"Sleepiness" is serious in adolescence: Two surveys of 3235 Canadian students
Open accessAbstract
Background: Evidence is growing that sleep problems in adolescents are significant impediments to learning and negatively affect behaviour, attainment of social competence and quality of life. The objectives of the study were to determine the level of sleepiness among students in high school, to identify factors to explain it, and to determine the association between sleepiness and performance in both academic and extracurricular activities Methods: A cross-sectional survey of 2201 high school students in the Hamilton Wentworth District School Board and the Near North District School Board in Ontario was conducted in 1998/9. A similar survey was done three years later involving 1034 students in the Grand Erie District School Board in the same Province. The Epworth Sleepiness Scale (ESS) was used to measure sleepiness and we also assessed the reliability of this tool for this population. Descriptive analysis of the cohort and information on various measures of performance and demographic data were included. Regression analysis, using the generalised estimating equation (GEE), was utilized to investigate factors associated with risk of sleepiness (ESS>10). Results: Seventy per cent of the students had less than 8.5 hours weeknight sleep. Bedtime habits such as a consistent bedtime routine, staying up late or drinking caffeinated beverages before bed were statistically significantly associated with ESS, as were weeknight sleep quantity and gender. As ESS increased there was an increase in the proportion of students who felt their grades had dropped because of sleepiness, were late for school, were often extremely sleepy at school, and were involved in fewer extracurricular activities. These performance measures were statistically significantly associated with ESS. Twenty-three percent of the students felt their grades had dropped because of sleepiness. Most students (58–68%) reported that they were "really sleepy" between 8 and 10 A.M. Conclusion: Sleep deprivation and excessive daytime sleepiness were common in two samples of Ontario high school students and were associated with a decrease in academic achievement and extracurricular activity. There is a need to increase awareness of this problem in the education and health communities and to translate knowledge already available to strategies to address it.
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Lack of sleep is significantly associated with a decline in academic performance.
“The lack of sleep that is frequently observed in adolescence seems to be significantly associated with a decline in academic performance [11,12,13].”
From Lifestyle Habits Predict Academic Performance in High School Students: The Adolescent Student Academic Performance Longitudinal Study (ASAP) (2019) · cites this paper as [11]
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Cites
(1998) · Cited by 36,049 · see citing works
Longitudinal data analysis using generalized linear models
LIANG, K.-Y., & ZEGER, S. L. (1986) · Biometrika · doi:10.1093/biomet/73.1.13 · Cited by 18,550 · see citing works
A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
Johns, M. W. (1991) · Sleep · doi:10.1093/sleep/14.6.540 · Cited by 17,364 · see citing works
A simulation study of the number of events per variable in logistic regression analysis
Peduzzi, P., Concato, J., Kemper, E., Holford, T. R., & Feinstein, A. R. (1996) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(96)00236-3 · Cited by 9,655 · see citing works
Longitudinal Data Analysis for Discrete and Continuous Outcomes
Zeger, S. L., & Liang, K. (1986) · Biometrics · doi:10.2307/2531248 · Cited by 7,730 · see citing works
Dialysis Dose and Intradialytic Hypotension: Results from the HEMO Study
Causland, F. R. M., Brunelli, S. M., & Waikar, S. S. (2013) · American Journal of Nephrology · doi:10.1159/000355958 · Cited by 2,705 · see citing works
Babyak, M. A. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000127692.23278.a9 · Cited by 2,061 · see citing works
Sleep Schedules and Daytime Functioning in Adolescents
Wolfson, A. R., & Carskadon, M. A. (1998) · Child Development · doi:10.1111/j.1467-8624.1998.tb06149.x · Cited by 1,676 · see citing works
