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Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale

  • Rhie, Seon-Kyeong (Department of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Lee, Si-Hyoung (Department of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Chae, Kyu-Young (Department of Pediatrics, CHA Bundang Medical Center, CHA University)
  • Received : 2010.09.11
  • Accepted : 2010.11.16
  • Published : 2011.01.15

Abstract

Purpose: Korean adolescents have severe nighttime sleep deprivation and daytime sleepiness because of their competitive educational environment. However, daytime sleep patterns and sleepiness have never been studied using age-specific methods, such as the pediatric daytime sleepiness scale (PDSS). We surveyed the daytime sleepiness of Korean adolescents using a Korean translation of the PDSS. Methods: We distributed the 27-item questionnaire, including the PDSS and questions related to sleep pattern, sleep satisfaction, and emotional state, to 3,370 students in grades 5-12. Results: The amount of nighttime sleep decreased significantly with increasing age. During weekday nights, $5-6^{th}$ graders slept for $7.95{\pm}1.05h$, $7-9^{th}$ graders for $7.57{\pm}1.05h$, and $10-12^{th}$ graders for $5.78{\pm}1.13h$. However, the total amounts of combined daytime and nighttime sleep during weekdays were somewhat greater, $8.15{\pm}1.12h$ for $5-6^{th}$ graders, $8.17{\pm}1.20h$ for $7-9^{th}$ graders, and $6.87{\pm}1.40h$ for $10-12^{th}$ graders. PDSS scores increased with age, $11.89{\pm}5.56$ for $5-6^{th}$ graders, $16.57{\pm}5.57$ for $7-9^{th}$ graders, and $17.71{\pm}5.24$ for $10-12^{th}$ graders. Higher PDSS scores were positively correlated with poor school performance and emotional instability. Conclusion: Korean teenagers sleep to an unusual extent during the day because of nighttime sleep deprivation. This negatively affects school performance and emotional stability. A Korean translation of the PDSS was effective in evaluating the severity of daytime sleepiness and assessing the emotional state and school performance of Korean teenagers.

