Original ArticleMedia devices, family relationships and sleep patterns among adolescents in an urban area
Introduction
Sleep plays a major role in health at all stages of life since important bodily functions and brain activity occur during sleep. Sleep loss has been associated with poor mental and physical health indicators [1], [2], including impaired memory and cognitive performance [3], lower academic performance [4], [5], emotional disorders [6], increased health complaints [7], and metabolic diseases such as type 2 diabetes and obesity [8], [9]. According to the National Sleep Foundation, the optimal sleep duration for adolescents is 9 or more hours per day while insufficient sleep duration is defined as less than 8 h [10]. Considering those cut-off points, a European study conducted in 2007 showed that sleep time was insufficient in more than 30% of adolescents [11]. In Spain, 18% of girls and 22% of boys aged 13–18 years old reported sleeping less than 8 h/day with an average sleep duration of 8.4 h and 8.3 h, respectively, in 2002 [12]. Girls slept less than boys, especially among the oldest adolescents [12]. Gender differences have also been found in studies performed in other countries, mostly showing later bedtimes [13] and shorter sleep duration [14], [15] in girls than in boys.
During adolescence, maturational changes in sleep and the circadian system lead to a delay in sleep and wake-up times [16], [17], [18]. Additionally, some psychosocial factors such as greater daily activities and academic obligations, the desire to engage in adult-like activities and be autonomous, and the availability of night-time activities mostly related to media devices also contribute to delayed bedtime [16], [17]. Nowadays, adolescents increasingly own different kinds of media devices, which are usually available in their bedrooms and are beyond parental control at night. A negative association has been demonstrated between the presence of media devices in bedrooms and sleep time [19], [20].
Some cultural characteristics may also contribute to a delayed bedtime. In Spain, dinner time (20:30–23:00 h) is usually later than in other countries and the meal usually takes 20 minutes longer than in other countries such as the United Kingdom [21]. Moreover, people have been found to spend more time watching television when they eat in front of it [22], [23]. Considering these facts, we hypothesize that watching television during dinner, the last meal of the day, could result in a higher amount of time watching television which may in turn lead to a later bedtime among adolescents.
There is some evidence that family environment directly influences sleep patterns in children [24], [25]. In particular, parental control on setting bedtime is a major issue in achieving optimal sleep time [26] in adolescents. Although only a few studies have analyzed family determinants of sleep patterns in adolescents, a positive relationship has been found between a greater parent-set bedtime and longer sleep duration [27], [28]. Moreover, negative parenting styles [29] and unstructured families [30] have been associated with later bedtimes and consequently with short sleep duration.
To our knowledge, studies of the influence of family characteristics on sleep patterns among adolescents are scarce and most have focused on isolated characteristics instead of the synergy between distinct factors. More extensive knowledge of different family characteristics analyzed together in our context is needed to prevent sleep deprivation among the adolescent population. Based on the literature, two hypotheses were formulated. First, a high percentage of adolescents do not meet sleep recommendations. Second, adolescents who have at least one media device in their bedroom, watch television during dinner, have poor family relationships, and live in a single-parent or reconstructed family sleep for a shorter duration than recommended. The objectives of this study were to describe sleep patterns and to examine the association of short sleep time with family relationships and the availability of media devices among adolescents.
Section snippets
Design and study population
A cross-sectional study was carried out among 8th- (13–14 years), 10th- (15–16 years) and 12th- (17–18 years) grade students from a random sample of high schools in Barcelona. In Spain, secondary education is structured as compulsory schooling and post-compulsory schooling. The compulsory schooling consists of 4 years, from 12 to 16 years of age, which are divided into two cycles. The first cycle includes 7th and 8th grades (equivalent to International Standard Classification of Education
Results
Descriptive characteristics of the sample are shown in Table 1. The mean age of the students was 15.9 years and 51.3% were girls. Overall, almost 90% of the students were from medium- or highly affluent families and three out of four students lived in two-parent families. Most of adolescents attended a subsidized school (60.9%) and went to schools located in medium- or high-SES neighborhoods (64.6%).
Table 2 describes sleep patterns on school and non-school days. Gender differences were found
Discussion
The main results of this study show that around 40% of students in compulsory schooling and more than 70% of students in post-compulsory schooling do not meet sleep duration recommendations on school days. The presence of a computer in the bedroom increases the risk of insufficient sleep time by 14% and 26% in boys and girls, respectively. Moreover, watching TV during dinner and poorer family relationships are also associated with short sleep time.
Our results show that sleep duration is shorter
Conflict of interest
The authors have no conflicts of interest to disclose.
The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: http://dx.doi.org/10.1016/j.sleep.2016.04.006.
Acknowledgments
The authors would like to thank the teachers and students of the participating schools. We would also like to thank personnel of the Evaluation and Intervention Methods Service of the Agència de Salut Pública de Barcelona who collaborated in the administration of the questionnaires and height and weight measurements. This paper represents partial fulfillment of the requirements for the PhD program of Xavier Garcia Continente at the Pompeu Fabra University (Barcelona, Spain). This work was
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