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The Pittsburg Sleep Quality Index (PSQI) and Associated Factors in Middle-school Students: A Cross-sectional Study

  • Received : 2019.10.14
  • Accepted : 2020.01.02
  • Published : 2020.01.31

Abstract

Purpose: The purpose of this study was to evaluate the current level of sleep quality among Korean middle-school students using the Pittsburg Sleep Quality Index (PSQI), and to analyze the factors influencing sleep quality. Methods: The study used a descriptive cross-sectional design and a self-report questionnaire. The participants were 744 middle-school students. The questionnaire included the PSQI and health-related questions, such as the types of diseases they had been diagnosed with and the frequency of hospital admissions. The data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and linear multiple regression. Results: The global PSQI score was 4.21, which indicated good sleep quality. The major factors that were associated with the sleep quality of middle-school students were the number of diseases they had been diagnosed with (β=.54, p=.001) and atopic dermatitis (β=.32, p=.001). In addition, asthma and the frequency of hospital admissions were significant factors influencing each component of the PSQI. Conclusion: The findings from this study suggest that sleep quality was associated with several health-related factors. Thus, nurses, school nurses, and nursing researchers may need to assess the health-related factors associated with adolescents' sleep quality as part of efforts to improve their sleep quality.

References

  1. Krystal AD, Edinger JD. Measuring sleep quality. Sleep Medicine. 2008;9(S1):S10-S17. https://doi.org/10.1016/S1389-9457(08)70011-X https://doi.org/10.1016/S1389-9457(08)70011-X
  2. 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 Research. 1989;28(2):193-213. https://doi.org/10.1016/0165-1781(89)90047-4 https://doi.org/10.1016/0165-1781(89)90047-4
  3. Dewald JF, Meijer AM, Oort FJ, Kerkhof GA, Bogels SM. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Sleep Medicine Reviews. 2010;14(3):179-189. https://doi.org/10.1016/j.smrv.2009.10.004 https://doi.org/10.1016/j.smrv.2009.10.004
  4. National Sleep Foundation. National Sleep Foundation recommends new sleep times [Internet]. Washington, DC: National Sleep Foundation; 2015 [cited 2019 September 30]. Available from: https://www.sleepfoundation.org/press-release/national-sleepfoundation-recommends-new-sleep-times
  5. Korean Sleep Research Society. Normal sleep [Internet]. Deagu: Korean Sleep Research Society; 2019 [cited 2019 December 17]. Available from: https://www.sleepnet.or.kr/sleep/normal
  6. Sohn GJ, Kang SH, Kim H, Lim M, Chung HG, Choi JH, et al. Sleep patterns and predictors of daytime sleepiness in high school students. Journal of The Korean Neuropsychiatric Association. 2014; 53(6):426-433. https://doi.org/10.4306/jknpa.2014.53.6.426 https://doi.org/10.4306/jknpa.2014.53.6.426
  7. Kim KH. Factors influencing high school students' sleep duration: Analyzing the 5th wave data from Korean children and youth panel study. Journal of Youth Welfare. 2017;19(1):57-84. https://doi.org/10.19034/KAYW.2017.19.1.03
  8. Park MS, Choi M, Lee H, Lee M. Quality of sleep and heart rate variability by physical activity in high school students. Child Health Nursing Research. 2015;21(3):195-203. https://doi.org/10.4094/chnr.2015.21.3.195 https://doi.org/10.4094/chnr.2015.21.3.195
  9. de Bruin EJ, van Run C, Staaks J, Meijer AM. Effects of sleep manipulation on cognitive functioning of adolescents: A systematic review. Sleep Medicine Reviews. 2017;32:45-57. https://doi.org/10.1016/j.smrv.2016.02.006 https://doi.org/10.1016/j.smrv.2016.02.006
  10. Dewald-Kaufmann JF, Oort FJ, Bogels SM, Meijer AM. Why sleep matters: Differences in daytime functioning between adolescents with low and high chronic sleep reduction and short and long sleep durations. Journal of Cognitive and Behavioral Psychotherapies. 2013;13(1A):171-182.
  11. Lee JE, Jang SI, Ju YJ, Kim W, Lee HJ, Park EC. Relationship between mobile phone addiction and the incidence of poor and short sleep among Korean adolescents: A longitudinal study of the Korean children and youth panel survey. Journal of Korean medical science. 2017;32(7):1166-1172. https://doi.org/10.3346/jkms.2017.32.7.1166 https://doi.org/10.3346/jkms.2017.32.7.1166
  12. Liao WC, Huang CY, Huang TY, Hwang SL. A systematic review of sleep patterns and factors that disturb sleep after heart surgery. The Journal of Nursing Research. 2011;19(4):275-288. https://doi.org/10.1097/JNR.0b013e318236cf68 https://doi.org/10.1097/JNR.0b013e318236cf68
