Sleep Quality and Its Health Correlates Among Egyptian Secondary School Students

Journal of Social, Behavioral, and Health Sciences, Apr 2017

The objective of the recent study was to determine the prevalence of poor sleep quality and to assess its psychological and general health correlates among secondary school students in the city of Assiut, Egypt. A cross sectional study was conducted among 829 secondary school students (selected by multistage stratified random sampling) aged 15–19 years in Assiut. Students filled in a self-administered questionnaire that included demographic data, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, general perception of health, and the short form of Depression Anxiety and Stress Scale. The prevalence of poor sleep quality (PSQI >5) was 72.5%. The mean PSQI score was 7.35 ± 2.94 standard deviation. Poor sleep quality was higher among females, urban residents and public school students. Correlates of poor sleep by multivariate analysis were age, urban residence, public education, mild to moderate and severe to very severe anxiety symptoms, severe to very severe depressive symptoms, excessive daytime sleepiness, and feeling fully active sometimes and not active at any time. Poor sleep quality was alarmingly highly prevalent among secondary school students, with significant health consequences. Increasing the awareness of the community especially adolescents, parents, and school teachers about healthy sleep is an essential priority.

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Sleep Quality and Its Health Correlates Among Egyptian Secondary School Students

Journal of Social, Behavioral, and Health Sciences Sleep Quality and Its Health Correlates Among Egyptian Secondary School Students Dalia M. Ismail Assiut University 0 Dalia G. Mahran Assiut University 0 Ali H. Zarzour Assiut University 0 Ghaydaa A. Sheahata 0 0 Assiut University Hospitals, Assiut University The objective of the present study was to determine the prevalence of poor sleep quality and to assess its psychological and general health correlates among secondary school students in the city of Assiut, Egypt. A cross sectional study was conducted among 829 secondary school students (selected by multistage stratified random sampling) aged 15-19 years in Assiut. Students filled in a self-administered questionnaire that included demographic data, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, general perception of health, and the short form of Depression Anxiety and Stress Scale. The prevalence of poor sleep quality (PSQI >5) was 72.5%. The mean PSQI score was 7.35 ± 2.94 standard deviation. Poor sleep quality was higher among females, urban residents and public school students. Correlates of poor sleep by multivariate analysis were age, urban residence, public education, mild to moderate and severe to very severe anxiety symptoms, severe to very severe depressive symptoms, excessive daytime sleepiness, and feeling fully active sometimes and not active at any time. Poor sleep quality was alarmingly highly prevalent among secondary school students, with significant health consequences. Increasing the awareness of the community especially adolescents, parents, and school teachers about healthy sleep is an essential priority. sleep quality; correlates; secondary schools Introduction Sleep is a physiological process that is essential for human life, especially during adolescence, which is a critical period for normal growth and development (Brand & Kirov, 2011) . It is a reversible state of behavioral unresponsiveness followed by a sense of revitalization and alertness (Orr, 2000) . Sleep consists of two components, quantitative and qualitative; the quantitative component includes sleep duration and sleep latency, while the qualitative component is a subjective measure of the depth of sleep and feeling restful upon awakening (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989) . Poor sleep can arise as a consequence of a number of problems, including difficulty falling or staying asleep, falling asleep at inappropriate times, long total sleep time, or abnormal behaviors related to sleep (Zhou et al., 2012) . Marked sleep changes that occur during adolescence include getting up earlier, going to bed later, insufficient sleep, irregular sleep patterns, and increased daytime sleepiness (Liu, Zhao, Jia, & Buysse, 2008). Many studies done in Arab countries, such as Saudi Arabia (Al-Hazzaa, Musaiger, Abahussain, AlSobayel, & Qahwaji, 2012; Merdad, Merdad, Nassif, El-Derwi, & Wali, 2014) , Oman (Kilani, AlHazzaa, Waly, & Musaiger, 2013), Lebanon (Assaad, Costanian, Haddad, & Tannous, 2014) , and Jordan (Suleiman et al., 2013) , have found the prevalence of short sleep duration or poor sleep quality using Pittsburgh Sleep Quality Index (PSQI) among secondary school or university student exceeding 50%. The same prevalence was found in Ethiopia (Lemma, Gelaye, Berhane, Worku, & Williams, 2012), United States (Lund, Reider, Whiting, & Prichard, 2010) , and Iran (Keshavarz Akhlaghi & Ghalebandi, 2009) . Reduction in sleep duration and sleep quality across populations has been linked to increased work and social demands, changes in lifestyle, increasing use of technology, smoking, alcohol, current sexual activity, caffeine intake, dietary factors and level of physical activity (Al-Hazzaa et al., 2012; Calamaro, Mason, & Ratcliffe, 2009; Chokroverty, 2009; McKnight-Eily et al., 2011; Van den Bulck, 2003, 2004; Zhou et al., 2012) . Studies suggest sleep not only plays a key role in the physical growth of adolescents but also is highly important for behavioral and emotional development, learning, attention, and cognitive functioning (Friedman, Corley, Hewitt, & Wright, 2009; Snell, Adam, & Duncan, 2007) . The way adolescents sleep and their tendency to get insufficient sleep make them vulnerable to negative effects on their mood and behavior (Lemma et al., 2012) , ability to think and concentrate in school, and school performance (Dewald, Meijer, Oort, Kerkhof, & Bögels, 2010) . There is also an increased risk for injuries and accidents (Komada, Asaoka, Abe, & Inoue, 2013), drugs and alcohol use (Passarella & Duong, 2008) , slow body metabolism and obesity (Garaulet et al., 2011) , and circadian sleep disorders (Zhou et al., 2012) . There appear to be no studies that determine sleep patterns and correlated factors in secondary school students in Egypt. There are differences of prevalence of sleep problems between countries, which are based on ethnic and cultural belief (...truncated)


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Dalia M. Ismail, Dalia G. Mahran, Ali H Zarzour, Ghaydaa A. Sheahata. Sleep Quality and Its Health Correlates Among Egyptian Secondary School Students, Journal of Social, Behavioral, and Health Sciences, 2017, pp. 5, Volume 11, Issue 1,