Sharma Mahesh, Bista Parvati, Khatri Bijay, Upadhyaya Dipak Prasad, Khanal Vijay Kumar, Sapkota Bhim Prasad, Tiwari Dipak Prasad, Jha Nilambar, Baral Dharanidhar, Gurung Gyanu Nepal, Acharya Dilaram
B.P. Memorial Health Institute and Research Center, Kathmandu, Nepal.
Ministry of Health and Population, Kathmandu, Nepal.
PLOS Glob Public Health. 2025 Jan 6;5(1):e0004083. doi: 10.1371/journal.pgph.0004083. eCollection 2025.
Insomnia among adolescents is a prevalent public health concern and is closely linked to suicidal tendencies, health risk behaviors, and other adverse health outcomes. This study builds on existing literature by exploring the multifaceted associations between insomnia and socio-behavioral factors, which are currently underexplored in the Nepalese context. It assesses the prevalence of insomnia and its association with socio-behavioral factors and internet addiction among adolescents in Bagmati Province, Nepal, to inform targeted public health interventions. From July to September 2022, a school-based descriptive cross-sectional study was conducted among grade 9 and 10 students (aged 13-19) using a self-administered semi-structured questionnaire. A questionnaire included the 7-item Insomnia Severity Index (ISI) for insomnia assessment and the 20-item Young's Internet Addiction Test for evaluating internet addiction. Binary logistic regression analysis was utilized to identify factors associated with insomnia. The study identified a significant prevalence of insomnia at 24.2%. Key socio-behavioral determinants included religion [AOR 3.58; 95% CI 1.56-8.23, AOR 3.36; 95% CI 1.27-8.89], experience of a break up [AOR 1.67; 95% CI 1.10-2.55] absence of close friendships [AOR 2.62; 95% CI 1.32-5.19], exposure to bullying [AOR 1.74, 95% CI 1.12-2.70], and internet addiction [AOR 2.74; CI 1.83-4.11]. These findings highlight the complex interplay of individual and environmental factors influencing insomnia. The significant prevalence of insomnia among school-going adolescents in Bagmati Province underscores the necessity for enhancing the role of schools in health counselling that considers behavioural, social, and demographic factors. Addressing internet addiction, fostering healthy social connections, and acknowledging the impact of demographic factors like religion could enhance intervention strategies.
青少年失眠是一个普遍的公共卫生问题，与自杀倾向、健康风险行为及其他不良健康后果密切相关。本研究基于现有文献，探讨失眠与社会行为因素之间的多方面关联，而这在尼泊尔背景下目前尚未得到充分研究。该研究评估了尼泊尔加德满都谷地省青少年失眠的患病率及其与社会行为因素和网络成瘾的关联，以为有针对性的公共卫生干预提供依据。2022年7月至9月，使用自行填写的半结构化问卷，对9年级和10年级学生（年龄在13 - 19岁之间）开展了一项基于学校的描述性横断面研究。问卷包括用于评估失眠的7项失眠严重程度指数（ISI）和用于评估网络成瘾的20项杨氏网络成瘾测试。采用二元逻辑回归分析来确定与失眠相关的因素。该研究发现失眠的患病率高达24.2%。关键的社会行为决定因素包括宗教信仰（调整后比值比[AOR]为3.58；95%置信区间[CI]为1.56 - 8.23，AOR为3.36；95% CI为1.27 - 8.89）、分手经历（AOR为1.67；95% CI为1.10 - 2.55）、缺乏亲密友谊（AOR为2.62；95% CI为1.32 - 5.19）、遭受欺凌（AOR为1.74，95% CI为1.12 - 2.70）以及网络成瘾（AOR为2.74；CI为1.83 - 4.11）。这些发现凸显了影响失眠的个体因素和环境因素之间的复杂相互作用。加德满都谷地省在校青少年中失眠的高患病率强调了加强学校在考虑行为、社会和人口因素的健康咨询方面作用的必要性。解决网络成瘾问题、培养健康的社会联系以及认识到宗教等人口因素的影响，可能会增强干预策略。
