Sleep Disturbances, Psychosocial Difficulties, and Health Risk Behavior in 16,781 Dutch Adolescents
Section snippets
Sample
This study used data from a Youth Health Care questionnaire by the Dutch Community Health Service of the greater Utrecht area. This area, located in the central part of the country, contains both urban and rural communities, and 76.7% of the 12–18-year-olds in the area are native Dutch.
In the Netherlands, children around age 12 change from primary to secondary school. Based on their academic levels, students enter 1 of 4 different educational attainment levels: prevocational, higher
Sleep Disturbances
We determined the presence of sleep disturbances with the question “In the past 4 weeks, how often did you experience trouble sleeping?” which was answered with “never,” “almost never,” “sometimes,” “often,” or “very often.” This question was dichotomized into (almost) never/sometimes versus (very) often.
Strengths and Difficulties Questionnaire
We assessed the presence of psychosocial problems with the self-report version of the Strength and Difficulties Questionnaire (SDQ).16 This behavioral screening measure was originally designed
Sample Characteristics
Table 1 presents the characteristics of the complete sample, which consisted of 8479 boys (50.5%) and 8302 girls (49.5%). Age ranged from 12 to 18 years, with a mean age of 14.5 ± 1.2 years. About one-half of the students (n = 8666; 51.6%) attended the 2nd year of secondary education and 8112 students (48.3%) attended the 4th year. In total, 3337 adolescents (19.9%) reported sleep disturbances. Age, grade, and ethnicity did not differ between adolescents with and without sleep disturbances (U
Discussion
In this large sample of Dutch secondary school adolescents (n = 16,781) we found a prevalence of sleep disturbances of just under 20%. Sleep disturbances were associated with psychosocial difficulties and suicidality, with girls showing a stronger relationship between sleep disturbances and suicide attempts compared with boys. Furthermore, sleep disturbances were related to nearly all assessed health risk behaviors, including the use of substances (ie, alcohol, tobacco, cannabis, and other
Acknowledgments
All of the data came from a Youth Health Care questionnaire adminstered by the Dutch Community Health Service of the greater Utrecht area, The Netherlands. The authors thank the Community Health Service of the greater Utrecht area and all participating schools for their effort in the process of data collection. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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The authors have no conflicts of interest to disclose.