Adolescent Brain Development: A Period of Vulnerabilities and Opportunities. Keynote Address
DAHL, R. E. (2004) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1308.001 · Cited by 1,667 · see citing works
Longitudinal Data Analysis Using Generalized Linear Models
Liang, K., & Zeger, S. L. (1986) · Biometrika · doi:10.2307/2336267 · Cited by 1,201 · see citing works
Association between Puberty and Delayed Phase Preference
Carskadon, M. A., Vieira, C., & Acebo, C. (1993) · Sleep · doi:10.1093/sleep/16.3.258 · Cited by 1,167 · see citing works
Regulation of adolescent sleep: Implications for behavior
CARSKADON, M. A., ACEBO, C., & JENNI, O. G. (2004) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1308.032 · Cited by 792 · see citing works
Adolescent Sleep Patterns, Circadian Timing, and Sleepiness at a Transition to Early School Days
Carskadon, M. A., Wolfson, A. R., Acebo, C., Tzischinsky, O., & Seifer, R. (1998) · Sleep · doi:10.1093/sleep/21.8.871 · Cited by 769 · see citing works
The impact of inadequate sleep on children's daytime cognitive function
Dahl, R. E. (1996) · Seminars in Pediatric Neurology · doi:10.1016/s1071-9091(96)80028-3 · Cited by 566 · see citing works
Pubertal Changes in Daytime Sleepiness
Mary, A. C., Harvey, K., Duke, P., Thomas, F. A., Iris, F. L., & William, C. D. (1980) · Sleep · doi:10.1093/sleep/2.4.453 · Cited by 545 · see citing works
Underdiagnosis of Sleep Apnea Syndrome in U.S. Communities
Kapur, V. K., Strohl, K. P., Redline, S. S., Iber, C., O’Connor, G. T., & Nieto, F. J. (2002) · Sleep And Breathing · doi:10.1055/s-2002-32318 · Cited by 474 · see citing works
Underdiagnosis of Sleep Apnea Syndrome in U.S. Communities
Kapur, V. K., Strohl, K. P., Redline, S. S., Iber, C., O’Connor, G. T., & Nieto, F. J. (2002) · Sleep And Breathing · doi:10.1007/s11325-002-0049-5 · Cited by 435 · see citing works
Cognitive Function Following Acute Sleep Restriction in Children Ages 10–14
(1998) · Sleep · doi:10.1093/sleep/21.8.861 · Cited by 430 · see citing works
The Medical Cost of Undiagnosed Sleep Apnea
Kapur, V., Blough, D. K., Sandblom, R. E., Hert, R., de Maine, J. B., Sullivan, S. D., & Psaty, B. M. (1999) · Sleep · doi:10.1093/sleep/22.6.749 · Cited by 384 · see citing works
Excessive Sleepiness in Adolescents and Young Adults: Causes, Consequences, and Treatment Strategies
Millman, R. P., & Working Group on Sleepiness in Adolescents/Young Adults; and AAP Committee on Adolescence (2005) · Pediatrics · doi:10.1542/peds.2005-0772 · Cited by 372 · see citing works
Sleep states and memory processes in humans: procedural versus declarative memory systems
Smith, C. (2001) · Sleep Medicine Reviews · doi:10.1053/smrv.2001.0164 · Cited by 355 · see citing works
The impact of school daily schedule on adolescent sleep
Hansen, M., Janssen, I., Schiff, A., Zee, P. C., & Dubocovich, M. L. (2005) · PEDIATRICS · doi:10.1542/peds.2004-1649 · Cited by 289 · see citing works
Morrison, D., McGee, R. O., & Stanton, W. R. (1992) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199201000-00014 · Cited by 286 · see citing works
The Practice of Pediatric Sleep Medicine: Results of a Community Survey
Owens, J. A. (2001) · PEDIATRICS · doi:10.1542/peds.108.3.e51 · Cited by 267 · see citing works
Sleep and Psychiatric Symptoms in School-Age Children
Aronen, E. T., Paavonen, E. J., Fjällberg, M., Soininen, M., & Törrönen, J. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200004000-00020 · Cited by 265 · see citing works
Adolescent brain development : vulnerabilities and opportunities
Dahl, R. E., & SPEAR, L. P. (2004) · New York Academy of Sciences eBooks · Cited by 262 · see citing works
Association of Sleep and Academic Performance
Eliasson, A. H., Eliasson, A., King, J., Gould, B., & Eliasson, A. H. (2002) · Sleep And Breathing · doi:10.1007/s11325-002-0045-9 · Cited by 122 · see citing works
Sleep history is neglected diagnostic information
Haponik, E. F., FRYE, A. W., RICHARDS, B. F., Wymer, A., Hinds, A., Pearce, K. A., McCall, W. V., & KONEN, J. C. (1996) · Journal of General Internal Medicine · doi:10.1007/bf02598994 · Cited by 120 · see citing works
Failure of physician documentation of sleep complaints in hospitalized patients.
