Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta Adorno Antoniotto, 11, 27100, Pavia, Italy.
Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
Eur J Pediatr. 2023 Jun;182(6):2625-2634. doi: 10.1007/s00431-023-04934-0. Epub 2023 Mar 23.
The present study explores the concurrent contribution to sleep problems of individual-related, family-related, and school-related factors in adolescence. Gathering from the Italian 2018 Health Behavior in School-Aged Children (HBSC) data collection, we used hierarchical logistic regression on a sample of 3397 adolescents (51% females, Mage = 13.99, SD = 1.62) to explore the contribution to sleep problems of the individual (Model 1: alcohol use, smoking, screen time, physical activity), familial (Model 2: parental communication, parental support), and school-related (Model 3: peer support, schoolmates/students support, teacher support and school pressure) variables. 28.3 percent of adolescents reported having sleep difficulties. Overall, Model 3 significantly improved over Model 2 and Model 1. Data showed that increasing smoking (OR = 1.11; 95% CI: 1.03-1.20) and screen time (OR = 1.05; 95% CI: 1.02-1.08) were associated with sleep difficulties but not alcohol use and physical activity. Also, impaired communication with both parents and increasing parental support (OR = 0.84; 95% CI: 0.78-0.90) were associated with decreased odds of sleep problems. Finally, both increases in school pressure (OR = 1.40; 95% CI: 1.26-1.56) and lack of student support (OR = 1.25; 95% CI: 1.10-1.42) were associated with a higher likelihood of sleep problems, while peer support and teacher support were not. Conclusion: Our findings highlight the importance of an integrated approach to the study of sleep difficulties in adolescence that includes specific psychosocial contributors such as the quality of parental communication and perceived parental support and considers the quality of the day-to-day relationship with schoolmates and the school level of demands. What is Known: • Adolescents' are at-risk of more significant sleep difficulties, and recent literature highlights the importance of an integrated approach to understanding this phenomenon, including biological, psychosocial, and contextual factors. • The literature lacks findings that consider the concurrent contribution of individual and psychosocial factors to sleep difficulties in adolescence. What is New: • The quality of parental communication and perceived parental support, as expressions of adult figures' emotional and behavioural availability in the adolescent's life, are significant determinants of sleep difficulties. • The quality of day-to-day relationships with schoolmates and the school level of demands contribute to adolescent sleep problems.
本研究探讨了个体相关、家庭相关和学校相关因素对青少年睡眠问题的共同贡献。我们从意大利 2018 年的健康行为在学校儿童（HBSC）数据收集，使用分层逻辑回归对 3397 名青少年（51%为女性，Mage=13.99，SD=1.62）的样本进行分析，以探讨个体（模型 1：饮酒、吸烟、屏幕时间、体育活动）、家庭（模型 2：父母沟通、父母支持）和学校相关（模型 3：同伴支持、同学/学生支持、教师支持和学校压力）变量对睡眠问题的贡献。28.3%的青少年报告有睡眠困难。总体而言，模型 3 显著优于模型 2 和模型 1。研究数据表明，增加吸烟（OR=1.11；95%CI：1.03-1.20）和屏幕时间（OR=1.05；95%CI：1.02-1.08）与睡眠困难有关，但与饮酒和体育活动无关。此外，与父母双方沟通不良和父母支持增加（OR=0.84；95%CI：0.78-0.90）都与降低睡眠问题的几率有关。最后，学校压力的增加（OR=1.40；95%CI：1.26-1.56）和缺乏学生支持（OR=1.25；95%CI：1.10-1.42）都与睡眠问题的可能性增加有关，而同伴支持和教师支持则没有。结论：我们的研究结果强调了一种综合方法的重要性，即包括特定的社会心理因素，如父母沟通质量和感知到的父母支持，以及考虑与同学的日常关系和学校的需求水平，来研究青少年的睡眠困难。已知的是：•青少年面临更大的睡眠困难风险，最近的文献强调了采用综合方法来理解这一现象的重要性，包括生物、社会心理和环境因素。•文献中缺乏关于个体和社会心理因素对青少年睡眠困难的共同贡献的研究结果。新的是：•父母沟通质量和感知到的父母支持，作为成年人物在青少年生活中情感和行为可用性的表现，是睡眠困难的重要决定因素。•与同学的日常关系质量和学校的需求水平都有助于青少年的睡眠问题。
