Purpose: A growing number of urban adolescents experience inadequate sleep duration, disrupted sleep, and/or trouble falling asleep, indicating poor sleep quality. Recent studies have highlighted the association between poor sleep and diminished psychological and physical health, increased risk-taking behavior, and poor academic performance. Racial and ethnic disparities in sleep quality have been observed among adolescents. To inform an intervention we: quantified the prevalence of sleep quality; described psychosocial stressor components of sleep hygiene that interfere with sleep; assessed demographic differences in poor sleep quality; and gauged interest in a sleep intervention that integrates mind-body integrative health (MBIH) approaches. Methods: A secondary data analysis of needs assessment data collected in two school-based health centers (SBHCs) included 167 adolescent patients in grades 9-12 who completed an anonymous online survey. Data include sociodemographic variables (age, sex, race/ethnicity), psychosocial stressors using items from the Adolescent Sleep Hygiene Scale, and sleep quality using the validated Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined as PSQI score >5. Bivariate analyses tested differences in sleep quality status by sociodemographics and psychosocial stressors. Regression models tested the association of psychosocial stressors with poor sleep quality, adjusting for sociodemographics. Results: Participants (mean age=16) were predominantly Hispanic (68%) and Black (21%); 64% were female. More than half (58%) had poor sleep quality as measured by PSQI. Adolescents reported experiencing psychosocial stressors that interfere with sleep. Relative to adolescents with good sleep quality, those with poor sleep quality were significantly more likely to report: replaying the day’s events over in their mind (30% vs. 48%, respectively; p=0.034); worrying about things happening at home or school (26% vs. 48%, p=0.008), feeling upset (15% vs. 31%, p=0.031), and experiencing things that made them feel strong emotions before going to bed (23% vs. 41%, p=0.022). In the adjusted model, adolescents who experienced 3-4 psychosocial stressors had three times the odds of having poor sleep quality (AOR: 3.32 [95% CI: 1.09-9.68]) compared to those who experienced none. Most students (77% overall, and 69% with poor sleep quality) reported they would likely participate in an SBHC intervention that integrates MBIH and sleep hygiene, with 60% reporting they would participate in four or more sessions. The proportion willing to participate did not differ significantly by sleep quality status, sex, or race/ethnicity. Conclusion: Urban adolescents served by NYC SBHCs, predominantly Black and Latino, have poor sleep quality and report psychosocial stressors that interfere with sleep and that have been shown to be modifiable in adults using MBIH. Adolescents are interested in MBIH interventions in SBHCs to address sleep problems. This represents a unique opportunity to offer an integrated MBIH/sleep hygiene intervention to a population at high-risk for poor sleep quality who would otherwise not have access.
Psychosocial stressors and poor sleep quality among NYC adolescents: Gauging the need for a sleep intervention incorporating mind-body integrative health
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Melanie A. Gold, Caitlyn Y. Suruki, Samantha Garbers, Katherine Falletta, Jean-Marie Bruzzese; Psychosocial stressors and poor sleep quality among NYC adolescents: Gauging the need for a sleep intervention incorporating mind-body integrative health. Pediatrics July 2020; 146 (1_MeetingAbstract): 252–254. 10.1542/peds.146.1MA3.252
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