Factors associated with excessive daytime sleepiness among Brazilian adolescents.

This study aimed to verify the prevalence and factors associated with excessive daytime sleepiness (EDS) among adolescents. In all, 1.132 people participated. They were aged between 14 and 19 years, of both sexes and they came from a city in southern Brazil. Many socio-demographic variables were collected (sex, age group, socioeconomic status, period of study, year of school and work), also variables related to their health (level of physical activity, alcohol intake, smoking, misuse of medicines, stress control, duration of sleep, sedentary behavior and self-rated health) and EDS, through the Pediatric Daytime Sleepiness Scale (PDSS). The prevalence of EDS in general sample was 54.2% and average score in PDSS was 16.0 (5.7). Comparing results between both sexes, female sex presents the higher prevalence of EDS (64.3%) and greatest average PDSS score 17.5 (5.4) compared to male sex (35.7%) with 14.5 (5.6%) score (p < .001). In analysis of the prevalence ratio, using 15 as an EDS cut-off point, prevalence was 35% higher in the female sex (PR = 1.35 CI 95% 1.08-1.69, p = .010). In addition, adolescents which had lower self-rated health (PR = 1.24 CI 95% 1.01-1.52, p = .038), low stress control (PR = 1.28 CI 95% 1.05-1.57, p = .014) and short sleep duration (PR = 1.30 CI 95% 1.02-1.65, p = .029), presented higher prevalence of EDS. High prevalence of EDS was identified, being more common in young women. Adequate sleep, greater stress control and better health perception should be promoted among Brazilian adolescents.

Proposal of cutoff points for pediatric daytime sleepiness scale to identify excessive daytime sleepiness.

The objective of the present study was to propose cutoff points for the Pediatric Daytime Sleepiness Scale (PDSS) through sensitivity and specificity analyses in order to identify excessive daytime sleepiness, considering parameters such as duration and quality of sleep, health perception, stress control and depressive moods (feelings of sadness) in adolescents. A total of 1,132 adolescents, aged 14-19 years old, of both sexes, from the public high school of São José - SC, answered the questionnaire with information on age, daytime sleepiness, sleep duration, health perception, stress management, depressive moods (feelings of sadness) and quality of sleep. The Receiver Operating Characteristic (ROC) curve was used to estimate cutoff points considering the sensitivity and specificity values ​​that best identify adolescents with excessive daytime sleepiness, using independent variables as a reference. The majority of the sample was female (54.2%), aged 14-16 years. The girls presented worse quality of sleep (66.4%), and the boys had a more positive perception of health (74.8%), better stress control (64.8%) and lower depressive moods (feelings of sadness) (63.3%). The largest area in the ROC curve was the one that considered sleep quality as a parameter in both sexes (area of the curve = 0.709 and 0.659, respectively, for boys and girls, p < 0.001). Considering sleep quality as a reference, the cutoff point for excessive daytime sleepiness was 15 points. The other parameters used were also significant (p < 0.005). Poor sleep quality was the parameter most strongly related to daytime sleepiness, and a cutoff of 15 points for the PDSS for both sexes should be used in the definition of excessive daytime sleepiness. For the other parameters, stress management, depressive mood (feelings of sadness) and health perception, different cutoff points are suggested for boys and girls.

Assessment of sleep in subjects with visual impairment: Comparison using subjective and objective methods.

The objective of the present study was to verify the agreement between objective and subjective measures of sleep in people with and without visual impairment. Thirty-seven subjects with visual impairment participated in the study (19 blind without light perception and 18 low-vision), as well as 34 subjects with normal vision, with paired age and gender characteristics. For the subjective sleep evaluation, we used the Sleep Quality Index-PSQI and for the objective evaluation we used the ActiGraph GT3X+. Among the three analyzed groups, the blind was the only ones who presented differences between subjective and objective sleep duration (p = 0.021). Furthermore, the concordance between subjective and objective sleep duration (ICC = 0.388; p = 0.108) was not observed in blind subjects, and a greater variability of differences in sleep duration between the two methods was observed by the Bland Altman scatter plot. We concluded that the sleep duration obtained by PSQI did not show agreement for the objective sleep duration in blind subjects without light perception.

Factors associated with sleep duration in Brazilian high school students.

The aim of this study was to investigate the factors associated with short sleep duration on southern Brazilian high school students. Our study was comprised of 1,132 adolescents aged 14 to 19 years, enrolled in public high schools in São José, Brazil. The students answered a questionnaire about working (work and workload), health perception, smoking, school schedule, sleep (duration and daytime sleepiness), and socio-demographics data. The results showed that more than two thirds of adolescent workers had short sleep duration (76.7%), and those with a higher workload (more than 20 hours) had a shorter sleep duration (7.07 hours) compared to non-workers (7.83 hours). In the analysis of factors associated with short sleep duration, adolescents who worked (OR = 2.12, 95% CI 1.53 to 2.95) were more likely to have short sleep duration compared to those who did not work. In addition, older adolescents (17-19 years) and students with poor sleep quality were 40% and 55% more likely to have short sleep duration compared to younger adolescents (14-16 years) and students with good sleep quality, respectively. Adolescents with daytime sleepiness were more likely to have short sleep duration (OR = 1.49, 95% CI 1.06 to 2.07) compared to those without excessive daytime sleepiness. In addition students of the morning shift (OR = 6.02, 95% CI 4.23 to 8.57) and evening shift (OR = 2.16, 95% CI 1.45 to 3.22) were more likely to have short sleep duration compared to adolescents of the afternoon shift. Thereby adolescents who are workers, older, attended morning and evening classes and have excessive daytime sleepiness showed risk factors for short sleep duration. In this sense, it is pointed out the importance of raising awareness of these risk factors for short sleep duration of students from public schools from São José, located in southern Brazil.