Document Type : Original Article
Authors
1 Student Research Committee, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
2 Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
Abstract
BACKGROUND: Sleep quality is an important factor in adolescents’ health; physical as well as
psychological. The aim of this study was to determine sleep quality and daytime sleepiness and their
effect on the quality of school life (QSL) and achievement.
MATERIALS AND METHODS: This cross‑sectional study was conducted in high schools. The data
collection was done on a random sample of 500 students from 15 to 19 years. The questionnaires
included the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the Epworth
Sleepiness Scale to measure daytime sleepiness as well as QSL. Data were analyzed by SPSS
25. Linear and logistic regressions were used to obtain adjusted and unadjusted odds ratios as well
as predictors.
RESULTS: The mean PSQI score was 6.2 ± 2.4. It was realized that 377 participants (75.4%)
were poor sleepers; 6.2% had excessive daytime sleepiness. There was a significant association
between age and quality of sleep (P < 0.04). No association between gender and quality of sleep
or between the quality of sleep and school achievement was found. Linear regression exhibited a
significant relationship between the quality of sleep and daytime sleepiness (β = 0.218; t = 4.982,
P = 0.000). There was a significant, inverse correlation between sleepiness and the total score of
QSL (P = 0.000). Stepwise linear regression analysis exhibited that daytime sleepiness (P = 0.002)
and school achievement (P = 0.001) were predictors of QSL.
CONCLUSION: According to the study results, sleepiness affects school performance and QSL,
and on the other hand, daytime sleepiness is under the effect of sleep quality.
Keywords
- Linnakylä P. Quality of school life in the Finnish comprehensive
school: A comparative view. Scand J Educ Res 1996;40:69‑85.
2. Verkuyten M, Thijs J. School satisfaction of elementary school
children: The role of performance, peer relations, ethnicity and
gender. SocIndic Res 2002;59:203‑28.
3. Thien LM, Abd Razak N. Academic coping, friendship quality,
and student engagement associated with student quality of school
life: A partial least square analysis.Soc Indic Res 2013;112:679‑708.
4. Williams T, Roey S. Consistencies in the Quality of School Life.
US Department of Education; 1996.p. 191.
5. Lombas AS, Jiménez TI, Arguís‑Rey R, Hernández‑Paniello S,
Valdivia‑Salas S, Martín‑Albo J, et al. Impact of the happy
classrooms programme on psychological well‑being, school
aggression, and classroom climate. Mindfulness 2019;10:1642‑60.
6. Khzami SE., Razouki A, Selmaoui S, Agorram B. Determinants of
well‑being of middle‑school students in Moroccan urban and rural
areas: A comparative study. J Educ Health Promot 2020;9:271.
7. Golmakani N, Naghibi F, Moharari F, Esmaily H. Health
promoting life style and its related factors in female adolescents.
J Midwifery Reprod Health 2013;1:42‑9.
8. Sakhelashvili I, Eliozishvili M, Basishvili T, Datunashvili M,
Oniani N, Cervena K, et al. Sleep‑wake patterns and sleep quality
in urban Georgia. TranslNeurosci 2016;7:62‑70.
9. Priou P, Le Vaillant M, Meslier N, Paris A, Pigeanne T, NguyenXL,
et al. Cumulative association of obstructive sleep apnea severity
and short sleep duration with the risk for hypertension. PLoS One
2014;9:e115666.
10. Zanuto EAC, Christofaro DGD, Fernandes RA. Sleep quality
and its associations with leisure‑time exercise and excess weight
among civil servants.Rev. bras. cineantropom. desempenho hum
2014;16:27‑35.
11. Lo MJ. Relationship between sleep habits and daytime sleepiness,
inattention, and aggressive behavior among Taiwanese
kindergarten children. Clin Mother Child Heal 2016;13:1000247.
12. Gerber L. Sleep deprivation in children: A growing public health
concern. NursManag 2014;45:22‑8.
13. Maume DJ. Social ties and adolescent sleep disruption. JHealth
and Soc Behav 2013;54:498‑515.
14. Liu J, Hay J, Joshi D, Faught BE, Wade T, Cairney J. Sleep
difficulties and preadolescent obesity. J Adolesc Health
2010;46:S15.
15. Javaheri S, Storfer‑Isser A, Rosen CL, Redline S. Sleep quality
and elevated blood pressure in adolescents. Circulation
2008;118:1034‑40.
16. Delaruelle K, Dierckens M, Vandendriessche A, Deforche B,
Poppe L. Adolescents’ sleep quality in relation to peer, family
and school factors: Findings from the 2017/2018 HBSC study in
Flanders. QualLife Res2021;30:55‑65.
17. Tynjälä J, Kannas L, Levälahti E. Perceived tiredness among
adolescents and its association with sleep habits and use of
psychoactive substances. JSleep Res 1997;6:189‑98.