  13. Lee SWH, Ng KY, Chin WK. The impact of sleep amount and sleep quality on glycemic control in type 2 diabetes: A systematic review and meta-analysis. Sleep Medicine Reviews. 2017;31:91-101. https://doi.org/10.1016/j.smrv.2016.02.001 https://doi.org/10.1016/j.smrv.2016.02.001
  14. Hayashino Y, Yamazaki S, Takegami M, Nakayama T, Sokejima S, Fukuhara S. Association between number of comorbid conditions, depression, and sleep quality using the Pittsburgh Sleep Quality Index: Results from a population-based survey. Sleep Medicine. 2010;11(4):366-371. https://doi.org/10.1016/j.sleep.2009.05.021 https://doi.org/10.1016/j.sleep.2009.05.021
  15. Fatima Y, Doi SA, Mamun AA. Sleep quality and obesity in young subjects: A meta-analysis. Obesity Reviews. 2016;17(11):1154-1166. https://doi.org/10.1111/obr.12444 https://doi.org/10.1111/obr.12444
  16. Oh WO, Im Y, Suk MH. The mediating effect of sleep satisfaction on the relationship between stress and perceived health of adolescents suffering atopic disease: Secondary analysis of data from the 2013 9th Korea Youth Risk Behavior Web-based Survey. International Journal of Nursing Studies. 2016;63:132-138. https://doi.org/10.1016/j.ijnurstu.2016.08.012 https://doi.org/10.1016/j.ijnurstu.2016.08.012
  17. Garden M, O'Callaghan M, Suresh S, Mamum AA, Najman JM. Asthma and sleep disturbance in adolescents and young adults: A cohort study. Journal of Paediatrics and Child Health. 2016;52(11):1019-1025. https://doi.org/10.1111/jpc.13234 https://doi.org/10.1111/jpc.13234
  18. Paiva T, Gaspar T, Matos MG. Sleep deprivation in adolescents: Correlations with health complaints and health-related quality of life. Sleep Medicine. 2015;16(4):521-527. https://doi.org/10.1016/j.sleep.2014.10.010 https://doi.org/10.1016/j.sleep.2014.10.010
  19. Park BK. Factors influencing ehealth literacy of middle school students in Korea: A descriptive cross-sectional study. Healthcare Informatics Research. 2019;25(3):221-229. https://doi.org/10.4258/hir.2019.25.3.221 https://doi.org/10.4258/hir.2019.25.3.221
  20. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-1160. https://doi.org/10.3758/BRM.41.4.1149
  21. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. p. 407-414.
  22. Sohn SI, Kim DH, Lee MY, Cho YW. The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep and Breathing. 2012;16(3):803-812. https://doi.org/10.1007/s11325-011-0579-9 https://doi.org/10.1007/s11325-011-0579-9
  23. Lee E, Lee S, Yang H, Hong S. Epidemiology of allergic diseases in Korean children. Allergy Asthma and Respiratory Disease. 2018;6:9-20. https://doi.org/10.4168/aard.2018.6.S1.S9
  24. Korean Statistical Information Service. Korean youth risk behavior survey [Internet]. Daejeon: Korean Statistical Information Service; 2018 [cited 2019 December 31]. Available from: http://kosis.kr/search/search.do
  25. Kong TS, Han TY, Lee JH, Son SJ. Correlation between severity of atopic dermatitis and sleep quality in children and adults. Annals of Dermatology. 2016;28(3):321-326. https://doi.org/10.5021/ad.2016.28.3.321 https://doi.org/10.5021/ad.2016.28.3.321
  26. Ramirez FD, Chen S, Langan SM, Prather AA, McCulloch CE, Kidd SA, et al. Association of atopic dermatitis with sleep quality in children. JAMA Pediatrics. 2019;173(5):e190025. https://doi.org/10.1001/jamapediatrics.2019.0025 https://doi.org/10.1001/jamapediatrics.2019.0025
  27. Lei Z, Qiongjing Y, Qiuli W, Sabrina K, Xiaojing L, Changli W. Sleep quality and sleep disturbing factors of inpatients in a Chinese general hospital. Journal of Clinical Nursing. 2009;18(17): 2521-2529. https://doi.org/10.1111/j.1365-2702.2009.02846.x https://doi.org/10.1111/j.1365-2702.2009.02846.x
  28. Jensen ME, Gibson PG, Collins CE, Hilton JM, Latham-Smith F, Wood LG. Increased sleep latency and reduced sleep duration in children with asthma. Sleep and Breathing. 2013;17(1):281-287. https://doi.org/10.1007/s11325-012-0687-1 https://doi.org/10.1007/s11325-012-0687-1
  29. Lawless C, Turner EM, LeFave E, Koinis-Mitchell D, Fedele DA. Sleep hygiene in adolescents with asthma. The Journal of Asthma. 2020;57(1):1-9. https://doi.org/10.1080/02770903.2018.1553049 https://doi.org/10.1080/02770903.2018.1543435
  30. Mindell JA, Meltzer LJ, Carskadon MA, Chervin RD. Developmental aspects of sleep hygiene: Findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Medicine. 2009;10(7):771-779. https://doi.org/10.1016/j.sleep.2008.07.016 https://doi.org/10.1016/j.sleep.2008.07.016