Sleep-Wake Patterns and Sleep Disturbance among Hong Kong Chinese Adolescents

STUDY OBJECTIVES: To determine sleep-wake patterns and evaluate sleep disturbance in Hong Kong adolescents; to identify factors that are associated with sleep disturbance; and to examine the relationship of sleep-wake variables and academic performance. DESIGN AND SETTING: A school-based cross-sectional survey. PARTICIPANTS: Sample included 1629 adolescents aged 12 to 19 years. MEASUREMENTS AND RESULTS: Self-report questionnaires, including sleep-wake habit questionnaire, Sleep Quality Index, Morningness/ Eveningness scale, Epworth Sleepiness Scale, Perceived Stress Scale, academic performance, and personal data were administered. The average school-night bedtime was 23:24, and total sleep time was 7.3 hr. During weekends, the average bedtime and rise time was delayed by 64 min and 195 min, respectively. The prevalence of sleep disturbances occurring > or = 3 days per week in the preceding 3 months were: difficulty falling asleep (5.6%), waking up during the night (7.2%), and waking up too early in the morning (10.4%). The prevalence of > or = 1 of these three symptoms was 19.1%. Stepwise regression analyses revealed that circadian phase preference was the most significant predictor for school night bedtime, weekend oversleep, and daytime sleepiness. Perceived stress was the most significant risk factor for sleep disturbance. Students with marginal academic performance reported later bedtimes and shorter sleep during school nights, greater weekend delays in bedtime, and more daytime sleepiness than those with better grades. CONCLUSION: The prevalence of sleep deprivation and sleep disturbance among Hong Kong adolescents is comparable to those found in other countries. An intervention program for sleep problems in adolescents should be considered.