Sleep problems and mental health among young Norwegian adolescents

Purpose: The present study investigated the associations between the aspects of sleep problems and mental health in Norwegian young adolescents. Materials and methods: Adolescents (12-13 years) were recruited from the primary schools in Telemark County, Norway. Sleep related problems were assessed by asking parents three questions related to their childrens' sleep quality, sleep sufficiency, and daytime sleepiness. Parents reported data on mental health by the extended version of the Strengths and Difficulties Questionnaire (SDQ), and information on the child's physical activity, screen time, eating pattern, gender, and background variables. Height and weight were objectively measured. Complete data were obtained for 690 adolescents. Results: Multiple logistic regressions were used. Bivariate analyses indicated important associations between the sleep aspects and mental health. When adjusting the sleep variables for each other, lifestyle factors and background variables, sleep quality problems were associated with any psychiatric problem (ORadj: 4.0, CI: 2.0-8.2), emotional problems (ORadj: 15.1, CI: 3.4-66.8), and hyperactivity-inattention problems (ORadj: 5.1, CI: 2.2-12.1). Daytime sleepiness problems were associated with any psychiatric problem (ORadj: 2.3, CI: 1.2-4.4), and hyperactivity-inattention problems (ORadj: 2.5, CI: 1.1-5.5). Bivariate associations between problems with sufficient sleep and mental health problems lost the significance when adjusted for other sleep variables. Conclusions: The results indicate that different aspects of sleep problems may be important underlying factors for mental health problems in adolescents, independently of lifestyle factors, BMI-category, gender, and background variables. This highlights the importance of examining specific sleep problems when investigating associations between sleep and mental health.