Sleep Habits, Sleep Problems, Sleep Hygiene, and Their Associations With Mental Health Problems Among Adolescents.

BACKGROUND: Studies in adults suggested that sleep could be a significant contributor to mental health. However, little is known about their relationship in adolescents.

OBJECTIVE: The present study aimed to examine the overall associations of full-spectrum sleep behaviors, including sleep habits, sleep problems, and sleep hygiene, with mental health problems among adolescents in Shanghai, China.

DESIGN: A stratified, cluster random sample of 4,823 adolescents aged 11 to 20 years participated in a cross-sectional survey. The Adolescent Sleep Disturbance Questionnaire and the modified Adolescent Sleep Hygiene Scale were used to examine sleep behaviors. The Strengths and Difficulties Questionnaire was used to evaluate mental health problems.

RESULTS: Five sleep variables were found to be associated with adolescents' mental health. The five factors covered three sleep domains: sleep habits (later bedtime during weekdays), sleep problems (maintaining sleep difficulties, disorders of arousal), and sleep hygiene (poor emotion at bedtime, unstable sleep schedule).

CONCLUSIONS: The clinical significance of the findings lies in the emphasis of comprehensive screening of sleep in the predicting, diagnosis, nursing, and intervention of adolescents' mental health problems.