Association between Physical Activity and Sleep Difficulties among Adolescents in Germany: The Role of Socioeconomic Status
Abstract
:1. Introduction
- How many adolescent girls and boys in Germany have sleep difficulties (unrecommended sleep duration, sleep-onset difficulties, trouble sleeping, daytime sleepiness)?
- Are there differences in sleep difficulties according to PA between adolescent girls and boys?
- Do the associations between sleep difficulties and PA persist after adjusting for age, screen time, and personal resources, as well as emotional and behavioral problems?
- Does SES moderate the association between PA and sleep difficulties in adolescent girls and boys?
2. Materials and Methods
2.1. Data
2.2. Variables
2.3. Statistical Analyses
3. Results
3.1. Unrecommended Sleep Duration
3.2. Sleep-Onset Difficulties
3.3. Trouble Sleeping
3.4. Daytime Sleepiness
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Sleep Variables | Socioeconomic Status | ||||
---|---|---|---|---|---|
Total | SES Low | SES Middle | SES High | p Value | |
% (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | ||
Boys | |||||
Unrecommended sleep duration | 32.1 (29.8–34.4) | 28.1 (22.1–35.0) | 33.9 (30.84–37.11) | 30.17 (26.6–43.0) | 0.1596 |
Sleep-onset difficulties | 57.1 (54.5–59.7) | 62.5 (56.0–68.6) | 56.1 (53.0–59.1) | 54.9 (50.6–59.0) | 0.0689 |
Trouble sleeping | 20.7 (18.6–23.0) | 24.9 (18.7–32.2) | 20.2 (17.7–23.0) | 17.8 (14.5–21.8) | 0.1612 |
Daytime sleepiness | 57.8 (55.3–60.3) | 55.0 (48.14–61.6) | 57.6 (54.5–60.7) | 61.6 (56.8–66.1) | 0.2785 |
Girls | |||||
Unrecommended sleep duration | 31.8 (29.8–33.9) | 34.7 (28.9–42.1) | 31.7 (29.3–34.2) | 28.5 (24.3–33.1) | 0.2542 |
Sleep-onset difficulties | 61.8 (59.5–64.1) | 67.0 (60.7–72.7) | 60.4 (57.5–63.3) | 60.1 (55.4–64.7) | 0.0890 |
Trouble sleeping | 27.3 (25.2–29.5) | 33.1 (27.6–39.1) | 26.2 (23.8–28.9) | 23.6 (19.7–28.1) | 0.0146 * |
Daytime sleepiness | 66.8 (64.8–68.8) | 67.8 (62.4–72.8) | 66.1 (63.4–68.6) | 68.5 (63.9–72.8) | 0.6385 |
Unrecommended Sleep Duration | Sleep-Onset Difficulties | Trouble Sleeping | Daytime Sleepiness | ||||||
---|---|---|---|---|---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | ||
Boys | |||||||||
PA recommendation | No | Ref. | - | Ref. | - | Ref. | - | Ref. | - |
Yes | 0.34 (0.15, 0.80) | 0.014 | 0.58 (0.28, 1.18) | 0.131 | 0.64 (0.24, 1.70) | 0.371 | 0.99 (0.48, 2.04) | 0.969 | |
SES | Low | Ref. | - | Ref. | - | Ref. | - | Ref. | - |
Middle | 1.27 (0.80, 2.02) | 0.312 | 0.74 (0.54, 1.01) | 0.054 | 0.76 (0.50, 1.17) | 0.210 | 1.15 (0.82, 1.61) | 0.413 | |
