DOI QR코드

DOI QR Code

Analysis of Factors Associated with Daytime Sleepiness in Korean Adolescents

대한민국 청소년의 주간 졸음증에 관련된 요인 분석

  • Eun Jeong Jang (College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University) ;
  • Jung Sun Kim (College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University) ;
  • Kitai Kim (Department of Communication, Honam University) ;
  • Hye Sun Gwak (College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University) ;
  • Ji Min Han (College of Pharmacy, Chungbuk National University)
  • 장은정 (이화여자대학교 약학대학) ;
  • 김정선 (이화여자대학교 약학대학) ;
  • 김기태 (호남대학교 미디어커뮤니케이션학과) ;
  • 곽혜선 (이화여자대학교 약학대학) ;
  • 한지민 (충북대학교 약학대학)
  • Received : 2023.12.13
  • Accepted : 2024.02.16
  • Published : 2024.03.31

Abstract

Background: Daytime sleepiness, a common phenomenon among adolescents focused on academics, has negative effects on aspects such as growth and overall learning. However, research on various drugs and diseases affecting daytime sleepiness is lacking in the reality. Therefore, this study aims to investigate the factors influencing daytime sleepiness in adolescents with daytime sleepiness. Methods: This study was conducted through a survey of 2,432 middle and high school students, aged 14 to 19. The questionnaire consisted of information on socio-demographic characteristics, overall health status, and sleep patterns. The Pediatric Daytime Sleepiness Scale (PDSS), translated into Korean, was used to assess daytime sleepiness. Daytime sleepiness was measured by calculating the total score for each item of the PDSS, and divided into two groups based on the cutoff value of 19, which was the upper quartile. Results: We analyzed a total of 1,770 students including 799 boys and 971 girls. Students with a PDSS score of 19 or higher made up 33.3% of boys and 66.7% of girls. In multivariate analyses, females, smoking, poor self-reported health level, sleep after 12 am, not feeling refreshed in the morning, headache, muscle pain, and scoliosis increased the risk of daytime sleepiness significantly. The AUROC of PDSS, including significant factors in multivariate analyses, was 0.751 (95% CI 0.725~0.776). Conclusions: Daytime sleepiness in adolescents affects growth, academic performance, and emotional stability. Therefore, it is important to manage medications, diseases, and other factors that affect daytime sleepiness on a social level.

Keywords

Acknowledgement

본 연구는 정부(과학기술정보통신부)의 재원으로 한국연구재단의 지원을 받아 수행된 연구임(No. 2022R1F1A1069718).

