Duration In Adolescents Research Articles

Examining family and neighborhood level predictors of sleep duration in urban youth.

Shortened sleep duration in adolescence has been found to be associated with adverse health outcomes. While several studies have explored individual predictors, few have examined the role of neighborhood-level factors, family, and peer contexts as predictors of sleep among adolescents. We examined contextual factors of sleep duration in a sample of 1,614 urban, public high school students from the 2008 Boston Youth Survey. Neighborhood data came from the 2008 Boston Neighborhood Survey of 1,710 adult Boston residents, the 2009 American Community Survey Census (ACS), and Boston Police. Using multilevel linear regression, adjusting for neighborhood and school clustering, age, race, and sex, we found concentrated neighborhood poverty to be positively associated with sleep duration (β = 0.09, p = .03). Family context was significantly associated with longer sleep duration: >1-3 hr of homework per night reported longer sleep compared with students reporting ≤1 hr per night (β = 0.20, p = .005). Students reporting lower levels of positive parenting influence had shorter sleep duration (0-25th percentile: β = -0.25, p = .01; 26th-50th β = -0.24, p = .03), compared with students in the highest percentile. Students who never ate dinner with family had shorter sleep duration as compared with those having dinner with family 5 or more times per week (β = -0.22, p = .05). Our findings focusing on neighborhood and family context represent potentially modifiable practices. These finding are important for public health advocates and health care providers as they seek to curb the epidemic of sleep deprivation in youth. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Later high school start times associated with longer actigraphic sleep duration in adolescents.

High school start times (SSTs) directly impact adolescents' sleep timing and duration. This study investigated the associations between SSTs and actigraphically-measured 24-hour sleep duration, sleep onset, sleep offset and sleep quality. This study included 383 adolescents (Mage = 15.5, SDage = 0.6 years) participating in the age 15 wave of the Fragile Families & Child Wellbeing Study, a national birth cohort study sampling from 20 large US cities. Multilevel models used daily observations (N = 1116 school days, Mdays = 2.9, SDdays = 1.4 per adolescent) of sleep and SSTs from concordant daily diary and actigraphy. A diverse range of SSTs were included in our analyses (MSST = 08:08, SDSST = 39 minutes, RangeSST = 06:00-11:05), and are presented in the following categories for ease of interpretation: before 07:30, 07:30-07:59, 08:00-08:29, and 08:30 or later. Adolescents starting school at 08:30 or later exhibited significantly longer actigraphically-assessed 24-hour sleep duration (by 21-34 minutes, p < .05) and later sleep offset (by 32-64 minutes, p < .001) when compared with the adolescents grouped by earlier SSTs. SSTs were also analyzed continuously for comparison with existing literature, and results indicated that every 1-hour delay in SST was significantly associated with 21 minutes longer 24-hour sleep duration (p < .001), 16 minutes later sleep onset (p < .01), and 39 minutes later sleep offset (p < .001). All models controlled for covariates including socioeconomic status. These findings support pediatric and public health expert recommendations for SSTs after 08:30. In our diverse national urban sample, adolescents with SSTs at 08:30 or later, compared with adolescents with earlier SSTs, had significantly longer actigraphy-measured sleep.

