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Published in: BMC Public Health 1/2006

Open Access 01-12-2006 | Research article

"Sleepiness" is serious in adolescence: Two surveys of 3235 Canadian students

Authors: Edward S Gibson, AC Peter Powles, Lehana Thabane, Susan O'Brien, Danielle Sirriani Molnar, Nik Trajanovic, Robert Ogilvie, Colin Shapiro, Mi Yan, Lisa Chilcott-Tanser

Published in: BMC Public Health | Issue 1/2006

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Abstract

Background

Evidence is growing that sleep problems in adolescents are significant impediments to learning and negatively affect behaviour, attainment of social competence and quality of life. The objectives of the study were to determine the level of sleepiness among students in high school, to identify factors to explain it, and to determine the association between sleepiness and performance in both academic and extracurricular activities

Methods

A cross-sectional survey of 2201 high school students in the Hamilton Wentworth District School Board and the Near North District School Board in Ontario was conducted in 1998/9. A similar survey was done three years later involving 1034 students in the Grand Erie District School Board in the same Province. The Epworth Sleepiness Scale (ESS) was used to measure sleepiness and we also assessed the reliability of this tool for this population. Descriptive analysis of the cohort and information on various measures of performance and demographic data were included. Regression analysis, using the generalised estimating equation (GEE), was utilized to investigate factors associated with risk of sleepiness (ESS>10).

Results

Seventy per cent of the students had less than 8.5 hours weeknight sleep. Bedtime habits such as a consistent bedtime routine, staying up late or drinking caffeinated beverages before bed were statistically significantly associated with ESS, as were weeknight sleep quantity and gender. As ESS increased there was an increase in the proportion of students who felt their grades had dropped because of sleepiness, were late for school, were often extremely sleepy at school, and were involved in fewer extracurricular activities. These performance measures were statistically significantly associated with ESS. Twenty-three percent of the students felt their grades had dropped because of sleepiness. Most students (58–68%) reported that they were "really sleepy" between 8 and 10 A.M.