High | 1.23 (0.76, 1.98) | 0.392 | 0.71 (0.49, 1.01) | 0.058 | 0.68 (0.42, 1.10) | 0.116 | 1.73 (0.17, 2.56) | 0.006 | |
PA#SES | Yes#Low | Ref. | - | Ref. | - | Ref. | - | Ref. | - |
Yes#Middle | 3.32 (1.27, 8.66) | 0.015 | 1.56 (0.71, 3.44) | 0.270 | 1.56 (0.54, 4.51) | 0.410 | 0.91 (0.41, 2.00) | 0.815 | |
Yes#High | 3.54 (1.26, 9.93) | 0.017 | 2.10 (0.87, 5.07) | 0.100 | 1.82 (0.58, 5.66) | 0.300 | 0.83 (0.36, 1.95) | 0.675 | |
Girls | |||||||||
PA recommendation | No | Ref. | - | Ref. | - | Ref. | - | Ref. | - |
Yes | 0.71 (0.29, 1.74) | 0.455 | 1.54 (0.70, 3.39) | 0.285 | 1.08 (0.49, 2.36) | 0.848 | 0.42 (0.19, 0.95) | 0.036 | |
SES | Low | Ref. | - | Ref. | - | Ref. | - | Ref. | - |
Middle | 0.99 (0.70, 1.40) | 0.938 | 0.82 (0.59, 1.15) | 0.248 | 0.78 (0.57, 1.07) | 0.123 | 1.00 (0.71, 1.41) | 0.989 | |
High | 1.02 (0.66, 1.56) | 0.937 | 0.81 (0.56, 1.16) | 0.241 | 0.79 (0.54, 1.17) | 0.240 | 1.36 (0.94, 1.96) | 0.099 | |
PA#SES | Yes#Low | Ref. | - | Ref. | - | Ref. | - | Ref. | - |
Yes#Middle | 1.41 (0.52, 3.83) | 0.502 | 0.70 (0.30, 1.64) | 0.407 | 1.39 (0.57, 3.40) | 0.462 | 2.31 (0.92, 5.79) | 0.074 | |
Yes#High | 1.30 (0.51, 3.32) | 0.586 | 0.63 (0.24, 1.71) | 0.365 | 0.98 (0.31, 3.07) | 0.975 | 3.80 (1.32, 10.93) | 0.014 |
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Sleep Variables | Total | Total | Boys | Boys | Girls | Girls | |
---|---|---|---|---|---|---|---|
n Unweighted | % Weighted | n Unweighted | % Weighted | n Unweighted | % Weighted | ||
6599 | 3176 | 3423 | |||||
Unrecommended sleep duration | Yes | 1789 | 31.9 | 830 | 32.1 | 959 | 31.7 |
No | 4348 | 68.1 | 2097 | 67.9 | 2251 | 68.3 | |
Sleep-onset difficulties | Yes | 3603 | 59.3 | 1628 | 57.2 | 1975 | 61.7 |
No | 2467 | 40.7 | 1269 | 42.8 | 1198 | 38.3 | |
Trouble sleeping | Yes | 1431 | 24.0 | 584 | 20.8 | 847 | 27.5 |
No | 4655 | 76.0 | 2317 | 79.3 | 2338 | 72.5 | |
Daytime sleepiness | Yes | 3843 | 62.4 | 1706 | 58.2 | 2137 | 67.0 |
No | 2251 | 37.6 | 1200 | 41.8 | 1051 | 33.1 | |
PA recommendation | Yes | 890 | 14.8 | 252 | 18.2 | 365 | 11.1 |
No | 5248 | 85.2 | 2403 | 81.8 | 2845 | 88.9 | |
SES | Low | 874 | 20.8 | 410 | 20.2 | 464 | 21.6 |
Middle | 4103 | 61.9 | 1967 | 61.7 | 2136 | 62.0 | |
High | 1477 | 17.3 | 734 | 18.2 | 743 | 16.4 | |
Age | 11–13 years | 3026 | 40.8 | 1496 | 40.6 | 1530 | 41.1 |
14–17 years | 3573 | 59.2 | 1680 | 59.4 | 1893 | 59.4 | |
Screen time | Low | 1470 | 23.1 | 561 | 18.8 | 909 | 27.7 |
High | 4685 | 76.9 | 2376 | 81.3 | 2309 | 72.32 | |
Emotional and behavioral problems | Inconspicuous | 241 | 4.1 | 77 | 2.8 | 164 | 5.48 |
