Association between Non-Restorative Sleep and Quality of Life in Chinese Adolescents

Abstract

To examine non-restorative sleep and its impact on quality of life (QOL) in Chinese adolescents, this cross-sectional study included 2827 students aged 12–20 who were selected from 15 secondary schools in Hong Kong, China. Non-restorative sleep was assessed by a single item, rated on a 0–10 scale: “To what extent did you feel refreshed upon awakening over the past month?”. QOL was evaluated by the World Health Organization Quality of Life Measure—Abbreviated Version Hong Kong Chinese Version. Univariable and multivariable linear mixed-effects regressions were conducted to examine the influence of non-restorative sleep (NRS) on QOL. In the present sample, the mean overall QOL was 13.83, and the extent of feeling refreshed upon awakening was 4.75 on average. In multivariable linear mixed-effects regression, one unit feeling less refreshed upon awakening was associated with 0.37 units of poorer overall QOL after adjusting for age, gender, medical conditions, parental education and occupation, weekly hours of aerobic exercises, smoking and drinking habits. Additionally, adolescents with a significantly poorer overall QOL were more likely to be older, have medical problems, have parents with an educational level of primary school or below, have an unemployed father, engage in less weekly aerobic exercise, and be current smokers or former drinkers. Adolescents who experienced non-restorative sleep had a poorer QOL. Future studies are needed to alleviate non-restorative sleep to improve health outcomes in adolescents.

Associations between Nonrestorative Sleep, Perceived Stress, Resilience, and Emotional Distress in Freshmen Students: A Latent Profile Analysis and Moderated Mediation Model

“…Although NRS has often been included in insomnia research, NRS does not necessarily mean insomnia [3]. Additionally, NRS has been relatively less explored in emotional distress-related studies based on a student sample [6,54,55]. Te current study provides some insights for early identifcation and intervention.…”

“…NRS is a core symptom of insomnia [3] and is characterized by waking up unrefreshed and restless following a normal sleep duration [4]. Studies have found that individuals with NRS are more likely to develop depression [5] and other psychological disorders [6] compared to those without NRS. Terefore, it is crucial to explore the association between emotional distress and NRS, considering that anxiety and depression appear to worsen with NRS deterioration and may cause further harm to both physical and psychological health.…”

Psychometric properties of the traditional Chinese version of the youth attitude to noise scale: a cross-sectional study in a large representative sample

“…With an anticipated prevalence of 5% and a 1% margin of error in a 95% CI, 1825 participants were needed. 17 After accounting for incomplete responses, 2000 participants were targeted. In this study, the sample was randomly divided into two halves to conduct EFAs and CFAs, respectively.…”

Measurement properties of the simplified Chinese version of Nonrestorative Sleep Scale in adolescents

“…Indeed, 43% of the adolescents often did not really feel rested and 17.7% has this feeling every day, which was much higher than the second sleep complaint of feeling tired during the daytime (15.6% and 7.3% respectively) (Roberts et al, 2002). Adolescents who had NRS reported lower quality of life regarding physical health, psychological, social relationships and environment (N. Chen et al, 2020). NRS was also reported to be associated with emotional problems, hyperactivity/inattention and even suicide ideation (Kilincaslan et al, 2014;Park et al, 2013).…”