Conclusion

Sleep deprivation and excessive daytime sleepiness were common in two samples of Ontario high school students and were associated with a decrease in academic achievement and extracurricular activity. There is a need to increase awareness of this problem in the education and health communities and to translate knowledge already available to strategies to address it.
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Literature
1.
go back to reference Carskadon MA, Acebo C, Seifer R: Extended nights, sleep loss, and recovery sleep in adolescents. Arch Ital Biol. 2001, 139: 301-312.PubMed Carskadon MA, Acebo C, Seifer R: Extended nights, sleep loss, and recovery sleep in adolescents. Arch Ital Biol. 2001, 139: 301-312.PubMed
2.
go back to reference Carskadon MA, Wolfson AR, Acebo C, Tzischinsky O, Seifer R: Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days. Sleep. 1998, 21 (8): 871-881.PubMed Carskadon MA, Wolfson AR, Acebo C, Tzischinsky O, Seifer R: Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days. Sleep. 1998, 21 (8): 871-881.PubMed
3.
go back to reference Carskadon MA, Acebo C, Jenni OG: Regulation of adolescent sleep: implications for behavior. Ann NY Acad Sci. 2004, 1021: 276-91. 10.1196/annals.1308.032.CrossRefPubMed Carskadon MA, Acebo C, Jenni OG: Regulation of adolescent sleep: implications for behavior. Ann NY Acad Sci. 2004, 1021: 276-91. 10.1196/annals.1308.032.CrossRefPubMed
4.
go back to reference Randazzo AC, Muehlbach MJ, Schweitzer PK, Walsh JK: Cognitive function following acute sleep restriction in children ages 10–14. Sleep. 1998, 21: 861-868.PubMed Randazzo AC, Muehlbach MJ, Schweitzer PK, Walsh JK: Cognitive function following acute sleep restriction in children ages 10–14. Sleep. 1998, 21: 861-868.PubMed
5.
go back to reference Carskadon MA, Vieira C, Acebo C: Association betweenpuberty and delayed phase preference sleep. Sleep. 1993, 16: 258-262.PubMed Carskadon MA, Vieira C, Acebo C: Association betweenpuberty and delayed phase preference sleep. Sleep. 1993, 16: 258-262.PubMed
6.
go back to reference Wolfson AR, Carskadon MA: Early school start times affect sleep and daytime functioning in adolescents. Sleep Research. 1996, 25: 117-124. Wolfson AR, Carskadon MA: Early school start times affect sleep and daytime functioning in adolescents. Sleep Research. 1996, 25: 117-124.
7.
go back to reference Carskadon MA, Harvey K, Duke P, Anders TF, Litt IF, Dement WC: Pubertal changes in daytime sleepiness. Sleep. 1980, 2: 453-460.PubMed Carskadon MA, Harvey K, Duke P, Anders TF, Litt IF, Dement WC: Pubertal changes in daytime sleepiness. Sleep. 1980, 2: 453-460.PubMed
8.
go back to reference Wolfson AR, Carskadon MA: Sleep schedules and daytimefunctioning in adolescents. Child Dev. 1998, 69: 875-887.CrossRefPubMed Wolfson AR, Carskadon MA: Sleep schedules and daytimefunctioning in adolescents. Child Dev. 1998, 69: 875-887.CrossRefPubMed
9.
go back to reference Eliasson A, Eliasson A, King J, Gould B, Eliasson A: Association of sleep and academic performance. Sleep Breath. 2002, 6 (10): 45-48. 10.1055/s-2002-23157.CrossRefPubMed Eliasson A, Eliasson A, King J, Gould B, Eliasson A: Association of sleep and academic performance. Sleep Breath. 2002, 6 (10): 45-48. 10.1055/s-2002-23157.CrossRefPubMed
10.
go back to reference Dahl RE: The impact of inadequate sleep on children's daytime cognitive function. Semin Pediatr Neurol. 1996, 3: 44-50.CrossRefPubMed Dahl RE: The impact of inadequate sleep on children's daytime cognitive function. Semin Pediatr Neurol. 1996, 3: 44-50.CrossRefPubMed
11.
go back to reference Morrison DN, McGee R, Stanton WR: Sleep problems in adolescence. J Am Acad Child Adolesc Psychiatry. 1992, 31: 94-99.CrossRefPubMed Morrison DN, McGee R, Stanton WR: Sleep problems in adolescence. J Am Acad Child Adolesc Psychiatry. 1992, 31: 94-99.CrossRefPubMed
12.
