Sleep Health and Its Related Influencing Factors in Primary and Middle School Students in Fuzhou: a Large Multi-Center Crowd-based Cross-sectional Study

Abstract

BackgroundThis current study set out to investigate the status of sleep health in 7-20-year-old students in Fuzhou and explore the related influencing factors of sleep health. MethodsA total of 38467 children and adolescents in Fuzhou were included in the study through a random stratified cluster sampling. Data were collected from May-June 2019, in 18 primary schools and 18 middle schools from 9 Districts, Fuzhou. Children's parents and adolescents of sampled classes were invited to fill a series of questionnaires about the performance of the last 6 months (sociodemographic characteristics, family sleep habits and routine activities before bedtime). Multiple linear regression was carried out to analyze data. ResultsOf the total 40888 questionnaires we released, 38467 were valid and effective with the response rate was 94.08%. The age of the surveyed participants was 11.85±3.1, including 20013 boys and 18454 girls. The multiple linear regression analysis identified factors associated with sleep health (P<0.05): Grl (coef=-0.073, 95%CI: -0.115--0.03), Age (coeff=0.234, 95%CI: 0.224-0.243), Key school (coeff=-0.149, 95%CI: -0.193- -0.105), Urban (coeff=-0.096, 95%CI: -0.139--0.054), Excessive daytime sleepiness (coeff=0.535, 95%CI: 0.432-0.639), Unhealthy sleep habits (coeff=0.363, 95%CI: 0.307-0.419), Using electronic products in bedroom (coeff=0.074, 95%CI: 0.028-0.121), Screen time per day during school (coeff=0.260, 95%CI: 0.235-0.284), Frequency of using electronics 30 minutes before bedtime (coeff=0.150, 95%CI: 0.134-0.166), Eating before sleep (coeff=0.578, 95%CI: 0.527-0.63), Sleep alone (coeff=-0.204, 95%CI: -0.262--0.147) Intense relationship with parents (coeff=0.361, 95%CI: 0.27-0.452), Intense relationship with peers (coeff=0.267, 95%CI: 0.171-0.363), Excessive homework or learning (coeff=0.189, 95%CI: 0.141-0.237), Time for doing homework (coeff=0.266, 95%CI: 0.245-0.287) and Mood swings frequently (coeff=1.174, 95%CI: 1.127-1.221) had greater impact on sleep health than other factors. ConclusionsSleep health is associated with factors covered sociodemographic characteristics, family sleep habits and routine activities before bedtime, and multiple measures should be taken to improve sleep quality in a targeted manner.