Prevalence and Determinants of Bad Sleep Perception among Italian Children and Adolescents

Abstract

Although sleep problems at young ages are well investigated, the prevalence of bad sleepers and the determinants of sleep quality perception remain unexplored in these populations. For this purpose, we addressed these issues in a sample of children (n = 307), preadolescents (n = 717), and adolescents (n = 406) who completed the School Sleep Habits Survey, addressing sleep quality perception, sleep habits, sleep features, daytime behavior and sleep disturbances, circadian preference, and dreaming. The sample was split in “good sleepers” and “bad sleepers”, based on the answer to the question item assessing overall subjective sleep quality. Being a bad sleeper was reported by 11.7% of the sample, with significant between-groups differences (children: 8.3%; preadolescents: 11.3%; adolescents: 15.3%; p = 0.01). At all ages, relative to good sleepers, bad sleepers showed higher eveningness, sleepiness, and depression, longer sleep latency, more frequent insufficient sleep, nocturnal awakenings, sleep–wake behavioral problems, and unpleasant dreams (all p’s ≤ 0.01). Sleep quality perception was predicted: in children, by depressed mood, eveningness, and unpleasant dreams (all p’s ≤ 0.01); in preadolescents, by sleep latency, awakening frequency, depressed mood, sufficiency of sleep, and unpleasant dreams (all p’s < 0.01); in adolescents, by awakening frequency, depressed mood, and sufficiency of sleep (all p’s < 0.001). In children, bad subjective sleep quality appears to be mainly determined by daytime psychological features, for example, depressed mood, whereas at later ages, sleep characteristics, such as frequent awakenings, add to the former determinants. This could depend on (a) the appearance, with increasing age, of objective sleep modifications and (b) a greater attention paid by adolescents to their sleep characteristics.

The Effects of the COVID19-Related Lockdown Are Modulated by Age: An Italian Study in Toddlers and Pre-Schoolers

“…Following statistical guidelines to correct for multiple testing without running a too high risk of Type II Error (see, for example, [36]), we applied an adapted Bonferroni procedure (as in [37,38]). The conventional alpha value (p ≤ 0.05) was divided by two, that is the number of relevant sleep "dimensions" addressed in our research ("sleep schedules" and "sleep quality").…”

“…In the same vein, our two groups of children differed in gender distribution. However, note that gender disparities in the frequency of sleep problems seem to appear only since late adolescence [33,38,52,53].…”