Bedtime Autonomy and Cellphone Use Influence Sleep Duration in Adolescents

PurposeThe aim of this study was to examine modifiable environmental contributors of shortened sleep duration in adolescents. MethodWe assayed sleep duration over two weeks using actigraphy in a sample of 98 adolescents (ages 14–18, 51 female). Reports of adolescents setting their own bedtime and parental monitoring of bedtime were collected and, using principal components analysis, reduced to one factor representing bedtime autonomy. In a subsample of participants (n = 63) frequency of nighttime cellphone use and reports of cellphone disruption were assessed and combined into a composite score of cellphone usage. ResultsIncreasing age was associated with shorter total sleep duration, r(98) = −.28, p = .006. Age-related sleep duration was mediated by bedtime autonomy, abcs = −.11, 95% BC CI [−.2167, −.0370]. The effects of bedtime autonomy were moderated by nighttime cellphone use such that bedtime autonomy was most problematic for adolescents who used cellphones more frequently, B = −10.44, SE = 4.64, 95% BC CI [−21.3749, −2.8139], compared with those who used cellphones less frequently, B = −1.94, SE = 3.28, 95% BC CI [−9.8694, 3.6205]. ConclusionsAdolescence is characterized by insufficient sleep due to biological and environmental factors. Although age is frequently cited as an important element in declining sleep duration, our results suggest age may be a proxy for other co-occurring psychosocial changes during adolescence. These findings identify mechanisms by which parents and adolescents may help increase the amount of sleep adolescents achieve.

Effects of school time on sleep duration and sleepiness in adolescents.

Delaying the time of start of school allows for longer sleep duration, better mood, and better school performance. In South Korea, a campaign was launched in 2014 to delay the school start time to 9 a.m. We analyzed the campaign’s effects on adolescents’ total sleep duration, sleepiness (presented as weekend catch-up sleep), emotions, and school performance. Based on data from 2013, changes of sleep patterns, emotions, and academic achievement in adolescents were evaluated using the 2012–2016 Korea Youth Risk Behavior Web-based survey from two educational districts: Gyeonggi (fully participated in the delayed school start time campaign; intervention group) and Daegu/Gyeongbuk/Ulsan (DGU, never participated; control group). The primary outcomes were sleep duration, time of sleep onset, and difference in sleep duration between weekdays and the weekend. Secondary outcomes were the proportional changes of mood, stress, and school performance. The sleep duration of students in the intervention group temporarily increased in 2015. However, because there was a simultaneous delay in time of sleep onset, sleep duration returned to pre-campaign levels in 2016. Although sleep duration did not increase, weekend catch-up sleep decreased by approximately 19 minutes for students in the intervention group. Meanwhile, in the control group sleep duration tended to decrease over the same period. The impact of the campaign on students' emotions and school performance could not be confirmed. This study demonstrated that delaying the school start time to 9 a.m. reduced duration of weekend catch-up sleep with a transient increase in sleep duration in adolescents.

Bullying involvement, psychological distress, and short sleep duration among adolescents.

Previous research has found links between involvement in bullying and sleep duration in adolescents. However, little is known about the factors that might mediate these relationships. This study examined the associations between cyberbullying victimization and school bullying involvement (bully, victim, bully-victim) with short sleep duration in a large sample of middle and high school students and tested whether psychological distress mediates these relationships. Data on 5061 students (49% females; mean age = 15.1years) from the 2015 Ontario Student Drug Use and Health Survey were used. Participants self-reported their sleep duration and their levels of bullying involvement over the past year. Psychological distress was assessed using the Kessler 6 (K6) scale. Covariates in multiple linear regression analyses included age, sex, racial background, socioeconomic status, and substance use. Being a victim of cyberbullying (β = - 1.179; 95% CI - 0.238; - 0.120) or school bullying (β = - 0.119; 95% CI - 0.190; - 0.049) was associated with short sleep duration. Mediation analyses suggested that psychological distress fully mediates the relationships between being cyberbullied, a school bullying victim or bully-victim with short sleep duration. There was a complementary mediation by psychological distress on the relationship between being a bully at school and short sleep duration. These results suggest that higher levels of bullying involvement place adolescents at risk of developing higher psychological distress which, in turn, can lead to short sleep duration. Longitudinal research is necessary to confirm the mediating role of psychological distress on the relationship between bullying involvement and short sleep duration among adolescents.

