Abstract
Among adolescents, mental health issues (i.e., stress and depressive symptoms) negatively affect sleep. We assessed whether the association between mental health and sleep varied between genders among Saudi adolescents. A total of 2206 school students (grades 7-12) from 40 randomly selected schools in four cities of Al-Qassim province in Saudi Arabia participated in this cross-sectional study. The survey assessed demography, lifestyle, sleep (12-item Medical Outcomes Study Sleep Scale), depression (Depression, Anxiety, Stress Scale (DASS-21)) and stress (10-item Perceived Stress Scale). Adjusted associations with sleep were tested with linear and logistic regressions. Of the sample, 55% were girls, and their average sleep score was lower than that of the boys (58.7 vs. 63.4, p < 0.001). Girls had worse mental health than boys; the proportion of girls with both severe stress and severe depressive symptoms was three times higher than that of the boys (12% vs. 4%, p < 0.001). For both boys and girls, those with severe depressive symptoms only or both severe depressive symptoms and severe stress had significantly lower sleep scores than those who had neither of the two conditions (reference group). On the other hand, among those who had severe stress only, the sleep score was significantly lower for the girls (p = 0.002) than for the boys (p = 0.19). Overall, girls had a significantly lower sleep score and worse mental health than boys. The association between mental health and sleep significantly differed between the sexes. Severe stress was negatively associated with sleep in girls but not in boys.
Highlights
Sleep plays a crucial role in the growth and development of adolescents, including their learning and cognition [1]
2675 students who were enrolled in governmental schools in four main cities of the central region of Saudi Arabia participated in this 2018 survey
Around 10% were from a single-parent home, 4% were smokers, 46% reported consuming an unhealthy diet, and 20% reported being physically inactive
Summary
Sleep plays a crucial role in the growth and development of adolescents, including their learning and cognition [1]. They may not be getting adequate sleep in this age of information technology due to an overreliance on electronic gadgets. Inadequate (or poor quality) sleep will likely put them at higher risk of psychological distress/disorders [4]. It affects adolescents in a myriad of other negative ways, such as inattentiveness, reduced academic performance, delinquent behavior, accidents, injury, obesity, and metabolic disturbances, to name a few [4, 5]
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