Journal List > J Korean Acad Community Health Nurs > v.26(2) > 1058368

Yu and Kim: The Effect of Sleep Duration and Relief of Fatigue after Sleep on the Risk of Injury at School among Korean Adolescents

Abstract

Purpose

To explore the association between sleep and the risk of accidental injury at school among Korean adolescents.

Methods

From the database of the Ninth Korea Youth Risk Behavior Web-based Survey (KYRBS), the researcher selected 63,307 adolescents who responded to a survey on sleep hours. We conducted logistic regression with sleep duration and fatigue after sleep as independent variables, the risk of injury at school as a dependent variable, and gender, grade, school type, economic status, parents' education level, number of participations in physical education, and current smoking and drinking as control variables.

Results

Using 9 hours of sleep as the reference, the adjusted injury risk (odds ratio) was 1.74 for those sleeping less than 5 hours a day, 1.61 for 5 hours, 1.45 for 6 hours, 1.31 for 7 hours, 1.13 for 8 hours, and 1.40 for 10 hours or longer. The difference between each pair of groups was statistically significant. In this study, injury risk increased as sleep duration decreased and fatigue after sleep increased.

Conclusion

The findings suggest that a short nightly duration of sleep and fatigue after sleep can be considered potential risk factorsfor unintentional injuries at school among Korean adolescents.

Figures and Tables

Table 1

Unintentional Injury at School according to Sleep and Other Variables among Adolescents in Korea (N=63,307)

jkachn-26-100-i001
Variables Categories Injured No injured x2 p
n (%) n (%)
Total 29,508 (46.4) 33,799 (53.6)
Gender Male 15,511 (48.6) 16,105 (51.4) 138.20 <.001
Female 13,997 (44.0) 17,694 (56.0)
Grade 7 5,195 (51.0) 5,053 (49.0) 770.98 <.001
8 5,541 (53.9) 4,738 (46.1)
9 5,398 (50.8) 5,149 (49.2)
10 4,517 (41.8) 6,164 (58.2)
11 4,578 (43.2) 6,052 (56.8)
12 4,279 (39.1) 6,643 (60.9)
School type Boys only 5,334 (49.2) 5,379 (50.8) 180.92 <.001
Girls only 4,634 (40.9) 6,550 (59.1)
Both 19,540 (47.1) 21,870 (52.9)
Perceived economic status Upper 9,678 (49.5) 10,079 (51.0) 91.94 <.001
Middle 13,684 (44.7) 16,675 (55.3)
Lower 6,146 (46.1) 7,045 (53.9)
Father's education level (year) ≤9 1,072 (45.1) 1,285 (54.9) 55.69 <.001
10~13 9,563 (45.0) 11,454 (55.0)
≥14 13,388 (47.9) 14,356 (52.1)
Unknown 4,238 (44.7) 5,238 (55.3)
Mother's education level (year) ≤9 989 (45.2) 1,220 (54.8) 97.73 <.001
10~13 12,024 (44.8) 14,540 (55.2)
≥14 11,185 (48.8) 11,623 (51.2)
Unknown 4,096 (44.4) 5,131 (55.6)
Number of physical education per week 0 4,324 (35.5) 7,603 (64.5) 1,003.46 <.001
1 5,102 (44.7) 6,261 (55.3)
2 8,483 (46.2) 9,702 (53.8)
3 11,599 (53.5) 10,233 (46.5)
Current smoking Yes 7,034 (52.1) 6,401 (47.9) 221.35 <.001
No 22,474 (44.8) 27,398 (55.2)
Alcohol consumption Yes 14,078 (50.3) 13,775 (49.7) 298.93 <.001
No 15,430 (43.4) 20,024 (56.6)
Sleep duration (hour/day) <5 3,877 (46.0) 4,538 (54.0) 22.30 .017
5 6,097 (45.5) 7,174 (54.5)
6 7,302 (46.1) 8,402 (53.9)
7 7,252 (47.8) 7,871 (52.2)
8 3,897 (46.7) 4,468 (53.3)
9 931 (44.1) 1,182 (55.9)
≥10 152 (49.5) 164 (50.5)
Relief of fatigue after sleep Very enough 1,724 (40.4) 2,542 (59.6) 199.44 <.001
Enough 5,127 (43.4) 6,507 (56.6)
So-so 9,173 (45.5) 11,058 (54.5)
Not enough 9,221 (48.8) 9,529 (51.2)
Never enough 4,263 (50.1) 4,163 (49.9)

Unweighted; Weighed.

Table 2

Logistic Regression Analysis of Relationship between Sleep hours, Relief of Fatigue after Sleep and Injury Risk

jkachn-26-100-i002
Variables Adjusted OR 95% CI
Sleep hours (ref : 9hr)
 <5 1.74 1.53~1.98
 5 1.61 1.43~1.83
 6 1.45 1.28~1.63
 7 1.31 1.16~1.47
 8 1.13 1.01~1.27
 ≥10 1.40 1.03~1.91
Relief of fatigue after sleep (ref : very enough)
 Enough 1.17 1.08~1.28
 So-so 1.36 1.26~1.47
 Not enough 1.63 1.50~1.77
 Never enough 1.77 1.62~1.95

OR=odds ratio; CI=confidential interval; Adjusted odds ratio is Logistic regression model with gender, grade, school type, economic status, parents education level, number of physical education, current smoking and drinking as covariate.

