The influencing factors of sleep quality among Chinese junior and senior high school adolescents during the COVID-19 pandemic

Zhai, Xiaobing; Zhang, Yanan; Eshak, Ehab S; Zeng, Jing; Yang, Mei; Di, Lihua; Xiang, Bing; Cao, Jinhong

BACKGROUND: Since coronavirus disease 2019 (COVID-19) outbreak, its terrible infectiousness has caused great panic, anxiety and poor sleep quality to the vulnerable adolescent populations. METHODS: This cross-sectional online survey recruited 10,569 Chinese junior and senior high school adolescents during January 31 to February 9, 2020. Basic sociodemographic information, Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), and Fear of negative evaluation (FNE) were included in the survey. Chi-square and logistic regression analyses were used to identify factors correlated with poor sleep quality. RESULTS: The prevalence of poor sleep quality was 18.6% in the Chinese adolescent population. The average score of PSQI was 3.39 (SD = 2.64), which was significantly correlated with scores for anxiety (r = 0.50, P < 0.01), and FNE (r = 0.36, P < 0.01). Adjusted logistic regression indicated that gender (females) and education (senior high school) were associated with poor sleep quality, while living in Hubei Province and time spent on the COVID-19 information were inversely associated with poor sleep quality. Having a family member or friend infected/suspected and spending time on electronics were associated with higher odds of having poor sleep quality. Adolescents with anxiety were 8-times, and those with FNE were 3-times more likely than ones without anxiety or FNE to have poor sleep quality. In addition, the number of meals, exercise time, and diet quality were also significantly associated with sleep quality. (P <0.05). CONCLUSIONS: Poor sleep quality was common during the COVID-19 pandemic in Chinese adolescents. Understanding several factors associated with the poor sleep quality will offer some important insights into determining potential interventions to improve sleep quality during the COVID-19 pandemic.