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.

A baixa duração do sono está associada com a inatividade física em adolescentes Amazonenses? / The short sleep duration associated with physical inactivity among Amazonas adolescents?

Este estudo teve como objetivo analisar os fatores associados à baixa duração do sono em adolescentes Amazonenses. Trata-se de um estudo epidemiológico transversal, conduzido com 2517 adolescentes (1106 do sexo masculino e 1411 do sexo feminino), com idades de 14 a 19 anos, matriculados em escolas públicas de ensino médio no estado do Amazonas. Além da baixa duração do sono (< oito horas/dia) foram investigadas informações sobre sexo, faixa etária, ano escolar, turno escolar, renda familiar, situação ocupacional e atividade física. Associações entre a baixa duração de sono com as demais variáveis foram analisadas por meio da regressão de Poisson. A prevalência de baixa duração de sono foi de (51,2%; IC95%: 49,2-52,9). Adolescentes mais velhos de 18 a 19 anos (RP= 1,14; IC95%: 1,01-1,29), que estudam no turno matutino (RP= 1,37; IC95%: 1,25-1,48) e noturno (RP= 1,16; IC95%: 1,04-1,28), os que trabalham (RP= 1,34; IC95%: 1,23-1,45) e são inativos fisicamente (RP=1,27; IC95%: 1,06-1,53) apresentaram maior risco para a baixa duração do sono. Os resultados mostram que fatores biológicos, comportamentais e ambientais são fatores importantes para a duração do sono dos adolescentes.

This study aimed to analyze the factors associated with short sleep duration in adolescents from Amazonas. It is a cross-sectional epidemiological study conducted with 2,517 adolescents (1,106 males and 1,411 females), aged 14 to 19 years, enrolled in public schools in the state of Amazonas. In addition to the short sleep duration (< eight hours per day), information about sex, age group, school grade, turn school, family income, occupation and physical activity were investigate. Associations between short sleep duration with the other variables were analyzed using Poisson regression. Prevalence of short sleep duration found in adolescents Amazonas was (51.2%; 95% CI: 49.2-52.9). Oldest adolescents from 18 to 19 years (PR = 1.14; 95% CI: 1.01-1.29), who are studying in the morning turn (PR= 1.37; 95% CI: 1.25-1.48) and nocturnal (PR= 1.16; 95% CI: 1.04-1.28), those who work (PR= 1.34; 95% CI: 1.23-1.45) and are physically inactive (RP=1.27; 95% CI= 1.06-1.53) presented higher risk for short sleep duration. The results show that biological, behavioral and environmental factors are important during period of adolescents' sleep.

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.