18. Brand S, Kirov R, Kalak N, Gerber M, Schmidt NB, Lemola S,
et al. Poor sleep is related to lower emotional competence among
adolescents. BehavSleep Med 2016;14:602‑14.
19. Dahl RE. Sleeplessness and aggression in youth. J Adolesc Health
2006;38:641‑2.
20. Matamura M, Tochigi M, Usami S, Yonehara H, Fukushima M,
Nishida A, et al. Associations between sleep habits and mental
health status and suicidality in a longitudinal survey of
monozygotic twin adolescents. J Sleep Res 2014;23:292‑6.
21. Gunnell D, Chang SS, Tsai MK, Tsao CK, Wen CP.Sleep and
suicide: An analysis of a cohort of 394,000 Taiwanese adults.
SocPsychiatry Psychiatr Epidemiol 2013;48:1457‑65.
22. Adelantado-Renau M, Beltran‑Valls MR, Migueles JH, Artero EG,
Legaz‑Arrese A, Capdevila‑Seder A, et al. Associations between
objectively measured and self-reported sleep with academic and
cognitive performance in adolescents: DADOS study. JSleep Res
2019;28:e12811.
23. Anderson C, Horne JA. Sleepiness enhances distraction during a
monotonous task. Sleep 2006;29:573‑6.
24. Owens JA, Dalzell V. Use of the ‘BEARS’sleep screening tool in
a pediatric residents’ continuity clinic: A pilot study. Sleep Med
2005;6:63‑9.
25. Wolfson AR, Carskadon MA. Understanding adolescent’s sleep
patterns and school performance: A critical appraisal. Sleep
MedRev 2003;7:491‑506.
26. Smedje H, Broman JE, Hetta J. Associations between disturbed
sleep and behavioural difficulties in 635 children aged six to eight
years: A study based on parents’ perceptions. EurChild Adolesc
Psychiatry 2001;10:1‑9.doi: 10.1007/s007870170041.
27. Payne JD, Stickgold R, Swanberg K, Kensinger EA. Sleep
preferentially enhances memory for emotional components of
scenes. PsycholSci 2008;19:781‑8.
28. Hassanzadeh R, Samiee F. Investigating the relationship between
quality of school life, career aspirations, and academic burnout
mediated by mental well‑being. J Sch Psychol 2020;9:43‑62.
29. Yang Q, Tian L, Huebner ES, Zhu X. Relations among academic
achievement, self‑esteem, and subjective well‑being in school
among elementary school students: A longitudinal mediation
model. Sch Psychol 2019;34:328‑40.
30. Wolfson AR, Carskadon MA. Sleep schedules and daytime
functioning in adolescents. Child Dev 1998;69:875‑87.
31. Buragadda S, Melam G, Alhusaini A, Perumal V, Mavilla V. Effect
of sleep problems on academic grade among school children in
Saudi Arabia. SciFed J Insomnia 2018;1. Available from: https://
www.researchgate.net/profile/Vaithiamanithi‑Perumal‑2/
publication/324994369_Effect_of_Sleep_Problems_on_
Academic_Grade_among_School_Children_in_Saudi_Arabia/
links/5af0bc33458515c2837303d7/Effect-of-Sleep-Problems‑onAcademic‑Grade-among-School-Children‑in‑Saudi‑Arabia.pdf.
32. Rafihi‑Ferreira RE, Pires MLN, de Mattos Silvares EF. Behavioral
intervention for sleep problems in childhood: A Brazilian
randomized controlled trial. Psicol ReflexCrít 2019;32.doi:
10.1186/s41155‑019‑0118‑3.
33. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The
Pittsburgh sleep quality index: A new instrument for psychiatric
practice and research. Psychiatry Res 1989;28:193‑213. - 34. Johns MW. Sleepiness in different situations measured by the
Epworth sleepiness scale. Sleep 1994;17:703‑10.
35. Hasanzadeh M, Kaveh AKN, Ghalehbandi MF, Yad Elahi Z,
Banafsheh G, Sadeghikia A, et al. Sleep quality in Iranian drivers
recognized as responsible for severe road accidents.J Res Behav
Sci 2008;6:97‑107.
36. Moghaddam JF, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A.
Reliability and validity of the Persian version of the Pittsburgh
sleep quality index (PSQI‑P). Sleep Breath 2012;16:79‑82.
37. Johns MW. A new method for measuring daytime sleepiness: The
Epworth sleepiness scale.Sleep 1991;14:540‑5.
38. Pahwa P, Karunanayake CP, Hagel L, Gjevre JA, Rennie D,
Lawson J, et al.Prevalence of high Epworth sleepiness scale scores
in a rural population. Can RespirJ 2012;19:e10‑4.
39. Johns M, Hocking B.Daytime sleepiness and sleep habits of
Australian workers. Sleep 1997;20:844‑7.