go back to reference Aronren ET, Paavonen EJ, Fjallberg M, Soininen M, Torronen J: Sleep and psychiatric symptoms in school age children. J Am Acad Child Adolesc Psychiatry. 2000, 39 (4): 502-508. 10.1097/00004583-200004000-00020.CrossRef Aronren ET, Paavonen EJ, Fjallberg M, Soininen M, Torronen J: Sleep and psychiatric symptoms in school age children. J Am Acad Child Adolesc Psychiatry. 2000, 39 (4): 502-508. 10.1097/00004583-200004000-00020.CrossRef
13.
go back to reference Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14: 540-545.PubMed Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14: 540-545.PubMed
14.
go back to reference Babyak MA: What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosom Med. 2004, 66 (3): 411-21. 10.1097/01.psy.0000127692.23278.a9.PubMed Babyak MA: What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosom Med. 2004, 66 (3): 411-21. 10.1097/01.psy.0000127692.23278.a9.PubMed
15.
go back to reference Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR: A simulation study of the number of events per variable in logisticregression analysis. J Clin Epidemiol. 1996, 49 (12): 1373-1379. 10.1016/S0895-4356(96)00236-3.CrossRefPubMed Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR: A simulation study of the number of events per variable in logisticregression analysis. J Clin Epidemiol. 1996, 49 (12): 1373-1379. 10.1016/S0895-4356(96)00236-3.CrossRefPubMed
16.
go back to reference Liang KY, Zeger SL: Longitudinal data analysis usinggeneralized Linear Models. Biometrika. 1986, 73: 13-22. 10.2307/2336267.CrossRef Liang KY, Zeger SL: Longitudinal data analysis usinggeneralized Linear Models. Biometrika. 1986, 73: 13-22. 10.2307/2336267.CrossRef
17.
go back to reference Zeger SL, Liang KY: Longitudinal Data Analysis forDiscrete and continuous outcomes. Biometrics. 1986, 42: 121-130.CrossRefPubMed Zeger SL, Liang KY: Longitudinal Data Analysis forDiscrete and continuous outcomes. Biometrics. 1986, 42: 121-130.CrossRefPubMed
18.
go back to reference Kline R: Data preparation and screening. Principles and Practice of Structural Equation Modeling. Edited by: Kline R. 1998, New York: The Guilford Press, 67-94. Kline R: Data preparation and screening. Principles and Practice of Structural Equation Modeling. Edited by: Kline R. 1998, New York: The Guilford Press, 67-94.
19.
go back to reference Horton NJ, Bebchuk JD, Jones CL, et al: Goodness of fitfor GEE: An example with mental health service utilization. Stat Med. 1999, 18: 213-222. 10.1002/(SICI)1097-0258(19990130)18:2<213::AID-SIM999>3.0.CO;2-E.CrossRefPubMed Horton NJ, Bebchuk JD, Jones CL, et al: Goodness of fitfor GEE: An example with mental health service utilization. Stat Med. 1999, 18: 213-222. 10.1002/(SICI)1097-0258(19990130)18:2<213::AID-SIM999>3.0.CO;2-E.CrossRefPubMed
21.
go back to reference Hansen M, Janssen I, Schiff A, Zee P, Dubocovich M: The impact of school daily schedule on adolescent sleep. Pediatrics. 2005, 115 (6): 1555-1561. 10.1542/peds.2004-1649.CrossRefPubMed Hansen M, Janssen I, Schiff A, Zee P, Dubocovich M: The impact of school daily schedule on adolescent sleep. Pediatrics. 2005, 115 (6): 1555-1561. 10.1542/peds.2004-1649.CrossRefPubMed
22.
go back to reference Smith C: Sleep states and memory processes in humans:procedural versus declarative memory systems. Sleep Medicine Reviews. 2001, 5 (6): 491-506. 10.1053/smrv.2001.0164.CrossRefPubMed Smith C: Sleep states and memory processes in humans:procedural versus declarative memory systems. Sleep Medicine Reviews. 2001, 5 (6): 491-506. 10.1053/smrv.2001.0164.CrossRefPubMed
23.
go back to reference Owen JA: The practice of pediatric sleep medicine:results of a community survey. Pediatrics. 2001, 108 (3): E5- Owen JA: The practice of pediatric sleep medicine:results of a community survey. Pediatrics. 2001, 108 (3): E5-
24.