Meissner, H.-H., Riemer, A., Santiago, S. M., Stein, M., Goldman, M., & Williams, A. J. (1998) · Europe PMC (PubMed Central) · Cited by 107 · see citing works
Diagnoses Received by Narcolepsy Patients in the Year Prior to Diagnosis by a Sleep Specialist
Kryger, M. H., Walld, R., & Manfreda, J. (2002) · SLEEP · doi:10.1093/sleep/25.1.36 · Cited by 100 · see citing works
Association of Sleep and Academic Performance
Eliasson, A., Eliasson, A., King, J., Gould, B., & Eliasson, A. (2002) · Sleep And Breathing · doi:10.1055/s-2002-23157 · Cited by 86 · see citing works
Extended nights, sleep loss, and recovery sleep in adolescents.
Carskadon, M. A., Acebo, C., & Seifer, R. (2001) · PubMed · Cited by 67 · see citing works
Knowledge and attitude of Primary Health Care Physicians towards sleep disorders
BaHammam, A. S. (2000) · Saudi Medical Journal · doi:10.15537/1658-3175.1329 · Cited by 59 · see citing works
Pubertal changes in daytime sleepiness. 1980.
Carskadon, M. A., Harvey, K., Duke, P. M., Anders, T. F., Litt, I. F., & Dement, W. C. (2002) · PubMed · Cited by 54 · see citing works
Wahlstrom, K. L. (2001) · Adolescent Sleep Patterns · doi:10.1017/cbo9780511499999.014 · Cited by 46 · see citing works
Walter, S. D. (1999) · Statistics in Medicine · doi:10.1002/(sici)1097-0258(19990130)18:2
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Sorted by citations
Dewald, J. F., Meijer, A. M., Oort, F. J., Kerkhof, G. A., & Bögels, S. M. (2010) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2009.10.004 · Cited by 1,526 · see citing works
Gradisar, M., Gardner, G., & Dohnt, H. (2011) · Sleep Medicine · doi:10.1016/j.sleep.2010.11.008 · Cited by 1,196 · see citing works
Sleep in Adolescents: The Perfect Storm
Carskadon, M. A. (2011) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2011.03.003 · Cited by 1,122 · see citing works
Functional consequences of inadequate sleep in adolescents: A systematic review
Shochat, T., Cohen-Zion, M., & Tzischinsky, O. (2014) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2013.03.005 · Cited by 837 · see citing works
Lovato, N., & Gradisar, M. (2014) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2014.03.006 · Cited by 594 · see citing works
Basch, C. E. (2011) · Journal of School Health · doi:10.1111/j.1746-1561.2011.00632.x · Cited by 521 · see citing works
Associations of executive function with sleepiness and sleep duration in adolescents
Anderson, B., Storfer-Isser, A., Taylor, H. G., Rosen, C. L., & Redline, S. (2009) · Pediatrics · doi:10.1542/peds.2008-1182 · Cited by 233 · see citing works
Britton, W. B., Bootzin, R. R., Cousins, J. C., Hasler, B. P., Peck, T., & Shapiro, S. L. (2010) · Substance Abuse · doi:10.1080/08897071003641297 · Cited by 133 · see citing works
School-based sleep promotion programs: Effectiveness, feasibility and insights for future research
Cassoff, J., Knäuper, B., Michaelsen, S., & Gruber, R. (2013) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2012.07.001 · Cited by 118 · see citing works
Sleep Insufficiency, Sleep Health Problems and Performance in High School Students
Ming, X., Koransky, R., Kang, V., Buchman, S., Sarris, C. E., & Wagner, G. C. (2011) · Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine · doi:10.4137/ccrpm.s7955 · Cited by 91 · see citing works
Asthma and the Achievement Gap Among Urban Minority Youth
Basch, C. E. (2011) · Journal of School Health · doi:10.1111/j.1746-1561.2011.00634.x · Cited by 88 · see citing works
Dubuc, M.-M., Aubertin-Leheudre, M., & Karelis, A. D. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010243 · Cited by 56 · see citing works