Girls' Sleep Trajectories Across the Pubertal Transition: Emerging Racial/Ethnic Differences

PurposeThis study aims to examine the longitudinal association between puberty and sleep in a diverse sample of girls and explore racial/ethnic differences in this association. MethodsUsing latent growth curve modeling, the present study measured pubertal development (timing and rate) and sleep (wake time and bedtime) in 1,239 socioeconomically and ethnically diverse girls starting when they were 6–8 years old and followed longitudinally for up to 8 years. Pubertal assessment was conducted annually in clinic by physical examination, classified by sexual maturation stage for breast and pubic hair development by trained raters. ResultsIn line with previous research, black girls had the earliest pubertal development, followed by Hispanic, white, and Asian girls. Black girls, on average, reported significantly shorter sleep duration than Hispanic (β = −.20, p < .001), Asian (β = −.29, p = .002), and white (β = −.35, p < .001) girls. In a series of dual-process models, we found that early pubertal timing predicted shorter sleep duration for early-maturing black girls (breast development: β = .13, p = .005; pubic hair development: β = .14, p = .012). There was no evidence of any association between pubertal rate and sleep. All models controlled for family socioeconomic status and body mass index. ConclusionSleep is essential for many aspects of youth development, including emotional, cognitive, and physical functioning. Developmental changes associated with puberty may put some early maturing girls at risk of shorter sleep duration in adolescence and exacerbate racial/ethnic disparities in health and well-being.

Moving into poverty during childhood is associated with later sleep problems

ObjectiveA social gradient in sleep has been demonstrated across the life span, but previous studies have been cross-sectional and used self-reported socioeconomic status (SES) indicators. Using registry-based data on family income trajectories, the current study examined the association between relative poverty in childhood and subsequent sleep in adolescence. MethodsData on family income during 2004–2010 was obtained from the National Income Registry. Poverty was defined as household income <60% of the mean national income. Information on self-reported sleep was based the youth@hordaland-survey (n = 8873) conducted in 2012 when the adolescents were 16–19 years old. Latent class analysis (LCA) was used to identify trajectories of family household poverty, and analysis of variance and general linear models were used to examine associations between income trajectories and sleep, adjusting for confounders. ResultsLCA identified four classes: ‘never poor’, two classes characterized by moving in or out of poverty, and ‘chronically poor’. Compared to the ‘never poor’ group, adolescents from families in the ‘moving into poverty’ group displayed worse sleep across most sleep measures, including shorter sleep, lower sleep efficiency, and more nocturnal wake time (but not sleep onset latency). Neither adolescents from families who had moved out of poverty by increasing family income, nor the ‘chronically poor’ group differed significantly from the reference group. ConclusionsThe study found that downward socioeconomic mobility was associated with increased adolescent sleep problems. More studies are required on the mechanisms that may account for the association, to find targeted and effective strategies to prevent short sleep duration in adolescents from families with unstable financial circumstances.

Sleep duration, quality of life and depression in adolescents: a school-based survey.

The main objective of this study was to assess the link between sleep duration, quality of life and depression in adolescents. The secondary objective was to study the sleeping behavior of a large sample of adolescents from different socioeconomic backgrounds. Study subjects were high school students studying in or around Paris with a general, vocational or technological training background. A survey was conducted to evaluate the subject's perception of their own sleep, quality of life and depression. The survey analyzed 855 students between 14 and 19 years of age, with equal numbers of males and females. The average sleep duration was 7 h 14 min ±1 h 20 min and was inversely correlated with age (r=-0.142, P<0.01). Students studying vocational subjects reported significantly more sleep than students studying technological subjects (P=0.02). Univariate analyses revealed a positive relationship between sleep duration and quality of life (r=0.17, P<0.001) and an inverse relationship between sleep duration and depression (r=-0.5, P<0.001). Multivariate analyses identified depression, delayed sleep phase disorder, and medical condition as determinants of sleep duration. This investigation of a large student cohort has confirmed that the average sleep duration in adolescents is far below what is recommended. Depression significantly influenced sleep duration. We recommend that a quantitative and qualitative evaluation of sleep should be made during the medical examination of any adolescent.