Keywords

References

  1. Banks S, Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med 2007; 3:519-528.
  2. Carskadon MA. Sleep deprivation: health consequences and societal impact. Med Clin North Am 2004; 88:767-776. https://doi.org/10.1016/j.mcna.2004.03.001
  3. Dahl RE. The impact of inadequate sleep on children's daytime cognitive function. Semin Pediatr Neurol 1996;3:44-50. https://doi.org/10.1016/S1071-9091(96)80028-3
  4. Randazzo AC, Muehlbach MJ, Schweitzer PK, Walsh JK. Cognitive function following acute sleep restriction in children ages 10-14. Sleep 1998; 21:861-868.
  5. Carskadon MA, Harvey K, Dement WC. Sleep loss in young adolescents. Sleep 1981;4:299-312. https://doi.org/10.1093/sleep/4.3.299
  6. Carskadon MA, Wolfson AR, Acebo C, Tzischinsky O, Seifer R. Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days. Sleep 1998;21:871-881. https://doi.org/10.1093/sleep/21.8.871
  7. Fallone G, Acebo C, Seifer R, Carskadon MA. Experimental restriction of sleep opportunity in children: effects on teacher ratings. Sleep 2005; 28:1561-1567.
  8. Nixon GM, Thompson JM, Han DY, Becroft DM, Clark PM, Robinson E, et al. Short sleep duration in middle childhood: risk factors and consequences. Sleep 2008;31:71-78.
  9. Suratt PM, Barth JT, Diamond R, D'Andrea L, Nikova M, Perriello VA Jr, et al. Reduced time in bed and obstructive sleep-disordered breathing in children are associated with cognitive impairment. Pediatrics 2007; 119:320-329. https://doi.org/10.1542/peds.2006-1969
  10. Wolfson AR, Carskadon MA. Sleep schedules and daytime functioning in adolescents. Child Dev 1998;69:875-887. https://doi.org/10.1111/j.1467-8624.1998.tb06149.x
  11. Stickgold R. Sleep-dependent memory consolidation. Nature 2005;437: 1272-1278. https://doi.org/10.1038/nature04286
  12. Sterpenich V, Albouy G, Darsaud A, Schmidt C, Vandewalle G, Dang Vu TT, et al. Sleep promotes the neural reorganization of remote emotional memory. J Neurosci 2009;29:5143-5152. https://doi.org/10.1523/JNEUROSCI.0561-09.2009
  13. WB & A Market Research, National Sleep Foundation. 2006 Sleep in America poll: summary of findings. Available from: http://www. sleepfoundation.org/%5Fcontent/hottopics/2006%5Fsummary%5Fof% 5Ffindings.pdf.
  14. Choi K, Son H, Park M, Han J, Kim K, Lee B, et al. Internet overuse and excessive daytime sleepiness in adolescents. Psychiatry Clin Neurosci 2009; 63:455-462 https://doi.org/10.1111/j.1440-1819.2009.01925.x
  15. Dorofaeff TF, Denny S. Sleep and adolescence. Do New Zealand teenagers get enough? J Paediatr Child Health 2006;42:515-520. https://doi.org/10.1111/j.1440-1754.2006.00914.x
  16. Epstein R, Chillag N, Lavie P. Starting times of school: effects on daytime functioning of fifth-grade children in Israel. Sleep 1998; 21:250-256
  17. Gupta R, Bhatia MS, Chhabra V, Sharma S, Dahiya D, Semalti K, et al. Sleep patterns of urban school-going adolescents. Indian Pediatr 2008; 45:183-189.
  18. Arakawa M, Taira K, Tanaka H, Yamakawa K, Toguchi H, Kadekaru H, et al. A survey of junior high school students' sleep habit and lifestyle in Okinawa. Psychiatry Clin Neurosci 2001;55:211-212. https://doi.org/10.1046/j.1440-1819.2001.00829.x
  19. Shin C, Kim J, Lee S, Ahn Y, Joo S. Sleep habits, excessive daytime sleepiness and school performance in high school students. Psychiatry Clin Neurosci 2003;57:451-453. https://doi.org/10.1046/j.1440-1819.2003.01146.x
  20. Yang CK, Kim JK, Patel SR, Lee JH. Age-related changes in sleep/wake patterns among Korean teenagers. Pediatrics 2005;115:250-256. https://doi.org/10.1542/peds.2004-0815G
  21. Lee JH, Cho YW, Sohn SI. Excessive daytime sleepiness and quality of sleep in Korean middle and high school students. J Korean Sleep Soc 2005;2:34-40. https://doi.org/10.13078/jksrs.05014
  22. 2008 Youth Statistics; Statistics Korea 2008. Available from: http://kostat. go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=58063
  23. Drake C, Nickel C, Burduvali E, Roth T, Jefferson C, Pietro B. The pediatric daytime sleepiness scale (PDSS): sleep habits and school outcomes in middle-school children. Sleep 2003;26:455-458.
  24. Carskadon MA, Harvey K, Duke P, Anders TF, Litt IF, Dement WC. Pubertal changes in daytime sleepiness. Sleep 1980;2:453-460. https://doi.org/10.1093/sleep/2.4.453
  25. Wolfson AR, Carskadon MA. Understanding adolescents' sleep patterns and school performance: a critical appraisal. Sleep Med Rev 2003;7:491- 506. https://doi.org/10.1016/S1087-0792(03)90003-7
  26. Walker MP, Stickgold R. Sleep-dependent learning and memory consolidation. Neuron 2004;44:121-133. https://doi.org/10.1016/j.neuron.2004.08.031
  27. Guilleminault C, Powell NB, Martinez S, Kushida C, Raffray T, Palombini L, et al. Preliminary observations on the effects of sleep time in a sleep restriction paradigm. Sleep Med 2003;4:177-184. https://doi.org/10.1016/S1389-9457(03)00061-3
  28. Liu Y, Tanaka H. Overtime work, insufficient sleep, and risk of non-fatal acute myocardial infarction in Japanese men. Occup Environ Med 2002; 59:447-451. https://doi.org/10.1136/oem.59.7.447
  29. Allen RP. Article reviewed: Impact of sleep dept on metabolic and endocrine function. Sleep Med 2000;1:149-150. https://doi.org/10.1016/S1389-9457(00)00018-6
  30. Carskadon MA, Vieira C, Acebo C. Association between puberty and delayed phase preference. Sleep 1993;16:258-262. https://doi.org/10.1093/sleep/16.3.258
  31. Owens JA, Spirito A, McGuinn M. The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 2000;23:1043-1051.
  32. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991;14:540-545.
  33. Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC. Quantification of sleepiness: a new approach. Psychophysiology 1973;10:431-436. https://doi.org/10.1111/j.1469-8986.1973.tb00801.x
  34. Perez-Chada D, Perez-Lloret S, Videla AJ, Cardinali D, Bergna MA, Fernandez-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; 30:1698-1703. https://doi.org/10.1093/sleep/30.12.1698
  35. Yang CM, Huang YS, Song YC. Clinical utility of the Chinese version of the Pediatric Daytime Sleepiness Scale in children with obstructive sleep apnea syndrome and narcolepsy. Psychiatry Clin Neurosci 2010;64:134- 140. https://doi.org/10.1111/j.1440-1819.2009.02054.x

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