Sleep quality of Chinese adolescents: Distribution and its associated factors

Aim: To investigate the sleep quality status and its associated factors (including psychological and physiological as well as social demographic factors) among Chinese mainland adolescents. Methods: Ten schools, including junior schools, senior schools and universities of Hefei (the capital of Anhui Province in China), were randomly selected. By using the Pittsburgh Sleep Quality Index, Self-Rated Health Measurement Scale Version 1.0, University of California, Los Angeles, Loneliness Scale, Beck Depression Inventory, Self-rating Anxiety Scale and a demographic survey, a cross-sectional study was implemented to 5226 students of the selected schools to investigate the adolescents' sleep quality, self-rated health, psychological status and demographic variables. Results: There were significant sleep quality differences between different groups of grade level, residence, family type, self-report personality, self-report examination scores, self-rated health, depression, loneliness and anxiety according to the results of the univariate analysis (P < 0.01 or < 0.05). The multivariate analysis indicated that high grade level (OR = 1.490, 95% CI = 1.350-1.645), living in rural areas (OR = 0.874, 95% CI = 0.799-0.956), poor self-rated health (OR = 0.934, 95% CI = 0.926-0.942), high degree of depression (OR = 1.867, 95% CI = 1.514-2.302) and anxiety (OR = 1.976, 95% CI = 1.647-2.372) may be the influencing factors of poor sleep. Conclusions: The poor sleep quality of many adolescents may be attributed to various causes, especially psychological reasons.