Sleep hygiene behaviours in Iranian adolescents: an application of the Theory of Planned Behavior

Abstract

SUMMARYPoor sleep quality and inadequate sleep in adolescents are a rising trend globally. The Theory of Planned Behaviour (TPB)-which centres on an individual's attitude toward performing the behaviour, subjective norms and perceived behavioural control-has been applied to examine sleep hygiene behaviours in young adults. We expanded on prior works by using a longitudinal design to examine the effects of TPB factors, together with sleep hygiene knowledge and planning constructs, on sleep hygiene behaviours and on sleep quality and health in a group of Iranian adolescents. A total of 1822 healthy adolescents (mean age = 13.97) from 25 high schools in Qazvin, Iran, completed a selfreported survey at baseline and 6 months later. Structural equation modelling (SEM) was used to delineate the pathway from adolescents' sleep hygiene knowledge, TPB constructs of their behavioural intentions and sleep hygiene behaviours and their sleep quality and self-reported health. The SEM model demonstrated that although behavioural intention, coping planning and action planning predicted the sleep hygiene behaviours positively 6 months later with acceptable model fit [comparative fit index (CFI) = 0.936; Tucker-Lewis index (TLI) = 0.902; root mean square error of approximation (RMSEA) = 0.080; standardized root mean square residual (SRMR) = 0.044], sleep hygiene knowledge did not predict behavioural intentions significantly. Sleep hygiene behaviours were associated with sleep quality and psychiatric wellbeing. Thus, the TPB, combined with coping and action planning, is useful in understanding the sleep hygiene behaviours of adolescents. Health-care providers may want to emphasize TPB constructs and coping and action planning to improve adolescents' sleep hygiene behaviours, rather than rely solely upon increasing adolescents' sleep hygiene knowledge.

Predicting Hand Washing and Sleep Hygiene Behaviors among College Students: Test of an Integrated Social-Cognition Model

“…Specifically, the TPB constructs of attitudes, subjective norm, and perceived behavioral control significantly predicted hand washing and sleep hygiene intentions, while intentions further predicted hand washing and sleep hygiene behaviors. This is also in line with the findings of previous studies using the TPB to predict individuals' hand washing [37][38][39] and sleep hygiene [40][41][42]. It is also important to note that perceived behavioral control had a direct effect on sleep hygiene, consistent with TPB predictions [35].…”

“…More specifically, and in the context of the current study, the TPB has been used to predict hand washing and sleep hygiene. For example, previous research has found support for the TPB constructs in predicting the intentions, and thus behavior, of caterers' [17], health care workers' [37,38], and nursing students' [39] hand hygiene, and adolescents' [40] and college students' [41,42] sleep hygiene.…”

Sleep hygiene, insomnia and mental health

“…Strong et al. () provide us with very interesting data concerning sleep hygiene behaviours in adolescents living in Iran. By studying 1,822 healthy adolescents with a mean age of approximately 14 years, they investigated relationships between sleep hygiene behaviours, psychological variables and the construct they call the Theory of Planned Behaviour (TPB).…”

Evaluation of Sleep Habits and Sleep Patterns Among 7-12-Year-Old Students in Qazvin, Iran; A School-Based Cross-Sectional Study

“…Children sleep disorder (CSD) is one of the most common disorders in children. It has gained a growing trend in recent years around the world (1). Studies indicate that 10 -75 percent of children in the world suffer from CSD, which may be in the forms of simple bedtime resistance, frequent sleep-waking, parasomnias, and obstructive sleep apnea (2).…”

“…This tool, designed by Owens et al (13), indicates the status of children's sleep disorders according to the most common manifestations. Various studies were conducted in Iran concerning sleep and health status (1,(14)(15)(16). However, the status of CSD among 7-12-year-old children has not been studied.…”