SUBJECTIVE SLEEP NEED AND DAYTIME SLEEPINESS IN ADOLESCENTS

Ferrari, Geraldo Jose; Barbosa, Diego Grasel; Andrade, Rubian Diego; Pelegrini, Andreia; Beltrame, Thais Silva; Felden, Érico Pereira Gomes

doi:10.1590/1984-0462/;2019;37;2;00014

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Revista Paulista de Pediatria

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Original Article • Rev. paul. pediatr. 37 (2) • Apr-Jun 2019 • https://doi.org/10.1590/1984-0462/;2019;37;2;00014 copy

SUBJECTIVE SLEEP NEED AND DAYTIME SLEEPINESS IN ADOLESCENTS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the contribution of subjective sleep need for daytime sleepiness in adolescents, and to compare questions about sleep, age and body mass index between adolescents who considered to sleep enough and those who reported the need for more sleep.

Methods:

This is a descriptive, epidemiological and cross-sectional study. Data collection was performed in August 2016, with 773 adolescents aged 14-19 years old, from Paranaguá, Paraná, Southern Brazil. The analysis included the following variables: time in bed, half-sleep phase, sleep need, social jetlag, daytime sleepiness, body mass index and physical activity.

Results:

The prevalence of adolescents with subjective need for sleep was 73.0%, with an average need of 1.7 extra hours of sleep. These adolescents woke up earlier (p<0.001) and slept less on school days (p<0.001). The need for more sleep was associated with higher daytime sleepiness scores (rho=0.480; p<0.001) and with later half-sleep phase (rho=0.200; p<0.001). No correlation was identified between the sleep need and time in bed (rho=-0.044; p=0.225). The subjective sleep need was the variable with the greatest explanatory power for daytime sleepiness (24.8%; p<0.001). In addition, the less adolescents practiced physical activity, the higher their daytime sleepiness scores (rho=-0.117; p<0.001).

Conclusions:

The subjective sleep need has an important role in explaining daytime sleepiness among adolescents. Adolescents who needed to sleep more reported waking up early and experienced sleep deprivation during class days; they also woke up later on the weekends and experienced more daytime sleepiness, compared to those who believed they had enough sleep.

Keywords:
Sleep; Sleepiness; Sleep deprivation; Adolescents

	Total (n=773)	Boys (n=388)	Girls (n=385)	p-value
Age (anos)	16.2±1.07	16.3±1.1	16.2±1.1	0.218
BMI (kg/m²)	21.9±3.68	22.0±3.7	21.9±3.67	0.867
BMI (Z score)	0.00±1.00	0.01±1.01	-0.01±0.10	0.867
Time to go to bed on days with classes (hours)	0:00±1:36	0:06±1:42	23:48±1:30	0.021
Time to wake up on days with classes (hours)	7:54±2:00	8:00±2:06	7:48±2:00	0.007
Time to go to bed on days without classes (hours)	1:50±2:06	2:06±2:18	1:30±1:48	0.003
Time to wake up on days without classes (hours)	11:00±1:54	11:00±2:12	10:54±1:42	0.662
Time in bed on days with classes (hours)	7:54±1:48	7:54±1:48	8:00±1:42	0.429
Time in bed on days without classes (hours)	9:12±1:48	9:00±2:00	9:24±1:42	0.001
Half-sleep phase on days with classes (hours)	3:54±1:36	4:06±1:42	3:48±1:30	0.018
Half-sleep phase on days without classes (hours)	6:24±1:48	6:36±2:00	6:12±1:30	0.053
Social jetlag (hours)	2:24±1:42	2:30±1:48	2:24±1:36	0.755
Subjective need for sleep, n (%)
I sleep enough	208±27.0	130±33.6	78±20.3	<0.001
1 hour	131±17.0	78±20.2	53±13.8
2 hours	190±24.6	77±19.9	113±29.4
3 hours	96±12.5	42±10.9	54±14.1
4 hours	146±18.9	60±15.5	86±22.4
Subjective need for sleep, n (%)
Sleep enough	208±27.0	130±33.6	78±20.3	<0.001
Need more sleep	563±73.0	257±66.4	306±79.7	<0.001
Daytime sleepiness (points)	14.9±5.6	21.3±12.7	16.0±5.6	<0.001
Physical activity (points)	2.2±1.2	2.4±1.2	2.1±1.1	<0.001

	Sleep enough (n=208)	Need more sleep (n=563)	p-value
Age (years)	16.22±1.13	16.24±1.06	0.705
BMI (kg/m²)	22.09±3.86	21.91±3.61	0.823
BMI (Z score)	0.035±1.049	-0.015±0.980	0.823
Time to go to bed on days with classes (hours)	23:59±1:50	23:58±1:32	0.601
Time to wake up on days with classes (hours)	8:22±2:00	7:44±2:01	<0.001
Time to go to bed on days without classes (hours)	1:45±2:15	1:50±2:00	0.252
Time to wake up on days without classes (hours)	10:43±1:57	11:04±1:55	0.027
Time in bed on days with classes (hours)	8:22±1:53	7:47±1:41	<0.001
Time in bed on days without classes (hours)	8:59±1:46	9:14±1:52	0.153
Daytime sleepiness (points)	11:34±4.93	16.08±5.37	<0.001
Half-sleep phase on days with classes (hours)	4:10±1:40	3:52±1:35	0.014
Half-sleep phase on days without classes (hours)	6:14±1:55	6:27±1:44	0.044
Jetlag social (hours)	2:03±1:43	2:35±1:39	<0.001
Physical activity (points)	2.28±1.20	2.18±1.14	0.311

	Daytime sleepiness
	rho	p-value
Age (years)	-0.106	0.004
BMI (Z score)	-0.053	0.153
Time to go to bed on days with classes (hours)	0.242	<0.001
Time to wake up on days with classes (hours)	0.137	<0.001
Time to go to bed on days without classes (hours)	0.221	<0.001
Time to wake up on days without classes (hours)	0.261	<0.001
Time in bed on days with classes (hours)	-0.044	0.225
Time in bed on days without classes (hours)	0.020	0.589
Subjective need for sleep (hours)	0.480	<0.001
Half-sleep phase on days with classes (hours)	0.200	<0.001
Half-sleep phase on days without classes (hours)	0.266	<0.001
Social jetlag (hours)	0.072	0.049
Physical activity (points)	-0.117	0.001

	Daytime sleepiness (%)	Model	95%CI		Variables
	r²	Standardized coefficients β	Min.	Max.	p-value
Model 1
Subjective need for sleep (points)	24.4	0.496	1.71	2.21	<0.001
Model 2
Subjective need for sleep (points)	29.3	0.501	1.74	2.23	<0.001
Half-sleep phase with classes (hours)	29.3	0.223	0.57	1.00	<0.001
Model 3
Subjective need for sleep (points)	30,1	0.502	1.74	2.23	<0.001
Half-sleep phase with classes (hours)		0.216	0.54	0.98	<0.001
Age (years)		-0.093	-0.82	-0.17	0.003
Model 4
Subjective need for sleep (points)	30,4	0.489	1.68	2.18	<0.001
Half-sleep phase with classes (hours)		0.188	0.43	0.90	<0.001
Age (years)		-0.086	-0.79	-0.13	0.007
Social jetlag (hours)		0.073	0.02	0.42	0.035

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[1] *Corresponding author. E-mail: ericofelden@gmail.com (E.P.G. Felden).