일 도시 고등학교 학생들의 수면형태와 주간졸음증의 예측인자 = Sleep Patterns and Predictors of Daytime Sleepiness in High School Students

다국어 초록 (Multilingual Abstract)

Objectives Various sleep patterns may be shown in adolescents to be busy for studying. The aim of this study was to investigate sleep-wake patterns and to evaluate predictors of daytime sleepiness.
Methods Among 1011 high school students living in Cheonan-si, demographic variables and self-reported questionnaires, including items about menstruation, Morningness-Eveningness Questionnaire (MEQ), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale (ESS) were admitted.
Results A total of 839 students (male=453, female=386) completed questionnaires. Significant differences in sleep pattern, categorized by score of MEQ (p=0.004), ESS (p<0.001), and BDI (p=0.012) were observed between male and female subjects. Logistic regression analysis showed that excessive daytime sleepiness was predicted by female [odds ratio (OR)=2.039, p=0.022] and sleep quality (OR=1.238, p=0.004). In the regression analysis of female students, dysmenorrhea (β=0.108, p=0.029), eating of caffeine (β=-0.114, p=0.019), MEQ (β=-0.108, p=0.027), insomnia (β=0.180, p=0.002), and depression (β=0.116, p=0.029) might be associated with daytime sleepiness.
Conclusion In Korean high school students, female and sleep quality might be risk factors of daytime sleepiness. Daytime sleepiness was known to be related with cognitive dysfunction. Therefore, an education program for improving sleep quality in these adolescents should be considered for mental health.

국문 초록 (Abstract)

본 연구는 839명의 고등학생을 대상으로 시행한 연구로서, 남녀학생에서 일주기 리듬에 따른 수면형태에서 차이를보였다. 수면형태에 따른 비교에서 저녁형 학생에서 아침형과 중간형 학생보다 수면의 질이 낮고, 주간졸음증이 더 심하며, 불면증상과 우울증상이 높았다. 주간기능에 영향을 준다고 알려진 주간졸음증 발생에는 여성과 수면의 질이 유의한 위험인자로 평가되었다. 특히 여학생에서는 월경곤란과저녁형 수면형태가 주간졸음증과 연관성이 있는 것으로 나타났다. 따라서, 청소년 학생들의 정신건강과 효율적인 학업수행을 지지하기 위해서, 수면의 질을 향상시키고 올바른 수면위생을 배울 수 있는 프로그램 개발과 교육이 중요할 것으로 생각된다.

참고문헌 (Reference)

• 1 장근영, "한국 청소년의 생활시간 국제비교와 라이프스타일 분석" 미래를 여는 청소년학회 6 (6): 139-155, 2009
• 2 홍창호, "청소년의 월경 장애" 대한소아과학회 49 (49): 1257-1262, 2006
• 3 성미혜, "청소년 여학생의 월경에 대한 태도, 월경증상 및 대처행위" 대한임상건강증진학회 11 (11): 106-114, 2011
• 4 Bastien CH, "Validation of the Insomnia Severity Index as an outcome measure for insomnia research" 2 : 297-307, 2001
• 5 Hong CH, "The sexual maturity rating of adolescent boys and girls in Korea" 37 : 193-198, 1994
• 6 Buysse DJ, "The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research" 28 : 193-213, 1989
• 7 Carskadon MA, "Sleep’s effects on cognition and learning in adolescence" 190 : 137-143, 2011
• 8 Chung KF, "Sleep-wake patterns and sleep disturbance among Hong Kong Chinese adolescents" 31 : 185-194, 2008
• 9 Wolfson AR, "Sleep schedules and daytime functioning in adolescents" 69 : 875-887, 1998
• 10 Tononi G, "Sleep function and synaptic homeostasis" 10 : 49-62, 2006
• 11 Brand S, "Sleep and its importance in adolescence and in common adolescent somatic and psychiatric conditions" 4 : 425-442, 2011
• 12 Kleitman N, "Sleep and Wakefulness" University of Chicago Press 1939
• 13 Sharma P, "Problems related to menstruation amongst adolescent girls" 75 : 125-129, 2008
• 14 Abdel-Khalek AM, "Prevalence of reported insomnia and its consequences in a survey of 5,044 adolescents in Kuwait" 27 : 726-731, 2004
• 15 Tarokh L, "Physiology of normal sleep in adolescents" 21 : 401-417, 2010
• 16 Sinkkonen HM, "Internet use and addiction among Finnish adolescents (15-19 years)" 37 : 123-131, 2014
• 17 Millman RP, "Excessive sleepiness in adolescents and young adults: causes, consequences, and treatment strategies" 115 : 1774-1786, 2005
• 18 Kang SH, "Eveningness, sleep patterns, daytime sleepiness and fatigue in Korean male adolescents" 19 : 89-96, 2012
• 19 Johnson EO, "Epidemiology of DSMIV insomnia in adolescence: lifetime prevalence, chronicity, and an emergent gender difference" 117 : e247-e256, 2006
• 20 Woosley JA, "Dysmenorrhea, the menstrual cycle, and sleep" 40 : 14-21, 2014
• 21 Mercer PW, "Differences in reported sleep need among adolescents" 23 : 259-263, 1998
• 22 Roberts RE, "Depression and insomnia among adolescents:a prospective perspective" 148 : 66-71, 2013
• 23 LeBourgeois MK, "Circadian phase and its relationship to nighttime sleep in toddlers" 28 : 322-331, 2013
• 24 Ohida T, "An epidemiologic study of self-reported sleep problems among Japanese adolescents" 27 : 978-985, 2004
• 25 Yang CK, "Age-related changes in sleep/wake patterns among Korean teenagers" 115 (115): 250-256, 2005
• 26 Carskadon MA, "Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days" 21 : 871-881, 1998
• 27 Yu NJ, "A study on the standardization of the Korean version of J.A. Horne and O. Ostbergs’ Morningness-Eveningness Questionnaire and on the sleep pattern" 34 : 642-656, 1995
• 28 Rhee MK, "A standardization study of Beck Depression Inventory I-Korean version (K-BDI): reliability and factor analysis" 4 : 77-95, 1995
• 29 Johns MW, "A new method for measuring daytime sleepiness: the Epworth sleepiness scale" 14 : 540-545, 1991