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Interactions between sleep duration and quality as predictors of adolescents' adjustment.

ABSTRACT: OBJECTIVES:We examined interactions between adolescents' sleep duration and quality as predictors of their internalizing symptoms and externalizing behaviors. As a secondary aim, we assessed adolescent sex, race/ethnicity, and socioeconomic status (SES) as additional moderators of risk (ie, 3-way interactions among sleep duration; quality; and sex, race, or SES). DESIGN:The study used a cross-sectional design. SETTING:Participants were from small towns and semirural communities in Alabama. PARTICIPANTS:The sample consisted of 235 adolescents (Mage?=?15.78?years, SD?=?9.60?months) and was diverse with respect to sex (54% female), race/ethnicity (32% Black/African American, 67% White), and SES. MEASUREMENTS:Sleep duration (actual sleep minutes) was examined with actigraphs for 1 week. Adolescents reported on their subjective sleep quality, internalizing symptoms, and externalizing behavior with psychometrically sound measures. RESULTS:Findings revealed interactions between sleep duration and sleep quality as predictors of adolescents' adjustment. Adolescents with both short sleep duration in conjunction with poor sleep quality had the highest levels of internalizing symptoms and aggressive and rule-breaking behavior. SES interacted with sleep duration and sleep quality to predict rule-breaking behavior, and the highest level of problems was observed for adolescents from lower-SES homes who had short sleep duration accompanied by poor sleep quality. CONCLUSIONS:Findings identify the conjoint role of sleep duration and quality as predictors of adolescents' socioemotional adjustment and emphasize the importance of examining multiple sleep parameters simultaneously toward a better understanding of adaptation in adolescence.

SUBMITTER: El-Sheikh M

PROVIDER: S-EPMC6442940 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Interactions between sleep duration and quality as predictors of adolescents' adjustment.

El-Sheikh Mona M Saini Ekjyot K EK Gillis Brian T BT Kelly Ryan J RJ

Sleep health 20190114 2

<h4>Objectives</h4>We examined interactions between adolescents' sleep duration and quality as predictors of their internalizing symptoms and externalizing behaviors. As a secondary aim, we assessed adolescent sex, race/ethnicity, and socioeconomic status (SES) as additional moderators of risk (ie, 3-way interactions among sleep duration; quality; and sex, race, or SES).<h4>Design</h4>The study used a cross-sectional design.<h4>Setting</h4>Participants were from small towns and semirural communi ...[more]

PMID: 30928119

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Project description:Background and objectiveThe 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.MethodsA 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.ResultsShort 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.ConclusionsOverall, 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.

Project description:In this large perspective cohort among European children and adolescents, we observed that daytime napping was positively associated with bone stiffness, while short or long sleep duration combined with poor sleep quality was associated with less bone stiffness. Our findings are important for obtaining optimal bone stiffness in childhood.IntroductionTo examine the cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness index (SI) in European children and adolescents.MethodsFour thousand eight hundred seventy-one children aged 2-11 years from the IDEFICS study and 861 children aged 6-15 years from the subsequent I.Family study were included. Sleep duration (i.e., nocturnal sleep and daytime napping) and sleep quality (i.e., irregularly bedtime routine, have difficulty falling asleep and trouble getting up in the morning) were reported by self-administrated questionnaires. Nocturnal sleep duration was converted into age-specific z-scores, and total sleep duration was classified into short, adequate, and long based on the National Sleep Recommendation. Calcaneal SI of both feet were measured using quantitative ultrasound. Linear mixed-effects models with country as a random effect were used, with adjustments for sex, age, pubertal status, family socioeconomic status, physical activity, screen time, body mass index, and daylight duration.ResultsNocturnal sleep duration z-scores were positively associated with SI percentiles among participants with adequate sleep duration at baseline. Moreover, the positive association between daytime napping and SI percentiles was more pronounced in participants with adequate sleep duration at baseline, while at 4-year follow-up was more pronounced in participants with short sleep duration. In addition, extreme sleep duration at baseline predicted lower SI percentiles after 4 years in participants with poor sleep quality.ConclusionThe positive associations between nocturnal sleep, daytime napping and SI depended on total sleep duration. Long-term detrimental effect of extreme sleep duration on SI only existed in individuals with poor sleep quality.

Project description:BackgroundSleep 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.MethodsA 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.ResultsThe 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.ConclusionsStudy 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.

