Introduction
Sleep disorders encompassing insomnia and symptoms of insomnia, insufÀ cient sleep and inadequate sleep patterns, and delayed sleep phase syndrome are frequent throughout adolescence. All changes at play in this stage of development lead to an increased sleep onset latency,1 more nocturnal awakenings and a progressive delay in sleep phase resulting in shortened sleep length and increased daytime sleepiness.2 Insomnia is regarded as the prevailing sleep disorder among adolescents and 4.4% to 13.4% of adolescents suffer from insomnia.3 The National Institutes of Health have stated that adolescents and young adults (aged 12 to 25) are the population at higher risk of excessive daytime sleepiness.4 Inadequate sleep patterns among adolescents are another frequent and present-day problem, especially insufÀ cient sleep patterns (short sleep length) and irregular sleep patterns (not going to bed or waking up at the same time and substantial asymmetries between week and weekend nights).5-7 This last routine is characterized by staying up late and waking up early on week nights (school days) and attempting to “recover” sleep (by waking up later) during the weekends.8 Among older adolescents, as bedtime moves to later hours of the night whilst waking up remains early due to school timetables, the percentage of adolescents with insufficient and irregular sleep and with excessive daytime sleepiness increases. A study done with Australian adolescents aged 13 to 18 showed that they slept an average 8 h 17 min on school nights, with bedtime 10:28 pm and wake time 07:10 am; older adolescents referred going to bed later and shorter sleep durations.6 The same study reported that only one in eight adolescents experienced regular spontaneous awakenings on school mornings, with over three quarters needing help from either parents or alarm clocks to wake them.6 ScientiÀ c evidence on the fact that adolescents sleep less than recommended is pilling up.7,9-11 A systematic review of the literature —Never Enough Sleep: A Brief History of Sleep Recommendations for Children— shows that recommended sleep for the different age groups diminished at an average rate of î0.71 minutes per year.9 Meaningfully this decline was identical to the actual decay in sleep length (î0.73 minutes per year).9 Some studies have suggested that adolescents need 9-9.5 hours of sleep each night.12,13 Accordingly, others studies with adolescents have considered a sleep duration of less than 8 h as “insufÀ cient sleep”, 8-8.9 hours as “acceptable sleep” and ≥ 9 h as “adequate sleep”.14,15 The National Sleep Foundation (2000) refers that “Adolescents require at least as much sleep as they did as pre-adolescents (in general, 8.5 to 9.25 hours each night)”.16 Besides school related activities, social life and entertain- ment practices (nightlife, staying out late, watching TV/ listening to music at night, using “new technologies”) pubertal physiological changes also play a role on sleep schedules delaying the “biological clock”, shifting adolescents towards eveningness and making it more difÀ cult for them to fall asleep earlier. Few studies have examined sleep patterns of Portuguese adolescents as well as insomnia. The objectives of this study were to describe sleep patterns and to determine the prevalence of insomnia and daytime sleepiness among Portuguese adolescents
แนะนำSleep disorders encompassing insomnia and symptoms of insomnia, insufÀ cient sleep and inadequate sleep patterns, and delayed sleep phase syndrome are frequent throughout adolescence. All changes at play in this stage of development lead to an increased sleep onset latency,1 more nocturnal awakenings and a progressive delay in sleep phase resulting in shortened sleep length and increased daytime sleepiness.2 Insomnia is regarded as the prevailing sleep disorder among adolescents and 4.4% to 13.4% of adolescents suffer from insomnia.3 The National Institutes of Health have stated that adolescents and young adults (aged 12 to 25) are the population at higher risk of excessive daytime sleepiness.4 Inadequate sleep patterns among adolescents are another frequent and present-day problem, especially insufÀ cient sleep patterns (short sleep length) and irregular sleep patterns (not going to bed or waking up at the same time and substantial asymmetries between week and weekend nights).5-7 This last routine is characterized by staying up late and waking up early on week nights (school days) and attempting to “recover” sleep (by waking up later) during the weekends.8 Among older adolescents, as bedtime moves to later hours of the night whilst waking up remains early due to school timetables, the percentage of adolescents with insufficient and irregular sleep and with excessive daytime sleepiness increases. A study done with Australian adolescents aged 13 to 18 showed that they slept an average 8 h 17 min on school nights, with bedtime 10:28 pm and wake time 07:10 am; older adolescents referred going to bed later and shorter sleep durations.6 The same study reported that only one in eight adolescents experienced regular spontaneous awakenings on school mornings, with over three quarters needing help from either parents or alarm clocks to wake them.6 ScientiÀ c evidence on the fact that adolescents sleep less than recommended is pilling up.7,9-11 A systematic review of the literature —Never Enough Sleep: A Brief History of Sleep Recommendations for Children— shows that recommended sleep for the different age groups diminished at an average rate of î0.71 minutes per year.9 Meaningfully this decline was identical to the actual decay in sleep length (î0.73 minutes per year).9 Some studies have suggested that adolescents need 9-9.5 hours of sleep each night.12,13 Accordingly, others studies with adolescents have considered a sleep duration of less than 8 h as “insufÀ cient sleep”, 8-8.9 hours as “acceptable sleep” and ≥ 9 h as “adequate sleep”.14,15 The National Sleep Foundation (2000) refers that “Adolescents require at least as much sleep as they did as pre-adolescents (in general, 8.5 to 9.25 hours each night)”.16 Besides school related activities, social life and entertain- ment practices (nightlife, staying out late, watching TV/ listening to music at night, using “new technologies”) pubertal physiological changes also play a role on sleep schedules delaying the “biological clock”, shifting adolescents towards eveningness and making it more difÀ cult for them to fall asleep earlier. Few studies have examined sleep patterns of Portuguese adolescents as well as insomnia. The objectives of this study were to describe sleep patterns and to determine the prevalence of insomnia and daytime sleepiness among Portuguese adolescents
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