Borderline | 504 | 8.0 | 211 | 6.8 | 293 | 9.21 | |
Conspicuous | 5400 | 87.9 | 2644 | 90.3 | 2756 | 85.32 | |
Personal resources | High | 5922 | 88.6 | 2924 | 91.4 | 2998 | 85.54 |
Low | 677 | 11.5 | 252 | 8.6 | 425 | 14.46 |
Sleep Variables | Total | Physical Activity (Met Recommendation) | ||
---|---|---|---|---|
Yes | No | p Value | ||
% (95% CI) | % (95% CI) | % (95% CI) | ||
Boys | ||||
Unrecommended sleep duration | 32.0 (29.7–34.4) | 29.0 (23.9–34.7) | 32.7 (30.2–35.3) | 0.2290 |
Sleep-onset difficulties | 57.3 (54.7–59.8) | 53.6 (47.5–59.5) | 58.1 (55.5–60.6) | 0.1388 |
Trouble sleeping | 20.7 (18.7–23.0) | 20.1 (16.0–24.9) | 20.9 (18.7–23.3) | 0.7469 |
Daytime sleepiness | 58.1 (55.7–60.6) | 54.1 (47.8–60.3) | 59.0 (56.3–61.7) | 0.1539 |
Girls | ||||
Unrecommended sleep duration | 31.7 (29.7–33.8) | 22.4 (17.4–28.3) | 32.9 (30.7–35.1) | 0.0012 * |
Sleep-onset difficulties | 61.7 (59.4–64.0) | 65.0 (57.8–71.6) | 61.3 (58.8–63.7) | 0.3350 |
Trouble sleeping | 27.6 (25.6–29.7) | 29.3 (22.9–36.6) | 27.4 (25.2–29.6) | 0.6040 |
Daytime sleepiness | 67.0 (65.0–69.0) | 56.2 (49.3–62.9) | 68.4 (66.2–70.5) | 0.0007 * |
Unrecommended Sleep Duration | Sleep-Onset Difficulties | Trouble Sleeping | Daytime Sleepiness | ||||||
---|---|---|---|---|---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | ||
Boys | |||||||||
PA recommendation | No | Ref. | - | Ref. | - | Ref. | - | Ref. | - |
Yes | 0.96 (0.70, 1.30) | 0.784 | 0.86 (0.67, 1.09) | 0.205 | 0.98 (0.73, 1.32) | 0.893 | 0.91 (0.68, 1.21) | 0.501 | |
Girls | |||||||||
PA recommendation | No | Ref. | - | Ref. | - | Ref. | - | Ref. | - |
Yes | 0.89 (0.63, 1.26) | 0.499 | 1.14 (0.83, 1.57) | 0.401 | 1.26 (0.88, 1.81) | 0.199 | 0.80 (0.57, 1.13) | 0.211 |
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Blume, M.; Rattay, P. Association between Physical Activity and Sleep Difficulties among Adolescents in Germany: The Role of Socioeconomic Status. Int. J. Environ. Res. Public Health 2021, 18, 9664. https://doi.org/10.3390/ijerph18189664
Blume M, Rattay P. Association between Physical Activity and Sleep Difficulties among Adolescents in Germany: The Role of Socioeconomic Status. International Journal of Environmental Research and Public Health. 2021; 18(18):9664. https://doi.org/10.3390/ijerph18189664
Chicago/Turabian StyleBlume, Miriam, and Petra Rattay. 2021. "Association between Physical Activity and Sleep Difficulties among Adolescents in Germany: The Role of Socioeconomic Status" International Journal of Environmental Research and Public Health 18, no. 18: 9664. https://doi.org/10.3390/ijerph18189664