References

1. Ministry of Education, Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Adolescent of seven to nine among ten is lack of sleep-the seventh Korea youth risk behavior web-based survey [Internet]. Osong: Ministry of Education, Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention;2011. cited 2015 January 15. Available from: http://yhs.cdc.go.kr/.
2. National Sleep Foundation. How much sleep do we really need? [Internet]. Arlington: National Sleep Foundation;cited 2015 January 15. Available from: http://sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need.
3. Nam SO. Normal sleep in children and adolescents. J Korean Child Neurol Soc. 2011; 19(2):66–75.
4. Rhie S, Lee S, Chae KY. Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale. Korean J Pediatr. 2011; 54(1):29–35. DOI: 10.3345/kjp.2011.54.1.29.
crossref
5. Goel N, Rao H, Durmer JS, Dinges DF. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2009; 29(4):320–339. DOI: 10.1055/s-0029-1237117.
crossref
6. Park S. Association between short sleep duration and obesity among South Korean adolescents. West J Nurs Res. 2011; 33(2):207–223. DOI: 10.1177/0193945910371317.
crossref
7. Rhie SK, Chae KY. Impact of sleep duration on emotional status in adolescents. J Depress Anxiety. 2013; 2(138):1–5. DOI: 10.4172/2167-1044.1000138.
crossref
8. Kim YY, Kim UN, Lee JS, Park JH. The effect of sleep duration on the risk of unintentional injury in Korean adults. J Prev Med Public Health. 2014; 47(3):150–157. DOI: 10.3961/jpmph.2014.47.3.150.
crossref
9. School Safety and Insurance Federation. 2013 accidents and compensation statistics. [Internet]. Seoul: School Safety and Insurance Federation;2014. cited 2015 January 15. Available from: http://www.ssif.or.kr/06_participation/part05.html.
10. Malta DC, do Prado RR, Caribe SS, da Silva MM, de Andreazzi MA, da Silva JB Júnior, et al. Factors associated with injuries in adolescents, from the National Adolescent School-based Health Survey(PeNSE 2012). Rev Bras Epidemiol. 2014; 17:Suppl 1. 183–202. DOI: 10.1590/1809-4503201400050015.
11. Mattila V, Parkkari J, Kannus P, Rimpelä A. Occurrence and risk factors of unintentional injuries among 12-to 18-year-old Finns-a survey of 8219 adolescents. Eur J Epidemiol. 2004; 19(5):437–444. DOI: 10.1023/B:EJEP.0000027355.85493.cb.
12. Stallones L, Beseler C, Chen P. Sleep patterns and risk of injury among adolescent farm residents. Am J Prev Med. 2006; 30(4):300–304. DOI: 10.1016/j.amepre.2005.11.010.
crossref
13. Lam LT, Yang L. Short duration of sleep and unintentional injuries among adolescents in China. Am J Epidemiol. 2007; 166(9):1053–1058. DOI: 10.1093/aje/kwm175.
crossref
14. Dawson D, Reid K. Fatigue, alcohol and performance impairment. Nature. 1997; 388:235.
crossref
15. Shin SM. Association of sleep habit with health behavior, experience of accident and injury treated among middle school students in seoul, Korea. Korean J Stress Res. 2015; 23(1):19–25. DOI: 10.17547/kjsr.2015.23.1.19.
crossref
16. Chen MY, Wang EK, Jeng YJ. Adequate sleep among adolescents is positively associated with health status and healthrelated behaviors. BMC Public Health. 2006; 6:59. DOI: 10.1186/1471-2458-6-59.
crossref
17. Grandner MA, Drummond SP. Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Med Rev. 2007; 11(5):341–360. DOI: 10.1016/j.smrv.2007.03.010.
crossref
18. Pilcher JJ, Ginter DR, Sadowsky B. Sleep quality versus sleep quantity: Relationships between sleep and measures of health, well-being and sleepiness in college students. J Psychosom Res. 1997; 42(6):583–596. DOI: 10.1016/S0022-3999(97)00004-4.
crossref
19. Parrott AC, Hindmarch I. The leeds sleep evaluation questionnaire in psychopharmacological investigations-a review. Psychopharmacology (Berl). 1980; 71(2):173–179.
crossref
20. Zhu H, Han Y, Sun Y, Xie Z, Qian X, Stallones L, et al. Sleeprelated factors and work-related injuries among farmers in heilongjiang province, people's republic of China. Int J Environ Res Public Health. 2014; 11(9):9446–9459. DOI: 10.3390/ijerph110909446.
crossref
21. Li Y, Jin H, Owens JA, Hu C. The association between sleep and injury among school-aged children in rural China: A case-control study. Sleep Med. 2008; 9(2):142–148. DOI: 10.1016/j.sleep.2007.01.018.
crossref
22. Boergers J, Gable CJ, Owens JA. Later school start time is associated with improved sleep and daytime functioning in adolescents. J Dev Behav Pediatr. 2014; 35(1):11–17. DOI: 10.1097/DBP.0000000000000018.
crossref
23. Owens JA, Belon K, Moss P. Impact of delaying school start time on adolescent sleep, mood, and behavior. Arch Pediatr Adolesc Med. 2010; 164(7):608–614. DOI: 10.1001/archpediatrics.2010.96.
crossref
24. Taylor DJ, Jenni O, Acebo C, Carskadon MA. Sleep tendency during extended wakefulness: Insights into adolescent sleep regulation and behavior. J Sleep Res. 2005; 14(3):239–244. DOI: 10.1111/j.1365-2869.2005.00467.x.
crossref
25. Choi YS. Jeonbuk, later school start time... I love it. but I'm still awkward [Internet]. Seoul: Yonhapnews;2014. cited 2014 October 1. Available from: http://www.yonhapnews.co.kr/bulletin/2014/10/01/0200000000AKR20141001097500055.HTML?from=search.
TOOLS
Similar articles