40. Johns MW. Reliability and factor analysis of the Epworth
sleepiness scale. Sleep 1992;15:376‑81.
41. Ahmadi H, MoeiniM. An investigation of the relationship between
social skills and high risk behaviors among the youth: The case of
Shiraz city. Strateg Res Soc Probl Iran Univ Isfahan2015;4:1‑24.
42. Saneie E, Raeisoon M. Role of social skills in predicting
the students’ sense of coherence and quality of school life.
JCMH2020;7:96‑107.
43. Rauchs G, Desgranges B, Foret J, Eustache F. The relationships
between memory systems and sleep stages. J Sleep Res
2005;14:123‑40.
44. Smith C.Sleep states and memory processes in humans:
Procedural versus declarative memory systems. Sleep MedRev
2001;5:491‑506.
45. Gais S, Born J. Declarative memory consolidation: Mechanisms
acting during human sleep. Learn Mem 2004;11:679‑85.
46. Curcio G, Ferrara M, De Gennaro L. Sleep loss, learning capacity
and academic performance. Sleep Med Rev 2006;10:323‑7.
47. Dahl RE, The development and disorders of sleep. AdvPediatr
1998;45:73‑90.
48. CarskadonMA, AceboC, JenniOG. Regulation of adolescent sleep:
Implications for behavior. Ann N Y Acad Sci 2004;1021:276‑91.
49. Sadeh A, Gruber R, and Raviv A.Sleep, neurobehavioral
functioning, and behavior problems in school-age children. Child
Dev 2002;73:405‑17.
50. Brown FC, Buboltz WC Jr, Soper B. Development and
evaluation of the sleep treatment and education program for
students (STEPS). J Am College Health 2006;54:231‑7.
51. Link S, Ancoli‑Israel S. Sleep and the teenager. Sleep Res
1995;24:184.
52. Gray EK, Watson D. General and specific traits of personality
and their relation to sleep and academic performance. JPersonal
2002;70:177‑206.
53. Sweileh WM, Ali IA, Sawalha AF, Abu‑Taha AS, Zyoud SH,
Al‑Jabi SW. Sleep habits and sleep problems among Palestinian
students. Child AdolescPsychiatry MentHealth 2011;5:1‑8.doi:
10.1186/1753‑2000‑5‑25.
54. Kazim M, Abrar A. Sleep patterns and academic performance
in students of a medical college in Pakistan. KUST Med J
2011;3:57‑60.
55. Perez‑Chada D, Perez‑Lloret S, Videla AJ, Cardinali D,
Bergna MA, Fernández‑Acquier M, et al. Sleep disordered
breathing and daytime sleepiness are associated with poor
academic performance in teenagers. A study using the pediatric
daytime sleepiness scale (PDSS). Sleep 2007;30:1698‑703.
56. Gaultney JF. The prevalence of sleep disorders in college students:
Impact on academic performance. J Am Coll Health 2010;59:91‑7.
57. Laberge L, Petit D, Simard C, Vitaro F, TremblayRE, MontplaisirJ.
Development of sleep patterns in early adolescence. JSleep Res
2001;10:59‑67.
58. Oginska H, Pokorski J. Fatigue and mood correlates of sleep
length in three age-social groups: School children, students, and
employees. ChronobiolInt 2006;23:1317‑28.
59. Park YM, Matsumoto K, Shinkoda H, Nagashima H, Kang MJ,
Seo YJ. Age and gender difference in habitual sleep–wake rhythm.
Psychiatry Clin Neurosci 2001;55:201‑2.
60. Royal KD, Hunt SA, Borst LB, Gerard M. Sleep hygiene among
veterinary medical students. JEducHealth Promot 2018;7:47.
61. Koren D, Dumin M, Gozal D. Role of sleep quality in the metabolic
syndrome. DiabetesMetab SyndrObes 2016;9:281‑310.
62. Miller MA, Kruisbrink M, Wallace J, Ji C, Cappuccio FP. Sleep
duration and incidence of obesity in infants, children, and
adolescents: A systematic review and meta‑analysis of prospective
studies. Sleep 2018;41:zsy018.
63. Hysing M, Haugland S, Stormark KM, Bøe T, Sivertsen B. Sleep
and school attendance in adolescence: Results from a large
population‑based study. ScandJPublic Health 2015;43:2‑9.
64. Chaput J‑P, Gray CE, Poitras VJ, Carson V, Gruber R, Olds T,
et al. Systematic review of the relationships between sleep
duration and health indicators in school‑aged children and youth.
ApplPhysiolNutr Metab 2016. 41:S266‑S282.
65. Yoon J, Järvinen T. Are model PISA pupils happy at school?
Quality of school life of adolescents in Finland and Korea. Comp
Educ 2016;52:427‑48.
66. Anderson LW, Bourke SF.Assessing Affective Characteristics in
the Schools. Routledge; New York. 2000.
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