References

  1. Brand S, Kirov R. Sleep and its importance in adolescence and in common adolescent somatic and psychiatric conditions. Int J Gen Med. 2011;4:425-42. https://doi.org/10.2147/IJGM.S11557
  2. Walker MP, Stickgold R. Sleep-dependent learning and memory consolidation. Neuron. 2004;44(1):121-33. https://doi.org/10.1016/j.neuron.2004.08.031
  3. Mercer PW, Merritt SL, Cowell JM. Differences in reported sleep need among adolescents. J Adolesc Health. 1998;23(5):259-63. https://doi.org/10.1016/S1054-139X(98)00037-8
  4. Yang CK, Kim JK, Patel SR, Lee JH. Age-related changes in sleep/wake patterns among Korean teenagers. Pediatrics. 2005;115(1 Suppl):250-6. https://doi.org/10.1542/peds.2004-0815G
  5. Noh JW, Kim J, Cheon J, Lee Y, Kwon YD. Relationships between extra-school tutoring time, somatic symptoms, and sleep duration of adolescent students: a panel analysis using data from the Korean children and youth panel survey. Int J Environ Res Public Health. 2020;17(21):8037.
  6. Fallone G, Owens JA, Deane J. Sleepiness in children and adolescents: clinical implications. Sleep Med Rev. 2002;6(4):287-306. https://doi.org/10.1053/smrv.2001.0192
  7. Beebe DW. Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatr Clin North Am. 2011;58(3):649-65. https://doi.org/10.1016/j.pcl.2011.03.002
  8. Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014;146:1387-94. https://doi.org/10.1378/chest.14-0970
  9. Ng TP, Tan WC. Prevalence and determinants of excessive daytime sleepiness in an Asian multi-ethnic population. Sleep Med. 2005;6(6):523-9. https://doi.org/10.1016/j.sleep.2005.01.007
  10. National Sleep Foundation. Sleep in America Poll, 2022. Available from http://www.sleepfoundation.org Accessed March 22, 2024.
  11. Rhie S, Lee S, Chae KY. Sleep patterns and school performance of korean adolescents assessed using a korean version of the pediatric daytime sleepiness scale. Korean J Pediatr. 2011;54(1):29-35. https://doi.org/10.3345/kjp.2011.54.1.29
  12. Millman RP; Working Group on Sleepiness in Adolescents/Young Adults; AAP Committee on Adolescence. Excessive sleepiness in adolescents and young adults: causes, consequences, and treatment strategies. Pediatrics. 2005;115(6):1774-86. https://doi.org/10.1542/peds.2005-0772
  13. Mahowald MW. Eyes wide shut. The dangers of sleepy driving. Minn Med. 2000;83(8):25-30.
  14. Carskadon MA. Sleep's effects on cognition and learning in adolescence. Prog Brain Res. 2011;190:137-43. https://doi.org/10.1016/B978-0-444-53817-8.00008-6
  15. Kim JH, Moon HS, Lee HW. Sleep patterns of middle & high school students in Seoul and their perceptions of their own sleep. J Korean Sleep Res Soc. 2014;11(1):21-32.
  16. 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(4):451-3. https://doi.org/10.1046/j.1440-1819.2003.01146.x
  17. Guilleminault C, Brooks SN. Excessive daytime sleepiness: a challenge for the practicing neurologist. Brain. 2001;124(Pt 8):1482-91. https://doi.org/10.1093/brain/124.8.1482
  18. Aldrich MS. Approach to the patients. In: Aldrich ed. Sleep medicine. New York, Oxford University Press, 1999;95-110.
  19. Lee W, Lee SA, Ryu HU, Chung YS, Kim WS. Quality of life in patients with obstructive sleep apnea: relationship with daytime sleepiness, sleep quality, depression, and apnea severity. Chron Respir Dis. 2016;13(1):33-9. https://doi.org/10.1177/1479972315606312
  20. 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(4):455-8.
  21. Komada Y, Breugelmans R, Drake CL, et al. Social jetlag affects subjective daytime sleepiness in school-aged children and adolescents: a study using the Japanese version of the pediatric daytime sleepiness scale (PDSS-J). Chronobiol Int. 2016;33(10):1311-9. https://doi.org/10.1080/07420528.2016.1213739
  22. Perez-Chada D, Perez-Lloret S, Videla AJ, 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(12):1698-703. https://doi.org/10.1093/sleep/30.12.1698
  23. Jacobsen JH, Shi L, Mokhlesi B. Factors associated with excessive daytime sleepiness in patients with severe obstructive sleep apnea. Sleep Breath. 2013;17(2):629-35. https://doi.org/10.1007/s11325-012-0733-z
  24. Chung KF, Cheung MM. Sleep-wake patterns and sleep disturbance among Hong Kong Chinese adolescents. Sleep. 2008;31(2):185-94. https://doi.org/10.1093/sleep/31.2.185
  25. Kang SH, Yoo HK, Chung S, Kim CY. Eveningness, sleep patterns, daytime sleepiness and fatigue in Korean male adolescents. Sleep Med Psychophysiol. 2012;19(2):89-96.
