Prevalence and correlates of sleep disturbance among adolescents in the eastern seaboard of China
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Abstract
Background: Sleep disturbances are serious public health issues that warrant increased attention, especially in adolescents. The aim of this study was to investigate the prevalence and factors associated with sleep disorders among urban adolescents in China. Methods: This study utilized an online survey to assess the demographic characteristics and mental health status of secondary school students in Lianyungang City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate sleep disturbances in adolescents. The seven-item Generalized Anxiety Disorder (GAD-7) assessed anxiety symptoms, and the Perceived Social Support Scale (PSSS) was used to measure perceived social support. Results: Among 3443 adolescents, the prevalence of sleep disorders were 10.8%, with significantly higher proportions of sleep disorders (13.7% VS 8.3%, P < 0.001) among female adolescents when compared to males. Binary regression analysis revealed that anxiety symptoms (OR = 1.305, 95% CI: 1.269–1.342, P < 0.001) was risk factor for sleep disturbances, and significant other support (OR = 0.944, 95% CI: 0.896–0.994, P = 0.028) and good annual household income (OR = 0.616, 95% CI: 0.394–0.963, P = 0.034) were protective factors. Furthermore, multinomial logistic regression analysis showed that age, sex, and anxiety symptoms were associated with an elevated risk of experiencing more frequent sleep disturbances (all P < 0.05). Conclusions: We have found that 10.8% of adolescents experience sleep disorders, and it is evident that various factors can influence healthy sleeping. These results underscore the significance of addressing these factors to enhance sleep health among this population.
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Recent advances in digital therapeutics have expanded the accessibility of behavioral sleep interventions, translating evidence-based methods such as CBT-I, ACT, and mindfulness into mobile and web-based formats.
“Recent advances in digital therapeutics have expanded the accessibility of behavioral sleep interventions, translating evidence-based methods such as CBT-I, ACT, and mindfulness into mobile and web-based formats [94].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [94]
The Introduction discusses the prevalence and consequences of adolescent sleep disturbance, while the Discussion calls generally for early identification and targeted interventions (page numbers unavailable). Our copy does not address digital therapeutics, improved access, or mobile and web-based delivery of CBT-I, ACT, or mindfulness; searches for those terms and online sleep interventions found no supporting passage. (LLM, conf=0.76)
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“Perceived social support was assessed using the Chinese version of the Perceived Social Support Scale (PSSS), which comprises 12 items categorized into three sub-scales: family (items 3, 4, 8, and 11), friends (items 6, 7, 9, and 12), and significant other (items 1, 2, 5, and 10) [29, 30].”
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“For example, the results were lower than the 26% of Chinese adolescents and 15% of the general population previously surveyed [8, 9], and another cross-sectional survey revealed that the prevalence of sleep disorders among adolescents aged 12–18 years was 26.9% [33].”
ResultInfluentialSleep Disturbances, Psychosocial Difficulties, and Health Risk Behavior in 16,781 Dutch Adolescents
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Cavalcanti, L. M. L. G., Lima, R. A., Silva, C., de Barros, M. V. G., & Soares, F. C. (2021) · Cadernos de Saúde Pública · doi:10.1590/0102-311x00207420 · Cited by 29 · cited 1× · see citing works
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Demographic and Socioeconomic Influences on Sleep Patterns among Adolescent Students
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“However, a study conducted in South Korea revealed that adolescents residing in urban areas, as well as those from high-income families, experienced shorter sleep durations and later bedtimes [49].”
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“A cut-off score of 0–1 signifies no sleep disorders, while a cutoff score of 2–3 indicates their presence [25].”
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Insomnia identity and its correlates in adolescents
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“Our results align with previous research highlighting the impact of psychological factors on sleep disturbances [36, 37].”
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“…follow-up study found that the use of composite measures of sleep disturbances (including insomnia and hypersomnia symptoms, insomnia and impaired daytime functioning, or hypersomnia and anergia) was associated with the risk of depression and hypomania in adolescents and young adults [15].”
BackgroundAssociations between parental relationship dissolution and child sleep: A systematic review
Lannes, É. E. M., Kenny, S., Hershon, M., Talwar, V., Kiafar, A., & Pennestri, M. (2023) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2023.101804 · Cited by 7 · see citing works
Sleep patterns among adolescents—a multi-facetted psychological and family-related phenomenon
Bahmani, D. S., & Brand, S. (2023) · SLEEP · doi:10.1093/sleep/zsad142 · Cited by 6 · see citing works
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Liu, X., Zhang, Y., Zhang, X., & Wu, S. (2025) · Journal of Youth and Adolescence · doi:10.1007/s10964-025-02194-9 · Cited by 10 · see citing works
“A study of 3443 Chinese adolescents found that 10.5% experienced sleep disorders (Yang et al., 2024).”
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The mediating role of anxiety in poor sleep quality and passive coping among adolescentsPreprint
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- Authors
- Yang, H., Luan, L., Xu, J., Xu, X., Tang, X., & Zhang, X.
- Affiliations
- Soochow University (CN)
- Xuzhou Medical College (CN)
- Yangzhou University (CN)
- Corresponding author
- Tang, Xiaowei
- Zhang, Xiaobin
- Venue
- BMC Public Health
- Published
- 2024-04-10
- Volume
- 24
- Issue
- 1
- Pages
- 1003-1003
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC11008010
- OpenAlex
- W4394646281
- Cited by
- 18
- References
- 64
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 4
- FWCI
- 7.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- General Program of Lianyungang Health Committee (NO.202336)
- the Youth Talent Support Project of Jiangsu Provincial 333 Project ((2022)3-29-052)
- Research Project of Jiangsu Commission of Health (M2020031)
- Elderly Health Research Project of Jiangsu Commission of Health (LR2022015, LKZ2023020)
- Suzhou clinical Medical Center for mood disorders (Szlcyxzx202109)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- sleep disorders, adolescents, anxiety symptoms, perceived social support, household income, sex differences, high school students, sleep health, Lianyungang
- MeSH terms
- Adolescent, Anxiety, China, Depression, Female, Humans, Male, Surveys and Questionnaires, Sleep, Sleep Wake Disorders, Prevalence
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