Published online June 2, 2008
PEDIATRICS Vol. 121 No. 6 June 2008, pp. 1165-1173 (doi:10.1542/peds.2007-1464)
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ARTICLE

Sleep Patterns and Problems Among Chinese Adolescents

Xianchen Liu, MD, PhDa, Zhongtang Zhao, MDb, Cunxian Jia, PhDb and Daniel J. Buysse, MDa

a Department of Psychiatry, University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
b Institute of Epidemiology, Shandong University School of Public Health, Jinan, China

OBJECTIVES. Little is known about sleep patterns and problems in Chinese adolescents. This study was designed to examine sleep/wake patterns and problems and their associations with parent sleep among adolescents in China.

METHODS. This report represents part of an epidemiological study of sleep and health in 6 high schools in Jinan city, China. A total of 1056 adolescents and 838 parents completed a questionnaire in March or April 2005. Participants consisted of 625 boys and 441 girls, 557 seventh-graders (mean age: 13.5 ± 0.6 years) and 509 tenth-graders (mean age: 16.4 ± 0.7 years), and 603 mothers and 235 fathers. Adolescents and parents reported their own sleep/wake patterns and problems.

RESULTS. Average morning rising time (5:56 AM vs 8:13 AM) and sleep duration (7.5 hours vs 9.4 hours) differed significantly between weekdays and weekends. Compared with seventh-graders, 10th-graders went to bed later and awoke earlier, resulting in ~1 hour of sleep less. Of the adolescents, 18.8% reported their sleep quality as poor, 26.2% were not satisfied with their sleep, 16.1% had insomnia, and 17.9% had daytime sleepiness. Significant but low adolescent-parent correlations were observed for sleep/wake patterns and perceived sleep quality. Difficulty initiating sleep in adolescents was significantly associated with history of insomnia in mothers and fathers.

CONCLUSIONS. Sleep insufficiency, insomnia, and daytime sleepiness are prevalent in Chinese adolescents. Sleep insufficiency on weekdays may be attributable to earlier morning rising to meet school schedules. Parental history of insomnia is associated with elevated risk for insomnia symptoms in adolescent offspring, although adolescent-parent correlations in sleep/wake patterns are relatively low.

Key Words: sleep patterns • insomnia • daytime sleepiness • familial study • Chinese adolescents

Abbreviations: AHQ—Adolescent Health Questionnaire • PFQ—Parent and Family Questionnaire • DIS—difficulty initiating sleep • DRS—difficulty returning to sleep • OR—odds ratio • CI—confidence interval

Accepted Oct 1, 2007.


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