School‐Based Sleep Education Programs for Short Sleep Duration in Adolescents: A Systematic Review and Meta‐Analysis

Insufficient sleep among students is a major school health problem. School-based sleep education programs tailored to reach large number of students may be one of the solutions. A systematic review and meta-analysis was conducted to summarize the programs' effectiveness and current status. Electronic databases were searched up until May 2015. Randomized controlled trials of school-based sleep intervention among 10- to 19-year-old students with outcome on total sleep duration were included. Methodological quality of the studies was assessed using the Cochrane's risk of bias assessment. Seven studies were included, involving 1876 students receiving sleep education programs and 2483 attending classes-as-usual. Four weekly 50-minute sleep education classes were most commonly provided. Methodological quality was only moderate, with a high or an uncertain risk of bias in several domains. Compared to classes-as-usual, sleep education programs produced significantly longer weekday and weekend total sleep time and better mood among students at immediate post-treatment, but the improvements were not maintained at follow-up. Limited by the small number of studies and methodological limitations, the preliminary data showed that school-based sleep education programs produced short-term benefits. Future studies should explore integrating sleep education with delayed school start time or other more effective approaches.

Association Between Active Commuting To School And Sleep Duration In Ecuadorian Youth

PURPOSE: Active commuting has been associated to longer sleep duration in adolescents, however, the literature is still limited. Thus, the aim of this study was to investigate the association between the mode of commuting to and from school and sleep duration in Ecuadorian youth. METHODS: A total of 732 students (13.6+2.1 years, 65.3% boys) belonging to 3 schools from Riobamba (Ecuador) were recruited via convenience sampling in class. Participants completed a self-reported paper-based questionnaire about personal data, usual mode of commuting to and from school and regular sleep-wake schedule at night on normal school days. Via sleep-wake schedule, sleep duration was calculated for each individual. They were classified as active (walk or bike), and passive (motorbike, bus, car or another motorized transport). Participants were also classified into two groups: sleeping at night for at least 8 hours/day or less than 8 hours/day. Binary logistic regression analyses were applied to examine the association between the mode of commuting (active vs passive) to and from school and the sleep duration (<8 hours/day and >8 hours/day) after correction for confounding factors (age, gender). RESULTS: The main mode of commuting used by Ecuadorian students was passive (86.4%), whereas active modes were less used (12.6%). The main passive mode chosen was the car (≈40%), followed by public bus (≈21%) and school bus (≈17%). Active commuters were more likely to sleep at least 8 hours/day than passive commuters showing a trend towards an increase in the sleep duration (OR, 95 % CI 1.50, 0.945 to 2.409, p=0.085). CONCLUSIONS: Active commuting to school could be associated with sleep duration in youth. The links between lifestyle factors, as sleep duration and active commuting to school need to be investigated in greater depth in order to promote public health strategies in youth.

Association of Exclusive Breastfeeding Duration With Systemic Inflammation Markers in Adolescents: A Cross-Sectional Study.

Breastfeeding duration has been associated with less low-grade inflammation in healthy adolescents, but there is scarce information regarding obese subjects. This study aimed to evaluate whether exclusive breastfeeding is related to serum concentrations of inflammatory markers in a population of Spanish adolescents. A cross-sectional study was performed on 1,001 adolescents (13.2 ± 1.2 years) randomly recruited from schools in southeast Spain. Data on breastfeeding duration were collected via a parental questionnaire. Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were determined by enzyme-linked immunosorbent assay. C-reactive protein (CRP) was determined by solid-phase chemiluminescent immunometric assay. Nonadjusted and adjusted multivariate correlation analyses confirmed a strong association ( p < .001, 95% confidence interval) between the three markers of inflammation and exclusive breastfeeding duration. No significant differences were observed for IL-6, TNF-α, and CRP serum concentrations among normal weight, overweight, and obese adolescents, except for IL-6 between normal weight and obese subjects. Likewise, no significant association was found between these markers of inflammation and body mass index (BMI) z-score. We found a possible association between inflammatory markers and exclusive breastfeeding duration in adolescents, regardless of their BMI. This finding suggests that increased body weight or obesity might not mediate the association between breastfeeding and inflammation. These results contribute to the understanding of the relationship between breastfeeding and inflammatory markers in adolescents.

