Sleep duration in Chinese adolescents: biological, environmental, and behavioral predictors

Objective: To examine sleep duration-related risk factors from multidimensional domains among Chinese adolescents. Methods: A random sample of 4801 adolescents aged 11-20 years participated in a cross-sectional survey. A self-reported questionnaire was used to collect information about the adolescents' sleep behaviors and possible related factors from eight domains. Results: In all, 51.0% and 9.8% of adolescents did not achieve optimal sleep duration (defined as <8.0 h per day) on weekdays and on weekends, respectively. According to multivariate logistic regression models, after adjusting for all possible confounders, 17 factors were associated with sleep duration <8 h. Specifically, 13 factors from five domains were linked to physical and psychosocial condition, environment, and behaviors. These factors were overweight/obesity, chronic pain, bedtime anxiety/excitement/depression, bed/room sharing, school starting time earlier than 07: 00, cram school learning, more time spent on homework on weekdays, television viewing >= 2 h/day, physical activity <1 h/day, irregular bedtime, and shorter sleep duration of father. Conclusion: Biological and psychosocial conditions, sleep environments, school schedules, daily activity and behaviors, and parents' sleep habits significantly may affect adolescents' sleep duration, indicating that the existing chronic sleep loss in adolescents could be, at least partly, intervened by improving adolescents' physical and psychosocial conditions, controlling visual screen exposure, regulating school schedules, improving sleep hygiene and daytime behaviors, and changing parents' sleep habits. (C) 2014 The Authors. Published by Elsevier B. V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).