  26. Sohn GJ, Kim HJ, Kang SH, et al. Sleep patterns and predictors of daytime sleepiness in high school students. J Korean Neuropsychiatr Assoc. 2014;53(6):426-33. https://doi.org/10.4306/jknpa.2014.53.6.426
  27. Abdel-Khalek AM. Prevalence of reported insomnia and its consequences in a survey of 5,044 adolescents in Kuwait. Sleep. 2004;27(4):726-31. https://doi.org/10.1093/sleep/27.4.726
  28. Fatani A, Al-Rouqi K, Towairky J, et al. Effect of age and gender in the prevalence of excessive daytime sleepiness among a sample of the saudi population. J Epidemiol Glob Health. 2015;5(4 Suppl 1):S59-66. https://doi.org/10.1016/j.jegh.2015.05.005
  29. Miura J, Honma R. Daytime sleepiness in relation to gender and premenstrual symptoms in a sample of Japanese college students. Sleep and Biological Rhythms 2020;18:3-8. https://doi.org/10.1007/s41105-019-00236-x
  30. Woosley JA, Lichstein KL. Dysmenorrhea, the menstrual cycle, and sleep. Behav Med. 2014;40(1):14-21. https://doi.org/10.1080/08964289.2013.829020
  31. Wetter DW, Young TB. The relation between cigarette smoking and sleep disturbance. Prev Med. 1994;23(3):328-34. https://doi.org/10.1006/pmed.1994.1046
  32. Theorell-Haglow J, Lindberg E, Janson C. What are the important risk factors for daytime sleepiness and fatigue in women? Sleep. 2006;29(6):751-7. https://doi.org/10.1093/sleep/29.6.751
  33. Jaehne A, Loessl B, Barkai Z, Riemann D, Hornyak M. Effects of nicotine on sleep during consumption, withdrawal and replacement therapy. Sleep Med Rev. 2009;13(5):363-77. https://doi.org/10.1016/j.smrv.2008.12.003
  34. Briones B, Adams N, Strauss M et al. Relationship between sleepiness and general health status. Sleep. 1996;19(7):583-8. https://doi.org/10.1093/sleep/19.7.583
  35. Gustafsson ML, Laaksonen C, Salantera S, Loyttyniemi E, Aroma M. Associations between daytime sleepiness, psychological symptoms, headache, and abdominal pain in schoolchildren. J Sch Nurs. 2019;35(4):279-86. https://doi.org/10.1177/1059840518774394
  36. Kim J, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Excessive daytime sleepiness is associated with an exacerbation of migraine: a population-based study. J Headache Pain. 2016;17(1):62.
  37. Stavem K, Kristiansen HA, Kristoffersen ES, Kvaerner KJ, Russell MB. Association of excessive daytime sleepiness with migraine and headache frequency in the general population. J Headache Pain. 2017;18(1):35.
  38. Kim KM, Kim J, Cho SJ, et al. Excessive daytime sleepiness in tension-type headache: a population study. Front Neurol. 2019;10:1282.
  39. Cho SJ, Song TJ, Chu MK. Sleep and tension-type headache. Curr Neurol Neurosci Rep. 2019;19(7):44.
  40. Wilson KG, Eriksson MY, D'Eon JL, Mikail SF, Emery PC. Major depression and insomnia in chronic pain. Clin J Pain. 2002;18(2):77-83. https://doi.org/10.1097/00002508-200203000-00002
  41. Alamir YA, Zullig KJ, Wen S, et al. Association between nonmedical use of prescription drugs and sleep quality in a large college student sample. Behav Sleep Med. 2019;17(4):470-80. https://doi.org/10.1080/15402002.2017.1403325
  42. Drewes AM. Pain and sleep disturbances with special reference to fibromyalgia and rheumatoid arthritis. Rheumatology (Oxford). 1999;38(11):1035-8. https://doi.org/10.1093/rheumatology/38.11.1035
  43. Affleck G, Urrows S, Tennen H, Higgins P, Abeles M. Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia. Pain. 1996;68:363-8. https://doi.org/10.1016/S0304-3959(96)03226-5
  44. Aldabbas MM, Tanwar T, Iram I, Spence DW, Pandi-Perumal SR, Veqar Z. Sleep disturbance in neck pain patients: implications to pain intensity and disability. Sleep and Vigilance. 2022;6(2):349-57. https://doi.org/10.1007/s41782-022-00216-1
  45. Li JJ, Appleton SL, Gill TK, et al. Association of musculoskeletal joint pain with obstructive sleep apnea, daytime sleepiness, and poor sleep quality in men. Arthritis Care Res (Hoboken). 2017;69(5):742-7. https://doi.org/10.1002/acr.22994
  46. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop. 2013;7(1):3-9. https://doi.org/10.1007/s11832-012-0457-4
  47. Wong AYL, Samartzis D, Cheung PWH, Cheung JPY. How common is back pain and what biopsychosocial factors are associated with back pain in patients with adolescent idiopathic scoliosis? Clin Orthop Relat Res. 2019;477(4):676-86. https://doi.org/10.1097/CORR.0000000000000569
  48. Li X, Guo H, Chen C, et al. Does Sscoliosis affect sleep breathing? World Neurosurg. 2018;118:e946-50. https://doi.org/10.1016/j.wneu.2018.07.106