among female adolescents when compared to males. Binary regression analysis revealed that anxiety symptoms (OR = 1.305, 95% CI: 1.269-1.342, P < 0.001) was risk factor for sleep disturbances, and significant other support (OR = 0.944, 95% CI: 0.896-0.994, P = 0.028) and good annual household income (OR = 0.616, 95% CI: 0.394-0.963, P = 0.034) were protective factors. Furthermore, multinomial logistic regression analysis showed that age, sex, and anxiety symptoms were associated with an elevated risk of experiencing more frequent sleep disturbances (all P < 0.05).

CONCLUSIONS

We have found that 10.8% of adolescents experience sleep disorders, and it is evident that various factors can influence healthy sleeping. These results underscore the significance of addressing these factors to enhance sleep health among this population.

Screen time is negatively associated with sleep quality and duration only in insufficiently active adolescents: A Brazilian cross-sectional school-based study

Background

Time spent on screen devices affects sleep quality and duration leading to several health impairments in youth. Although physical activity (PA) benefits sleep patterns and decreases screen time in adolescents, it is unclear whether the relationship between sleep quality/duration and screen time could be influenced by PA levels.

Objective

To analyze the association between sleep quality and duration with screen time in Brazilian adolescents according PA levels.

Methods

The sample included 1010 adolescents aged 13.2 ± 2.4 years (n = 556 females - 55 % of the sample). Sleep quality and sleep duration, and PA were assessed by Mini Sleep and Baecke questionnaires, respectively. Participants in the highest quartile were classified as physically active. Screen time was analyzed by the self-reported number of hours spent on different screen devices (i.e., television, computer, videogame, and cellphone/tablet). Participants in the highest tertile were classified as having high screen time. Sex, age, and body mass index were considered covariates in binary logistic regression models.

Results

Poor sleep quality was observed in 52.3 % of the sample, whereas 46.6 % reported sleeping less than eight hours/day. High screen time was associated with poor sleep quality (OR = 1.45; 95 %CI = 1.01-2.12) and insufficient sleep duration (OR = 1.52; 95 %CI = 1.01-2.03) in adolescents insufficiently active. There were no associations between screen time and sleep parameters in active adolescents.

Conclusion

High screen time was associated with poor sleep quality and insufficient sleep duration only in insufficiently active adolescents. These results suggest that high PA levels may contribute to improving sleep patterns in pediatric population.

Association between Sleep Quality and Cardiac Autonomic Modulation in Adolescents: A Cross Sectional Study

Objective  To analyze the impact of sleep quality/duration on cardiac autonomic modulation on physically active adolescents with obesity. Materials and Methods  The present cross-sectional study included 1,150 boys with a mean age of 16.6 ± 1.2 years. The assessment of cardiac functions included the frequency domain of heart rate variability (HRV; low frequency - LF; high frequency - HF; and the ratio between these bands -LF/HF -, defined as the sympathovagal balance), and each parameter was categorized as low / high . Physical activity levels and sleep quality/duration were obtained by questionnaires. Abdominal obesity was assessed and defined as waist circumference > 80 th percentile. Results  Poor sleep quality resulted in lower HF (odds ratio [OR]: 1.8; 95% confidence interval [95%CI]: 1.01-3.21]) regardless of physical activity and abdominal obesity. Moreover, the study found no association between sleep duration and HRV parameters in adolescents. Conclusion  Sleep quality, not sleep duration, reduces parasympathetic cardiac modulation apart from other factors such as physical activity and abdominal obesity in adolescents.

Low mindfulness is related to poor sleep quality from middle adolescents to emerging adults: a process model involving resilience and emotional dysfunction

OBJECTIVES

Transitions from middle adolescence into merging adulthood, a life stage between age 15-25, has a high prevalence of sleep problems. Mindfulness is a trait defined as being attentive to the present moment which positively relates to sleep quality. In this study, we aimed to investigate how resilience and emotional dysfunction may influence the relationship between trait mindfulness and sleep quality.

METHODS

The Five Facet Mindfulness Questionnaire, Connor-Davidson Resilience Scale, Pittsburgh Sleep Quality Index and Depression Anxiety Stress Scales were used to measure the key variables through an online survey of 497 participants between middle adolescence and emerging adults (317 females, mean age 18.27 ± 0.76 years). A process model was built to investigate the mediating roles of resilience and emotional dysfunction in the impact of trait mindfulness on sleep quality, together with the relationships between their specific components.

RESULTS

We found a positive association between mindfulness and sleep quality through resilience and through emotional dysfunction, and through the sequential pathway from resilience to emotional dysfunction. Of note, acting with awareness (mindfulness facet) showed significant indirect effects on sleep quality, mediated by resilience and emotional dysfunction.

CONCLUSIONS

Our findings may unveil the underlying mechanisms of how low mindfulness induces poor sleep quality. The findings indicate that conceiving mindfulness as a multifaceted construct facilitates comprehension of its components, relationships with other variables, and underscores its potential clinical significance given its critical implications for mental health.