go back to reference Meissner HH, Riemer A, Santiago SM, Stein M, Goldman MD, Williams AJ: Failure of physician documentation of sleep complaints in hospitalized patients. Western Journal of Medicine. 1998, 169 (3): 146-149.PubMedPubMedCentral Meissner HH, Riemer A, Santiago SM, Stein M, Goldman MD, Williams AJ: Failure of physician documentation of sleep complaints in hospitalized patients. Western Journal of Medicine. 1998, 169 (3): 146-149.PubMedPubMedCentral
25.
go back to reference Kapur V, Strohl KP, Redline S, Iber C, O'Connor G, Nieto J: Underdiagnosis of sleep apnea syndrome in U.S. communities. Sleep and Breathing. 2002, 6 (2): 49-54. 10.1055/s-2002-32318.CrossRefPubMed Kapur V, Strohl KP, Redline S, Iber C, O'Connor G, Nieto J: Underdiagnosis of sleep apnea syndrome in U.S. communities. Sleep and Breathing. 2002, 6 (2): 49-54. 10.1055/s-2002-32318.CrossRefPubMed
26.
go back to reference Kryger MH, Walid R, Manfreda J: Diagnoses received bynarcolepsy patients in the year prior to diagnosis by a sleep specialist. Sleep. 2002, 25 (1): 36-41.PubMed Kryger MH, Walid R, Manfreda J: Diagnoses received bynarcolepsy patients in the year prior to diagnosis by a sleep specialist. Sleep. 2002, 25 (1): 36-41.PubMed
27.
go back to reference Haponik EF, Frye AW, Richards B, Wymer A, Hinds A, Pearce K, McCall V, Konen J: Sleep history is neglected diagnostic information. Challenges for primary care physicians. Journal of General Internal Medicine. 1996, 11 (12): 759-761.CrossRefPubMed Haponik EF, Frye AW, Richards B, Wymer A, Hinds A, Pearce K, McCall V, Konen J: Sleep history is neglected diagnostic information. Challenges for primary care physicians. Journal of General Internal Medicine. 1996, 11 (12): 759-761.CrossRefPubMed
28.
go back to reference BaHamman AS: Knowledge and attitude of primary health care physicians towards sleep disorders. Saudi Medical Journal. 2000, 21 (12): 1164-1167. BaHamman AS: Knowledge and attitude of primary health care physicians towards sleep disorders. Saudi Medical Journal. 2000, 21 (12): 1164-1167.
29.
go back to reference Kapur V, Blough DK, Sandblom RE, Hert R, de Maine JB, Sullivan SD, Psaty BM: The medical cost of undiagnosed sleep apnea. Sleep. 1999, 22 (6): 749-755.PubMed Kapur V, Blough DK, Sandblom RE, Hert R, de Maine JB, Sullivan SD, Psaty BM: The medical cost of undiagnosed sleep apnea. Sleep. 1999, 22 (6): 749-755.PubMed
31.
go back to reference Adolescent Brain Development: Vulnerabilities and Opportunities. Edited by: Dahl RE, Spear LP. 2004, New York. The New York Academy of Sciences Adolescent Brain Development: Vulnerabilities and Opportunities. Edited by: Dahl RE, Spear LP. 2004, New York. The New York Academy of Sciences
32.
go back to reference Millman PM: Excessive sleepiness in adolescents and young adults: Causes, consequences, and treatment strategies. Pediatrics. 2005, 115 (6): 1774-1787. 10.1542/peds.2005-0772.CrossRefPubMed Millman PM: Excessive sleepiness in adolescents and young adults: Causes, consequences, and treatment strategies. Pediatrics. 2005, 115 (6): 1774-1787. 10.1542/peds.2005-0772.CrossRefPubMed
34.
go back to reference Wahlstrom KL: Accommodating the sleep patterns of adolescents within current educational structures: an uncharted path. Adolescent Sleep Patterns: Biological, Sociological and Psychological Influences. Edited by: Carskadon M. 2002, Cambridge: Cambridge University Press, 172-197.CrossRef Wahlstrom KL: Accommodating the sleep patterns of adolescents within current educational structures: an uncharted path. Adolescent Sleep Patterns: Biological, Sociological and Psychological Influences. Edited by: Carskadon M. 2002, Cambridge: Cambridge University Press, 172-197.CrossRef
Metadata
Title
"Sleepiness" is serious in adolescence: Two surveys of 3235 Canadian students
Authors
Edward S Gibson
AC Peter Powles
Lehana Thabane
Susan O'Brien
Danielle Sirriani Molnar
Nik Trajanovic
Robert Ogilvie
Colin Shapiro
Mi Yan
Lisa Chilcott-Tanser
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2006
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-6-116

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