Changing Risk Trajectories and Health Outcomes for Vulnerable Adolescents: Reclaiming the Future.

Adolescents in the juvenile justice system are underserved and understudied even though they are disproportionately affected by myriad health risks and comorbidities.1 Less well understood is whether duration of incarceration is associated with poorer long-term health outcomes and whether risk behaviors persist into adulthood. This issue of Pediatrics provides 2 studies addressing these questions. Barnert et al2 analyzed data from the National Longitudinal Study of Adolescent to Adult Health and observed that incarceration duration in adolescence and early adulthood is independently predictive of poorer physical and mental health in adulthood. Relative to adolescents without an incarceration history, incarceration duration of 1 year predicted adult functional limitations, adult depressive symptoms, and adult suicidality. In a related study, Abrams et al3 examined changes in adolescents’ HIV and AIDS sex- and drug-risk behaviors during the 14 years after incarceration. Although risk behaviors decreased, the prevalence of sexual risk behaviors remained higher than in the general population, with marked racial differences. As adolescents traverse the developmental trajectory to adulthood, we need to marshal new initiatives to reduce risk behaviors and improve … Address correspondence to Ralph J. DiClemente, PhD, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Room 554, Atlanta, GA 30322. E-mail: rdiclem{at}emory.edu

Sleep quality and its parameters in schoolchildren

Sleep disorders are very common among teenagers. One of possible reasons is a discrepancy between social and biological activity of children. It is known that adolescents with a late chronotype (e.g., a later midpoint of sleep) have a lowered academic achievement. The aim of our study was to evaluate sleep quality and other sleep-wake characteristics in relation to academic scores self-reported by teenagers living in urban and rural areas of Republic of Karelia. Five hundred respondents, aged 10-17 years, participated in a questionnaire survey of chronotype and sleep quality. The Munich chronotype questionnaire (MCTQ) and the Pittsburgh Sleep Quality Index (PSQI) were used. Sleep duration during week and weekend, sleep quality and hygiene were assessed. A decrease in sleep duration in adolescents, aged 10-18 years, was observed. A larger social jetlag was significantly higher in girls compared to boys. Gender had a significant impact on sleep quality. More than 10% of the total variation in academic achievement of Karelian teenagers can be explained by the difference in their gender and average sleep duration.

Relationship between Mobile Phone Addiction and the Incidence of Poor and Short Sleep among Korean Adolescents: a Longitudinal Study of the Korean Children & Youth Panel Survey.

Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011–2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality.

Relationship Between Time to Initiation of Antiretroviral Therapy and Treatment Outcomes: A Cohort Analysis of ART Eligible Adolescents in Zimbabwe.

Age-specific retention challenges make antiretroviral therapy (ART) initiation in adolescents difficult, often requiring a lengthy preparation process. This needs to be balanced against the benefits of starting treatment quickly. The optimal time to initiation duration in adolescents is currently unknown. To assess the effect of time to ART initiation on mortality and loss to follow-up (LTFU) among treatment eligible adolescents. We conducted a retrospective cohort analysis among 1499 ART eligible adolescents aged ≥10 to <19 years registered in a public sector HIV program in Bulawayo, Zimbabwe, between 2004 and 2011. Hazard ratios (HR) for mortality and LTFU were calculated for different time to ART durations using multivariate Cox regression models. Median follow-up duration was 1.6 years. Mortality HRs of patients who initiated at 0 to ≤7 days, >14 days to ≤1 month, >1 to ≤2 months, >2 months, and before initiation were 1.59, 1.19, 1.56, 1.08, and 0.94, respectively, compared with the reference group of >7 to ≤14 days. LTFU HRs were 1.02, 1.07, 0.85, 0.97, and 3.96, respectively. Among patients not on ART, 88% of deaths and 85% of LTFU occurred during the first 3 months after becoming ART eligible, but only 37% and 29% among adolescents on ART, respectively. Neither mortality or LTFU was associated with varying time to ART. The initiation process can be tailored to the adolescents' needs and individual life situations without risking to increase poor treatment outcomes. Early mortality was high despite rapid ART initiation, calling for earlier rather than faster initiation through HIV testing scale-up.

