S33.C Adolescents' health and sleep problems in Thai urban and rural communities

Abstract

There is a global trend of increase in sleep problems, among adolescents with rapid changes in lifestyles, academic and social demand. Modernization, media and information technologies with less parental control, allow children and adolescents to spend more time particularly during late hours, disrupting their normal sleep waking cycles. In addition, socio-economic and political problems increase conflicts and violence in families and communities have added more stresses to life. In this community based study, using 2 steps stratified random sampling method to identify 1670 households representatives of the population in five provinces located in different geographical areas in Thailand, 315 adolescents age 12−18 years old, mean age 14.70±1.97 years, were interviewed during home visit. Thai version of Subjective Health Complaints Questionnaire, Strength and Difficulties Questionnaire (SDQ) and Health Related Quality of Life (HRQoL) Questionnaire were used for self assessment. Sleep problems were reported in 35.7%; with significantly higher prevalence in females (41.8%) than males (26.6%); late adolescence 16 years (41.2%) than younger age groups (34.3%); and in urban (41.3%) than rural settings (29%). Among those with sleep problems, self assessment of strength and difficulties showed significantly higher difficulties mean score 14.18±6.31 versus 11.6±4.51 (p = 0.0001), with higher emotional problems scores. Significant association was found in Subjective Health Complaints between sleep problem and tiredness, depression, and anxiety. Excellent and very good health status was found in higher percentage among those without sleep problem (46.46%) than poor sleepers (29.09%). The HRQoL revealed that in the last 30 days, the numbers of days affected by physical illness, mental problems and inability to function normally increased according to the severity of sleep problems. Adolescents with sleep problems reported more days affected by physical and mental problems within the last 30 days. Severe sleep problems associated with longer period of absence from schools or work at highly significant level (6.8±10.7 versus 1.04±3.1 days; p = 0.00001). In conclusion, Thai adolescents were faced with sleep problems which related negatively to both their physical and mental health. Parents, health care providers, educators, children and adolescents themselves need to be aware about sleep problems and the consequences on health and performance, implement high school sleep education programs and cooperate in adjusting daily routine for adequate sleep. Contributed support: Research grants from Royal Thai Government through Mahidol University.