Gender and Sleep Health in High School Students: A Cross-Cultural Study

Abstract

Background & Objective: Many recent studies have shown that sleep health is important for overall health and performance. However, adolescents often report poor sleep health, such as short duration and low quality sleep. In some cases, sleep characteristics are independent of gender and culture, but not in others. In this study, we tested for effects of gender, culture, and their interaction on measures of sleep health (adequacy and quality) for adolescents in an American population and a Chinese population. Methods:A common survey instrument was administered to high school students in New Jersey, USA and Wen Zhou, PRC. Students were asked to answer questions about their sleep duration, perception of sleep adequacy, daytime sleepiness, and napping for typical school days and weekends. Our final sample included 2,986 female students (2,059 American and 837 Chinese) and 2,544 male students (1,764 American and 780 Chinese).Results: Differences in sleep duration were minor or absent, but differences in sleep health were substantial. Females were more likely than males to report inadequate sleep and daytime sleepiness, for both school days and weekends, and higher hypersomnolence scores. Chinese students were more likely than American students to report inadequate sleep and daytime sleepiness, for both school days and weekends, and higher hypersomnolence scores, with the exception that perception of adequate sleep did not differ between Chinese and American males on weekends. Especially dramatic was the difference in hypersomnolence, in which 74% of Chinese students reported inadequate sleep, sleepiness, and a nap for a typical school day, compared to only 29% of American students. Conclusions:The results suggest the presence of gender and cultural differences in sleep quality that yield divergent outcomes for similar sleep durations.