Insomnia Phenotypes Based on Objective Sleep Duration in Adolescents: Depression Risk and Differential Behavioral Profiles.

Based on previous studies on the role of objective sleep duration in predicting morbidity in individuals with insomnia, we examined the role of objective sleep duration in differentiating behavioral profiles in adolescents with insomnia symptoms. Adolescents from the Penn State Child Cohort (n = 397, ages 12–23, 54.7% male) underwent a nine-hour polysomnography (PSG), clinical history, physical examination and psychometric testing, including the Child or Adult Behavior Checklist and Pediatric Behavior Scale. Insomnia symptoms were defined as a self-report of difficulty falling and/or staying asleep and objective “short” sleep duration as a PSG total sleep time ≤7 h. A significant interaction showed that objective short sleep duration modified the association of insomnia symptoms with internalizing problems. Consistently, adolescents with insomnia symptoms and short sleep duration were characterized by depression, rumination, mood dysregulation and social isolation, while adolescents with insomnia symptoms and normal sleep duration were characterized by rule-breaking and aggressive behaviors and, to a lesser extent, rumination. These findings indicate that objective sleep duration is useful in differentiating behavioral profiles among adolescents with insomnia symptoms. The insomnia with objective short sleep duration phenotype is associated with an increased risk of depression earlier in the lifespan than previously believed.

Physical Activity, Screen-Based Sedentary Behavior, and Sleep Duration in Adolescents: Youth Risk Behavior Survey, 2011-2013.

This study examined the concurrent associations of physical activity and screen-based sedentary behavior with sleep duration among adolescents by using data from the national Youth Risk Behavior Survey 2011–2013. Using latent class analysis, we identified 4 latent subgroups of adolescents with various levels of physical activity and screen-based sedentary behavior. The subgroup with high levels of physical activity and low levels of sedentary behavior generally showed greater odds of having sufficient sleep (≥8 hours/night) than the other subgroups. Findings imply that concurrent achievement of a high level of physical activity and low level of screen-based sedentary behavior is necessary to promote sufficient sleep among adolescents.

Prevalence of sleep disorders and their relationship with core symptoms of inattention and hyperactivity in children with attention-deficit/hyperactivity disorder.

To determine the prevalence of sleep disorders in children with attention-deficit/hyperactivity disorder (ADHD) and in a control population. To examine the relationship between sleep disorders and symptoms of inattention, hyperactivity/impulsiveness and executive dysfunction. We studied 126 children with ADHD and 1036 control children aged between 5 and 18 years old. Caregivers completed the Pediatric Sleep Questionnaire and the ADHD Rating Scale (ADHD-RS). Children with ADHD were subsequently assessed for executive function with the Conner's Continuous Performance Test (CPT) or with AULA Nesplora. Children with ADHD slept less at night and were more likely to display sleep-related rhythmic movements. Children in the ADHD group who were under 12 years old and who had total ADHD-RS scores over the 90th percentile had more difficulty falling asleep than other children; there was also a relationship between total ADHD-RS scores over the 90th percentile and certain parasomnias in the control population. There was a correlation between shorter duration of night-time sleep and omission errors in children who were 12 or older and who were under pharmacological treatment for ADHD. Bedtime resistance and difficulty falling sleep were more frequent in children with ADHD whose symptoms were not treated pharmacologically, than in children receiving treatment. Symptoms of inattention and hyperactivity are correlated with impaired sleep duration and quality; specifically, there is an association between ADHD symptoms and problems falling asleep and parasomnias, however, the current study does not address the nature and direction of causality. Children with ADHD and receiving methylphenidate had fewer sleep disorders, suggesting that, at least in some children, stimulant treatment is associated with improvement of some aspects of sleep. Shorter sleep duration in adolescents under pharmacological treatment for ADHD tended to result in more errors of omission, suggesting that it is important to promote good sleep habits in this population.