Project description:ImportanceSleep is a resource that has been associated with health and well-being; however, sleep insufficiency is common among adolescents.ObjectiveTo examine how delaying school start time is associated with objectively assessed sleep duration, timing, and quality in a cohort of adolescents.Design, setting, and participantsThis observational cohort study took advantage of district-initiated modifications in the starting times of 5 public high schools in the metropolitan area of Minneapolis and St Paul, Minnesota. A total of 455 students were followed up from grade 9 (May 3 to June 3, 2016) through grade 11 (March 15 to May 21, 2018). Data were analyzed from February 1 to July 24, 2019.ExposuresAll 5 participating schools started early (7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), 2 schools delayed their start times by 50 and 65 minutes, whereas 3 comparison schools started at 7:30 am throughout the observation period.Main outcomes and measuresWrist actigraphy was used to derive indices of sleep duration, timing, and quality. With a difference-in-difference design, linear mixed-effects models were used to estimate differences in changes in sleep time between delayed-start and comparison schools.ResultsA total of 455 students were included in the analysis (among those identifying sex, 225 girls [49.5%] and 219 boys [48.1%]; mean [SD] age at baseline, 15.2 [0.3] years). Relative to the change observed in the comparison schools, students who attended delayed-start schools had an additional mean 41 (95% CI, 25-57) objectively measured minutes of night sleep at follow-up 1 and 43 (95% CI, 25-61) at follow-up 2. Delayed start times were not associated with falling asleep later on school nights at follow-ups, and students attending these schools had a mean difference-in-differences change in weekend night sleep of -24 (95% CI, -51 to 2) minutes from baseline to follow-up 1 and -34 (95% CI, -65 to -3) minutes from baseline to follow-up 2, relative to comparison school participants. Differences in differences for school night sleep onset, weekend sleep onset latency, sleep midpoints, sleep efficiency, and the sleep fragmentation index between the 2 conditions were minimal.Conclusions and relevanceThis study found that delaying high school start times could extend adolescent school night sleep duration and lessen their need for catch-up sleep on weekends. These findings suggest that later start times could be a durable strategy for addressing population-wide adolescent sleep deficits.

Project description:The objective of the present study was to investigate the relationship between sleep insufficiency and sleep duration, particularly regarding negative cardiometabolic health outcomes already considered to be affected by reduced sleep time.A total of N=30,934 participants from the 2009 Behavioural Risk Factor Surveillance System (BRFSS) answered questions about their sleep duration as well as subjective feelings of sleep insufficiency. Outcomes included body mass index (BMI), obesity (BMI ? 30kgm(-2)) and history of hypertension, diabetes, hypercholesterolaemia, heart attack and stroke. Linear and logistic regression models examined whether cardiometabolic outcomes were associated with (1) sleep duration alone, (2) sleep insufficiency alone and (3) the combined effect of sleep duration and sleep insufficiency.Results indicated that, when examined alone, sleep duration <5h (versus 7h) was related to BMI (B=2.716, p<0.01), obesity (B=2.080, p<0.000001), diabetes (B=3.162, p<0.000001), hypertension (B=2.703, p<0.000001), hypercholesterolaemia (B=1.922, p<0.00001), heart attack (B=4.704, p<0.000001) and stroke (B=4.558, p<0.000001), and sleep insufficiency (days per week, continuous) was related to BMI (B=0.181, p<0.01), obesity (B=1.061, p<0.000001) and hypercholesterolaemia (B=1.025, p<0.01). All of these relationships remained significant after adjustment for covariates, except for diabetes and sleep duration. Also, after adjustment, a significant relationship between insufficient sleep and hypertension emerged (B=1.039, p<0.001). When evaluated together, after adjustment for covariates, significant relationships remained between sleep duration <5h (versus 7h) and BMI (B=1.266, p<0.05), obesity (B=1.389, p<0.05), hypertension (B=1.555, p<0.01), heart attack (B=2.513, p<0.01) and stroke (B=1.807, p<0.05). It should be noted that relationships between sleep duration >9h (versus 7h) were seen for heart attack (B=1.863, p<0.001) and stroke (B=1.816, p<0.01). In these models, sleep insufficiency was associated with hypercholesterolaemia (B=1.031, p<0.01) and hypertension (B=1.027, p<0.05).These analyses show that both sleep duration and insufficiency are related to cardiometabolic health outcomes, and that when evaluated together, both variables demonstrate unique effects.

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Interactions between sleep duration and quality as predictors of adolescents' adjustment.

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Interactions between sleep duration and quality as predictors of adolescents' adjustment.

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