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Sleep Patterns Of High School Students Living In São Paolo, Brazil
ANDRADE, M.M.M. 1,2 MENNA-BARRETO, L. 2
1 Depto. Ciencias Biologicas, FCL, Unesp, Assis, Sao Paulo, Brazil
2 Grupo Multidisciplinar de Desenvolvimento e Ritmos Biologicos, Depto.
Fisiologia e Biofisica, ICB, USP, Sao Paulo, Brazil.
Introduction
Sleep-wake cycle patterns observed in
adolescents reflect the underlying endogenous
and exogenous components of biological
rhythmicity. While the endogenous component is
a specie's feature, the exogenous one may
differ according to geophysical conditions and
social organization. Comparison between
different populations provides a general
understanding of the characteristics of this
age-group as well as adolescents' sleep
strategies in distinct situations, sleep-wake
cycle's flexibility and the consequences of
modifying sleep patterns. The present work
surveys high school students living in Sao
Paulo city, Brazil. The aim of the study is to
investigate the temporal patterns of
sleep-wake cycle as well as sleep complaints
that may be associated to them.
Methodology
Ninety-nine female students (67% aged 14-16
years), answered a sleep questionnaire in May
94. They attended a public school from 0715h
to 1705h, Monday to Friday. The sleep
questionnaired covered the following aspects:
health status, sleep complaints, home
conditions, sleep habits. Weekday and weekend
sleep characteristics were compared (paired
T-Student test). Students were divided into
two groups according to their sleep length on
weekdays (<8h, n=55, and 38h, n=44), and
contingency tables were prepared for sleep
length groups versus prevalence of sleep
complaints. Differences between group means
were investigated by means of unpaired
T-Student test.
Results
Students slept almost 2 hours earlier on
weekdays (2204h ± 0100h) comparing to weekends
(2354h ± 0154h; t = -9.0; p<0.00001), and woke
up 3.5 hours earlier (0548h ± 0032h vs 0919h ±
0135h; t = -23.5, p<0.00001). Sleep length was
1.7 hours shorter on weekdays (7.7h ± 1.2h vs
9.4h ± 1.8h; t = -8.0; p<0.00001). Students
reported worse sleep quality (t = -3.5;
p<0.001) and more difficulty in waking up (t =
-3.8; p<0.001) on school days. More students
woke up spontaneously on weekends (18% vs 86%,
McNemar test c2 = 60.7; gl =1; p<0.0001).
About 11% reported napping more than once a
week. The prevalence of frequent (more than
once a week) daytime sleepiness was 45%,
trouble in falling asleep 14%, trouble in
maintaining sleep 6%, and sleep breathing
problems 2%. There were different weekdays to
weekends patterns: some students advanced
their sleep onset (10%) others showed no
change (7%), some delayed it up to 2.8h (59%)
and others reported a 3-9h delay (24%). No
students advanced the sleep offset (2%
maintained their wake-up hour, 32% delayed it
up to 2.8h, and 66% showed a 3-9h delay. Sleep
length decrease was reported by 17% of the
students, 3% reported the same duration, 49%
increased it up to 2.8h and 31% had an extra
sleep amount of 3-8h. Longer sleepers on
weekdays ( 38h), slept earlier ( t = -12.4;
p<0.00001), reported better sleep quality ( t
= 3.17; p<0.005) and had a tendency to wake up
slightly later (t = 1.79; p = 0.08) than
shorter sleepers ( <8h). The prevalence of
general sleep complaints were higher for
shorter sleepers (30% vs 11%; c2 = 5.02;
p<0.05), as well as trouble in falling asleep
(36% vs 14%; c2 = 6.52; p<0.05) and daytime
sleepiness (60% vs 41%; c2 = 3.57; p=0.06).
Discussion
Sleep patterns described were similar to those
obtained with European (1) and American (2)
students of the same age group. Brazilian high
school students went to bed at the same time
but woke up about 0.5h earlier and slept 0.5h
less on weekdays comparing to a younger cohort
(12-13 years) of Brazilian students (3) .
Sleep onset and offset delays were found in
both age groups but older students showed
greater delays. The finding that high school
students sleep less than middle school
students on weekdays but sleep the same amount
on weekends agrees with previous work on
American students (2). The greater prevalence
of sleep complaints found in the shorter
sleepers evinces the schoolday sleep
restriction consequences. Although the
"delayed sleep phase irregular sleep time and
daytime sleepiness" pattern is usual for
adolescents, they may exhibit different phase
shift types (advance or delay) and magnitude,
sleep onset and/or sleep offset displacements
and amounts of sleep, yelding distinct
individual patterns. Investigation of these
patterns should provide a better knowledge of
adolescents' sleep needs and complaints.
REFERENCES
(1) Tynjnln, J.; Kannas, L.; Vnlimaa, R. Health Educ. Res., 8(1):69-80,
1993.
(2) Manber, R.; Pardee, R.E.; Bootzin, R.R et alli, Sleep Res., 24(A):106,
1995.
(3) Andrade, M.M.M.; Benedito-Silva, A.A.; Domenice, S. et alli, J. Adol.
Health, 14:401-406, 1993.
Supported by CNPq, CAPES.
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