Correlates of self-reported weekday sleep duration in adolescents: the 18-year follow-up of the 1993 Pelotas (Brazil) Birth Cohort Study

ObjectiveTo investigate factors associated with sleep duration in adolescence. MethodsData are from the 1993 Pelotas Birth Cohort Study of 5249 live births. Of these individuals, 4563 were located for follow-up at 18 years of age, and 4106 agreed to be interviewed (follow-up rate 81.3%). Sleep duration was continuously assessed by survey as hours per weekday. Additional covariates were collected during the perinatal period and at the 11- and 18-year follow-ups. Linear regression models were used to estimate associations between sleep duration and its hypothesized influences. All analyses were sex-stratified. ResultsThe average sleep duration among participants was 8.4 hours (standard deviation 1.9). Longer sleep duration at 18 years of age was associated with the following perinatal factors: low maternal schooling, low family income, maternal black skin color, and low birth weight; and with the following factors measured at 18 years of age: being out of school, low achieved schooling, low family income, absence of depressive symptoms, and high screen time. ConclusionSocial and demographic variables may play an important role in determining adolescents' sleep duration, but the nature of these relationships in Brazil may differ from those observed in higher-income contexts.

Concurrent Associations Of Physical Activity And Screen-based Sedentary Behaviors On Sleep Duration Among Us Adolescents

Adolescence is a vulnerable period for experiencing insufficient sleep due to puberty-related changes in circadian rhythm and increasing sleep deprivation during school days. Physical activity (PA) and sedentary behaviors (SB) are well-documented, modifiable sleep hygiene behaviors independently associated with sleep duration; however, scarce data are available regarding their concurrent associations in adolescents. PURPOSE: This study examined the concurrent associations of PA and screen-based SB on sleep duration in US adolescents using a latent class analysis (LCA) approach. METHODS: A total of 11,204 adolescents who participated in the 2013 Youth Risk Behavior Survey were analyzed. The outcome variables of interest included self-reported PA regarding 1) moderate and vigorous-intensity PA ≥ 60 minutes/day; 2) sport team participation ≥ 1 per year; and 3) muscle-strengthening exercise ≥ 3 days/week; and self-reported screen-based SB regarding 4) watching TV ≥ 3 hours/day; and 5) using a computer/playing video games ≥ 3 hours/day. Self-reported sleep durations on average school nights was obtained to determine the sufficient sleep (≥8 hours). A LCA model was developed 1) to identify the latent subgroups with varying response probabilities of each PA and screen-based SB items; and 2) to examine the associations of latent subgroups with likelihood of having sufficient sleep. RESULTS: Four latent subgroups with varying levels of PA and screen-based SB were identified. Using the estimated response probability ≥ .50 as a threshold to determine ‘High’ level of respective PA and screen-based SB items, four latent subgroups were characterized as the High PA/Low SB (26.06%), High PA/High SB (23.23%), Low PA/Low SB (29.41%), and Low PA/High SB (21.29%). The likelihoods of having sufficient sleep was greater for the High PA/Low SB when comparing to the High PA/High SB (OR = 1.51) and Low PA/Low SB (OR = 1.49), whereas no difference was found when comparing to the Low PA/High SB. CONCLUSIONS: The results demonstrated the complexity of concurrent associations of PA and screen-based SB with sleep duration in adolescents. However, the findings generally implied that increasing PA and reducing screen-based SB would yield greater likelihood of having sufficient sleep in this population.