Sleep and school attendance in adolescence: Results from a large population-based study

Background: The aim of this study was to examine the link between adolescent sleep and non-attendance in school. Methods: A large population-based study from Norway conducted in 2012, the youth@hordaland study, surveyed 8,347 adolescents aged 16-19 years (54% girls). Self-reported sleep measures included bedtime, rise time, sleep duration, sleep efficiency, sleep onset latency (SOL), wake after sleep onset (WASO), insomnia symptoms, tiredness, and sleepiness. School attendance was obtained from national administrative registries. Results: Most sleep parameters were associated with increased risk of school non-attendance. After adjusting for gender and socioeconomic status, short sleep duration and sleep deficiency were the sleep measures with the highest odds of non-attendance (OR=4.61, CI 95% 3.29-6.46) and (OR=3.26, CI 95% 2.67-3.99), respectively). Also, large bedtime discrepancies in weekend versus weekdays were associated with non-attendance (OR=2.43, CI 95% 1.93-2.02), as well as insomnia (OR=2.25, CI % 1.89-2.67) and daytime tiredness (OR=2.09, CI 95% 1.70-2.57). The associations were somewhat reduced after additional adjustment for depression, but remained significant in the fully adjusted model. Conclusion: The demonstrated relationship between sleep problems and school absence suggests that careful assessment of sleep is warranted when adolescents present with extensive school absence. Future studies on how the sleep-school absence relationship in adolescence may impact later work affiliation in adulthood are needed.