Sleep Quality Assessment of Adolescents Residing in an Urban Resettlement Colony, New Delhi, India

Depression, sleep, body image, and lifestyle: Prevalence and associated factors of depression among school-going adolescents in Delhi National Capital Region

Background

Adolescents are known to be vulnerable to depression, which worsened during the COVID-19 pandemic. They also exhibit poor sleep quality and body image issues (BIIs) which are considered risk factors for depression. There is a paucity of Indian studies regarding adolescent depression and its correlation with lifestyle.

Aims

To detect the prevalence of depression in adolescents, and understand its association with sociodemographic variables, sleep quality, BIIs, and lifestyle factors.

Materials and Methods

A cross-sectional study was conducted among 392 adolescents attending classes 8th-12th in two schools in Delhi National Capital Region. A pre-tested semi-structured questionnaire was used to collect sociodemographic and lifestyle data. Depression anxiety stress scale-21 was used to detect depression. Pittsburgh Sleep Quality Index and Stunkard Figure Rating Scale were used to evaluate sleep quality and BIIs. Data was analyzed using Statistical Package for Social Sciences Version-25.

Results

Depression was present in 40.3% of students. It was more common in girls, older students, students in higher classes, who lacked siblings and whose mothers were engaged in professions as well as those with BIIs. However, after multivariate analysis, the association of depression with poor sleep quality, meal skipping, lack of exercise, family history of mental illness, and inverse association with open discussion of one's thoughts and worries with family remained significant.

Conclusions

Depression is common among adolescents and shows associations with poor sleep quality and lifestyle choices. Awareness of these associations may enable better screening and early intervention for vulnerable adolescents.

Determinants of timing, adequacy and quality of antenatal care in Rwanda: a cross-sectional study using demographic and health surveys data

BACKGROUND

Antenatal care (ANC) is a recommended intervention to lessen maternal and neonatal mortality. The increased rate in ANC coverage in most Sub-Saharan African countries is not considerably reducing the maternal and neonatal mortality. This disconnection has raised concerns to study further the trend and determinants of the ANC timing and quality. We aimed to assess the determinants and trend of the timing, the adequacy and the quality of antenatal care in Rwanda.

METHOD

A population-based cross-sectional study design. We used data from the 2010,2015 and 2020 Rwanda demographic and health surveys (RDHS). The study included 18,034 women aged 15-49 years. High quality ANC is when a woman had her first ANC visit within 3 months of pregnancy, had 4 or more ANC visits, received services components of ANC during the visits by a skilled provider. Bivariate analysis and multivariable logistic regression were used to assess the ANC (timing and adequacy), the quality of the content of ANC services and the associated factors.

RESULTS

The uptake of antenatal services increased in the last 15 years. For instance, the uptake of adequate ANC was 2219(36.16%), 2607(44.37%) and 2925(48.58%) respectively for 2010;2015 and 2020 RDHS. The uptake of high quality ANC from 205(3.48%) in 2010 through 510(9.47%) in 2015 to 779(14.99%) in 2020. Women with unwanted pregnancies were less likely to have timely first ANC (aOR:0.76;95%CI:0.68,0.85) compared to planned pregnancies, they were also less likely to achieve a high-quality ANC (aOR: 0.65;95%CI:0.51,0.82) compared to the planned pregnancies. Mothers with a secondary and higher education were 1.5 more likely to achieve a high-quality ANC (aOR:1.50;95%CI:1.15,1.96) compared to uneducated mothers. Increasing maternal age is associated with reduced odds of update of ANC component services (aOR:0.44;95%CI:0.25,0.77) for 40 years and above when referred to teen mothers).

CONCLUSION

Low-educated mothers, advanced maternal age, and unintended pregnancies are the vulnerable groups that need to be targeted in order to improve ANC-related indicators. One of the credible measures to close the gap is to strengthen health education, promote family planning, and promote service utilization.

Impact of screen time during COVID-19 on eating habits, physical activity, sleep, and depression symptoms: A cross-sectional study in Indian adolescents

OBJECTIVE

This study attempted to address the limited knowledge regarding the impact of screen time (ST) on lifestyle behaviors in Indian adolescents during the ongoing COVID-19 pandemic. The objectives were to 1) evaluate frequency and duration of using screens, and screen addiction behaviors in 10-15 years old adolescents in Mumbai during the COVID-19 pandemic and 2) examine the association of ST with lifestyle behaviors- eating habits, snacking patterns, physical activity (PA) levels, sleep quality and depression symptoms.

