Cell phone use before bedtime: a risk factor for excessive sleepiness in adolescents from military schools

ABSTRACT Objective To investigate the prevalence of excessive daytime sleepiness (EDS) and associated factors in adolescents attending military schools. Methods 466 high school students (15-17 years old) of both sexes (230 men) participated. Participants were interviewed about sociodemographic characteristics and sleep duration (week and weekend), adopting values < 8 hours of sleep as insufficient sleep time. EDS was assessed with the Epworth Sleepiness Scale; where students with scores ≥ 10 had EDS. Results The overall prevalence of EDS was 34.1%. The mean for sleep hours was 6.9 h (±1,85) on weekdays and 8.5 h (±1.96) on weekends. It was identified that 60% of the adolescents presented short weekly sleep duration (p = 0.05). In the final regression model, higher EDS risks were observed in those subjects that had a short sleep duration (OR: 1.55; 95% CI: 1.04-2.31) and those that used the cell phone before bedtime (OR: 4.30; 95% CI: 2.00-9.23). Conclusion EDS was strongly associated with cell phone use before bedtime. Other associated factors are insufficient sleep and studying full-time. Educational, administrative and health measures are needed to improve sleep in adolescents.

摘要
研究目的：探讨就读军校的青少年的日间过度嗜睡（Excessive Daytime Sleepiness，EDS）患病率及其相关影响因素。
研究方法：纳入466名15至17岁的高中生，其中男性230名。对受试者进行访谈，收集其社会人口学特征及睡眠时长信息（包括工作日与周末睡眠时长），将每日睡眠时长不足8小时判定为睡眠不足。采用爱泼沃斯嗜睡量表（Epworth Sleepiness Scale）评估受试者的日间过度嗜睡情况，得分≥10分者即被判定为存在日间过度嗜睡。
研究结果：受试者总体日间过度嗜睡检出率为34.1%。工作日平均睡眠时长为6.9小时（±1.85），周末平均睡眠时长为8.5小时（±1.96）。研究发现，60%的青少年周睡眠时长不足（p=0.05）。在最终回归模型中，睡眠时长不足者（优势比[OR]=1.55，95%置信区间[CI]：1.04~2.31）及睡前使用手机者（OR=4.30，95%CI：2.00~9.23）的日间过度嗜睡风险显著升高。
研究结论：日间过度嗜睡与睡前使用手机存在显著关联，其余相关危险因素包括睡眠不足及全日制就读。需采取教育、管理及健康干预措施以改善青少年的睡眠状况。