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Adolescents' sleep in a 24/7 society: Epidemiology and prevention
Örebro University, School of Law, Psychology and Social Work.ORCID iD: 0000-0002-1485-8564
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Sleep undergoes important changes during adolescence and many teenagers experience problems sleeping. These in turn affect adolescents´ academic, physical and psychosocial functioning. Moreover, there are some indications that sleep problems in this age group may be increasing, possibly as a consequence of societal changes, e.g., internet availability. Research on adolescents´ sleep is growing, but more epidemiological studies are needed to clarify the prevalence of poor sleep, long and short-term outcomes associated with it, and potential risk and protective factors to target in preventive interventions. The aim of this dissertation was to contribute to each of these goals; Study I investigated the longitudinal association between sleep problems, defined as symptoms of insomnia, and school absenteeism; Study II explored the prevalence of poor sleep, defined as sleep deficit, in an adolescent population and psychosocial and contextual factors associated with it, including emotional and behavioral problems, stress, sleep hygiene and technology use; finally, Study III evaluated the short-term effects of a novel universal school-based intervention to improve adolescents´ sleep health.

The findings show that poor sleep was strongly related to adolescents´ functioning, including emotional and behavioral problems and school attendance, and that sleep deficit was prevalent in adolescents. This supports the need for prevention. Moreover, sleep deficit was associated with stress, technology use and arousal at bedtime, which may represent important barriers to sleep. A preventive intervention targeting these barriers to promote adolescents´ sleep health was successful with the individuals most at risk. However, it remains to be seen whether these changes will be maintained after the intervention and whether incidence of sleep problems will be lower relative to a control group. Implications for theory and practice are discussed.

Place, publisher, year, edition, pages
Örebro: Örebro University , 2017. , 76 p.
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 37
Keyword [en]
Sleep problems, adolescents, sleep deficit, insomnia, sleep duration, technology, stress, prevention, epidemiology
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
URN: urn:nbn:se:oru:diva-57856ISBN: 978-91-7529-202-1 (print)OAI: oai:DiVA.org:oru-57856DiVA: diva2:1103675
Public defence
2017-09-11, Örebro universitet, Långhuset, Hörsal 2, Fakultetsgatan 1, Örebro, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2017-05-30 Created: 2017-05-30 Last updated: 2017-10-16Bibliographically approved
List of papers
1. Too tired for school?: the effects of insomnia on absenteeism in adolescence
Open this publication in new window or tab >>Too tired for school?: the effects of insomnia on absenteeism in adolescence
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2015 (English)In: Sleep Health, ISSN 2352-7218, E-ISSN 2352-7226, Vol. 1, no 3, 205-210 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Sleep has important consequences for a person's daytime functioning. Numerous studies have shown that insomnia predicts work absenteeism and work disability in adults, but only a few studies have examined this association in adolescents. This study aims to explore whether symptoms of insomnia in adolescents predict school absenteeism 1 year later, over and above known psychological risk factors for absenteeism.

Design: The study used a longitudinal design with 2 measurement points over 1 year.

Setting: The students completed questionnaires during school hours at baseline and again at follow-up.

Participants: Students in the 10th to 12th grades in a Swedish upper secondary school were followed prospectively for 1 year (age, 16-20 years; N = 353; 48.1% girls).

Measurements and results: We used logistic regression analyses, controlling for the known effects of psychological factors, and arrived at a model elucidating the role of insomnia. That is, besides symptoms of insomnia, the model included previous absenteeism, alcohol intoxication, school-related social phobia, social anxiety, depressive symptoms, somatic symptoms, and bully victimization. Symptoms of insomnia predicted school absenteeism 1 year later, over and above known risk factors for absenteeism. Adolescents reporting severe symptoms of insomnia were almost 3 times more likely than adolescents reporting no or low symptoms to report problematic absenteeism 1 year later. We did not find any gender difference.

Conclusions: Our findings underscore the importance of sleep problems on adolescents' daytime functioning as measured by school absenteeism. Therefore, sleep may be an important target for preventive interventions with adolescents.

Place, publisher, year, edition, pages
Elsevier, 2015
Keyword
Sleep, Insomnia, School absenteeism, Adolescence, Longitudinal
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-46656 (URN)10.1016/j.sleh.2015.07.007 (DOI)2-s2.0-84940890895 (Scopus ID)
Available from: 2015-11-27 Created: 2015-11-20 Last updated: 2017-10-16Bibliographically approved
2. Sleep duration and patterns in adolescents: Correlates and the role of daily stressors
Open this publication in new window or tab >>Sleep duration and patterns in adolescents: Correlates and the role of daily stressors
2016 (English)In: Sleep Health, ISSN 2352-7218, E-ISSN 2352-7226, Vol. 2, no 3, 211-218 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The first aim of this study was to assess the prevalence of sleep deficit in a large sample of adolescents. Second, the study aimed to assess whether short sleep duration in the sample was associated with emotional and behavioral problems. Lastly, the study aimed to investigate the association between daily stressors-bedtime activities and sleep duration.

Design: Cross-sectional survey.

Setting: The questionnaires were completed during school hours in 17 municipal junior high schools in Sweden.

Participants: A total of 2767 adolescents aged 12 to 16 years, 48% girls.

Measurements and Results: Sleep measures included total sleep time (TST) for schooldays and weekends, obtained as combined measures of self-reported bed-time, wake-time, and sleep onset latency. We used the new National Sleep Foundation's guidelines to operationalize sleep duration. Overall 12% of younger adolescents (age 12-13 years) and 18% of older adolescents (14-16 years) slept less than recommended (TST < 7 hours). Adolescents reporting nonrecommended TST also reported more behavioral (ie, norm-breaking behaviors) and emotional problems (ie, depression, anxiety, and anger), with effects in the small-medium range. Finally, adolescents reporting bedtime arousal and use of information and communication technology in bed were more likely to report TST < 7 hours. Stress at home (for younger adolescents) and stress of school performance (for older adolescents) were also associated with TST less than 7 hours.

Conclusions: The new National Sleep Foundation's recommendations were informative in this context. Future sleep interventions need to target barriers to good sleep practices, such as use of information and communication technology, stress, and worry that may contribute to arousal at bedtime.

Place, publisher, year, edition, pages
Elsevier, 2016
Keyword
National Sleep Foundation (NSF); Sleep duration recommendations; Sleep deficit; Sleep patterns; Emotional and behavioral problems; Adolescent sleep; Daily stressors; Electronic media; Information and communication technology (ICT); Sleep hygiene; Bedtime arousal
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-51652 (URN)10.1016/j.sleh.2016.05.006 (DOI)2-s2.0-84977147448 (Scopus ID)
Projects
Tre Stads Studien
Funder
Swedish Research Council FormasSwedish Research CouncilVINNOVA
Note

Funding agency:

Forskningsrådet för Arbetsliv och Socialvetenskap (FAS)

Available from: 2016-08-11 Created: 2016-08-11 Last updated: 2017-10-16Bibliographically approved
3. Making room for sleep: The evaluation of a preventive school-based program to improve adolescents´ sleep
Open this publication in new window or tab >>Making room for sleep: The evaluation of a preventive school-based program to improve adolescents´ sleep
(English)Manuscript (preprint) (Other academic)
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-59254 (URN)
Available from: 2017-08-23 Created: 2017-08-23 Last updated: 2017-10-16Bibliographically approved

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