The relationship between insomnia symptoms and school performance among 4966 adolescents in Shanghai, China

Abstract Purpose Insomnia symptoms are common in adolescents. This study examined the associations of insomnia symptoms with school performance among adolescents in Shanghai, China. Methods A total of 4966 adolescents aged 11-20 years participated in a cross-sectional survey during November of 2009. The Adolescent Sleep Disturbance Questionnaire was used to examine insomnia symptoms, and the Teacher School Achievement Form was applied to evaluate adolescents' school performance. Results The results demonstrated that, after adjusting for possible confounders, all 3 dimensions of insomnia symptoms were associated with adolescents' school performance. Difficulty falling asleep problem was associated with poor attention and concentration (odds ratio [OR] = 1.30, 95% confidence interval [CI] 1.11-1.52, P  = .001), academic frustration (OR = 1.24, 95% CI: 1.06-1.45, P  = .007), and poor school relationships (OR = 1.26, 95% CI: 1.08-1.48, P  = .003); maintaining sleep problem was associated with poor attention and concentration (OR = 1.25, 95% CI: 1.06-1.46, P  = .007) and poor interest and motivation (OR = 1.22, 95% CI: 1.04-1.44, P  = .017); and reinitiating sleep problem was related to poor interest and motivation (OR = 1.20, 95% CI: 1.00-1.45, P  = .048). Coexisting insomnia symptoms were associated with poorer school performance, especially in maintaining attention and concentration. Conclusions The findings of this study highlight the importance of sleep in the social and cognitive development of adolescents.