DEWALD, J. F., SHORT, M. A., GRADISAR, M., OORT, F. J., & MEIJER, A. M. (2012) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2012.00999.x · Cited by 47 · see citing works
De Bernardi Rodrigues, A. M., da Silva, C. D. C., Vasques, A. C. J., Camilo, D. F., Barreiro, F., Cassani, R. S. L., Zambon, M. P., Antonio, M. Â. R. D. G. M., Geloneze, B., & for the Brazilian Metabolic Syndrome Study (BRAMS) Investigators (2016) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2015.4365 · Cited by 47 · see citing works
Short Duration of Sleep and Unintentional Injuries among Adolescents in China
Lam, L. T., & Yang, L. (2007) · American Journal of Epidemiology · doi:10.1093/aje/kwm175 · Cited by 40 · see citing works
KOPASZ, M., LOESSL, B., VALERIUS, G., KOENIG, E., MATTHAEAS, N., HORNYAK, M., KLOEPFER, C., NISSEN, C., RIEMANN, D., & VODERHOLZER, U. (2010) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2009.00742.x · Cited by 37 · see citing works
Luo, C., Zhang, J., Chen, W., Lu, W., & Pan, J. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.01.016 · Cited by 33 · see citing works
Later school start times in a flexible system improve teenage sleep
Winnebeck, E. C., Vuori-Brodowski, M. T., Biller, A. M., Molenda, C., Fischer, D., Zerbini, G., & Roenneberg, T. (2020) · Sleep · doi:10.1093/sleep/zsz307 · Cited by 30 · see citing works
School start times and academic achievement - A systematic review on grades and test scores
Biller, A. M., Meissner, K., Winnebeck, E. C., & Zerbini, G. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101582 · Cited by 27 · see citing works
Adolescents’ preference for later school start times
Werner, H., Albrecht, J. N., Widmer, N., Janisch, D., Huber, R., & Jenni, O. G. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13401 · Cited by 17 · see citing works
FİLİZ, B., & KAYA, D. G. (2021) · Ankara Üniversitesi Beden Eğitimi ve Spor Yüksekokulu SPORMETRE Beden Eğitimi ve Spor Bilimleri Dergisi · doi:10.33689/spormetre.730516 · Cited by 10 · see citing works
- Authors
- Gibson, E. S., Powles, A. P., Thabane, L., O'Brien, S., Molnar, D. S., Trajanovic, N., Ogilvie, R., Shapiro, C., Yan, M., & Chilcott-Tanser, L.
- Affiliations
- McMaster University (CA)
- St. Joseph’s Healthcare Hamilton (CA)
- Brock University (CA)
- University of Toronto (CA)
- University of Waterloo (CA)
- Corresponding author
- Gibson, Edward S
- Venue
- BMC Public Health
- Published
- 2006-05-02
- Volume
- 6
- Issue
- 1
- Pages
- 116-116
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC1464124
- OpenAlex
- W1604110134
- Cited by
- 298
- References
- 36
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 14 · 2022: 17 · 2021: 20 · 2020: 13 · 2019: 9 · 2018: 23 · 2017: 22 · 2016: 14 · 2015: 20 · 2014: 24 · 2013: 19 · 2012: 14
- FWCI
- 14.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Mspace (University of Manitoba) (submittedVersion)
- Funders
- Health Canada
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- excessive daytime sleepiness, adolescent sleep problems, sleep deprivation, high school students, Epworth Sleepiness Scale, academic performance, extracurricular activities, sleep duration, gender differences, Ontario
- MeSH terms
- Adolescent, Adolescent Behavior, Cross-Sectional Studies, Educational Status, Female, Habits, Humans, Disorders of Excessive Somnolence, Life Style, Male, Mental Processes, Ontario, Psychomotor Performance, Surveys and Questionnaires, Sleep Deprivation, Students, Time Factors
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