METHODS

An online survey was completed between January and March 2021. Eating habits, snacking patterns, time spent in different screen-based activities, and screen addiction behaviors were reported. The PA levels, sleep quality, and depression symptoms were evaluated using the Physical Activity Questionnaire for Children/Adolescents (PAQ C/A), Pittsburg Sleep Quality Index (PSQI), and Patient Health Questionnaire-2 (PHQ-2) respectively. Multiple linear regression analyses were performed to determine the impact of ST on lifestyle behaviors.

RESULTS

Adolescents (n = 1298, Mage 13.2(1.1), 53.3% boys) reported the mean weekday and weekend ST as 442.3 (201.5) minutes/d and 379.9 (178.2) minutes/d respectively. Overall, 33.4% spent > 6hours/d for studying or doing homework, 65.4% used social networking sites for at least 2-3 hours/d, and 70.7% agreed that ST had taken up the majority of their leisure time. Only 12% engaged in moderate to vigorous PA (PAQ C/A scores <2). More than half (52.5%) reported PSQI >5 indicating poor sleep quality and 8.6% scored ≥ 3 on PHQ-2 to suggest a risk of depression. A higher ST was associated with lower PA and increased sleep problems and a greater screen addiction was inversely associated with the eating habit, PA, and sleep-related variables.

CONCLUSION

The study draws attention to a high prevalence of excess ST and its impact on eating habits, PA levels, and sleep quality in Indian adolescents during the COVID-19 pandemic. Targeted health promotion interventions that encourage judicious use of screens for education and entertainment and emphasize the adverse health effects of excess ST are required.

Independent and combined influences of physical activity, screen time, and sleep quality on adiposity indicators in Indian adolescents

BACKGROUND

Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes.

METHODS

Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex.

RESULTS

The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes.

CONCLUSIONS

The results indicated a co-existence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.

Discriminant Function Analysis of Sleep Quality and its Determinants among General Adult Population of Ahmedabad City, Gujarat

Background:

Poor sleep quality harms the ability to think, lowers stress, and sustains a healthy immune system. The present study assessed sleep quality and its determinants in adult population using discriminant function analysis (DFA) in Ahmedabad city, Gujarat.

Objectives:

The objective of the study was (1) to assess the quality of sleep using the Pittsburgh Sleep Quality Index (PSQI) and (2) to determine various parameters affecting sleep quality using DFA.

Materials and Methods:

A cross-sectional study was conducted among the general adult population (18–60 years) residing at Ahmedabad city during July–December 2019. The interviewers conducted house-to-house visit among selected households for filling up the predesigned and pretested questionnaire.

Results:

Out of 600 participants, the mean age of participants was 37.8 ± 18.3 years. As per PSQI, overall sleep quality was poor among 31% of participants. Sleep quality was significantly associated with gender, education, occupation, social class, body mass index, Internet addiction, depression, and spirituality.

Conclusion:

Overall sleep quality was poor among the study participants. This article considered analysis of determinants of sleep quality among the urban adult population.

Psychological Distress, Drug Use, and Internet Use: The Association with Poor Sleep Quality in a Sample of Secondary School Students

Sleep problems are common among children and adolescents. Sleep quality plays a significant role in their mental health. We aimed to determine the prevalence of poor sleep quality (PSQ) among secondary school students, identify sociodemographic factors associated with PSQ in this group, and examine the independent associations of psychological distress, stimulant use, and internet use with PSQ. Data were collected from 420 secondary school students from four different schools who were selected using a mixture of convenience and random sampling. A set of questionnaires was administered to collect data, and it consisted of 5 sections measuring: the sociodemographic, drug use, psychological distress, internet use, and sleep quality. A total of 378 questionnaires were analyzed. The participants comprised 174 (46.2%) males and 203 (53.8%) females who were between 10 and 21 years. The mean age was 14.78 years. The prevalence of those who had PSQ was 12.2%. A logistic regression model showed that anxiety (AOR = 1.20, 95% CI: 1.10-1.32), depression (AOR = 1.12, 95% CI: 1.00-1.25), and internet use (AOR = 1.02, 95% CI: 1.00-1.03) were significantly associated with PSQ. PSQ commonly exists among students and has a relationship with their psychological state and potentially addictive behavior, such as internet use. We prescribed the optimal treatment of psychological disorders and addictive behavior, of which sleep problems are a typical fallout.