Pagnotta Valerie F, Donnelly Peter D, Gobina Inese, Elgar Frank, Ng Kwok, Pickett William
Department of Health Sciences, Brock University, St Catharines, ON, Canada.
School of Medicine, University of St Andrews, St Andrews, Fife, United Kingdom.
Eur J Public Health. 2025 Jun 1;35(3):505-511. doi: 10.1093/eurpub/ckaf032.
Adolescent poor sleep is common and has been associated with unintentional injury risks. Yet the comparability of evidence is limited by differences in measures of sleep and injury implemented across studies. We examined the potential cross-national consistency of relationships between poor sleep and unintentional injury using self-reports from 239 816 adolescents (50.8% girls) in 46 countries collected using a common survey procedure. A cross-sectional study was conducted using nationally representative records from the 2017/2018 International Health Behaviour in School-aged Children study. The prevalence of sleep indicators (difficulties in falling asleep, insufficient sleep, social jetlag) and annual medically treated injuries (any, multiple) were described cross-nationally and by gender. Multivariable modified Poisson regression analyses were conducted within and across countries to test the consistency of associations between sleep and injury. 16.3%-48.3% of adolescents reported an indicator of poor sleep and 44.0% sustained any injury. We observed striking cross-national variations in sleep, yet consistent gendered patterns across countries [e.g. sleep difficulties more prevalent among girls vs. insufficient sleep (non-school days) more prevalent among boys]. Country-level models displayed relatively consistent and positive associations. Multi-country (pooled) models demonstrated a consistency of effects, with the strongest association observed between difficulties in falling asleep and multiple injuries (prevalence ratio: 1.58, 95% CI: 1.55-1.61); these effects were especially pronounced in girls. Using standard indicators, this novel cross-national study demonstrated that poor sleep is a consistent risk factor for adolescent injuries. Given the recent epidemic of adolescent sleep problems, sleep hygiene represents a novel target for injury prevention.
青少年睡眠质量差的情况很常见，且与意外伤害风险有关。然而，由于各项研究中睡眠和伤害测量方法的差异，证据的可比性受到限制。我们使用共同调查程序收集的来自46个国家的239816名青少年（50.8%为女孩）的自我报告，研究了睡眠质量差与意外伤害之间关系的潜在跨国一致性。使用2017/2018年国际学龄儿童健康行为研究的全国代表性记录进行了一项横断面研究。对睡眠指标（入睡困难、睡眠不足、社会时差）和年度接受药物治疗的伤害（任何伤害、多处伤害）的患病率进行了跨国和按性别的描述。在国家内部和国家之间进行了多变量修正泊松回归分析，以检验睡眠与伤害之间关联的一致性。16.3%-48.3%的青少年报告有睡眠质量差的指标，44.0%的青少年遭受过任何伤害。我们观察到睡眠方面存在显著的跨国差异，但各国存在一致的性别模式[例如，女孩中入睡困难更为普遍，而男孩中非上学日睡眠不足更为普遍]。国家层面的模型显示出相对一致且呈正相关的关联。多国（汇总）模型显示了效应的一致性，入睡困难与多处伤害之间的关联最强（患病率比：1.58，95%置信区间：1.55-1.61）；这些效应在女孩中尤为明显。使用标准指标，这项新的跨国研究表明，睡眠质量差是青少年受伤的一个一致风险因素。鉴于近期青少年睡眠问题的流行，睡眠卫生是预防伤害的一个新目标。
