title: Adolescent sleep disturbance and school performance: the confounding variable of socioeconomics.
abstract: OBJECTIVE
  To assess how selected socioeconomic variables known to affect school performance alter the association between reported sleep disturbance and poor school performance in a contiguous middle school/high school population.
  
  
  METHODS
  A school district/college IRB approved questionnaire was distributed in science and health classes in middle school and high school. This questionnaire included a frequency scaled pediatric sleep disturbance questionnaire for completion by students and a permission and demographic questionnaire for completion by parents (completed questionnaires n = 238 with 69.3% including GPA).
  
  
  RESULTS
  Sleep complaints occur at high frequency in this sample (sleep onset insomnia 60% > 1 x /wk.; 21.2% every night; sleepiness during the day (45.7% > 1 x /wk.; 15.2 % every night), and difficulty concentrating (54.6% > 1 x /wk.; 12.9% always). Students with lower grade point averages (GPAs) were more likely to have restless/aching legs when trying to fall asleep, difficulty concentrating during the day, snoring every night, difficulty waking in the morning, sleepiness during the day, and falling asleep in class. Lower reported GPAs were significantly associated with lower household incomes. After statistically controlling for income, restless legs, sleepiness during the day, and difficulty with concentration continued to significantly affect school performance.
  
  
  CONCLUSIONS
  This study provides additional evidence indicating that sleep disturbances occur at high frequencies in adolescents and significantly affect daytime performance, as measured by GPA. The socioeconomic variable of household income also significantly affects GPA. After statistically controlling for age and household income, the number and type of sleep variables noted to significantly affect GPA are altered but persistent in demonstrating significant effects on school performance.
authors.affiliation: University of Colorado School of Medicine, Pueblo, CO, USA. Pueo34@earthlink.com
authors.forename: James F
authors.initials: JF
authors.lastname: Pagel
authors.forename: Natalie
authors.initials: N
authors.lastname: Forister
authors.forename: Carol
authors.initials: C
authors.lastname: Kwiatkowki
mesh_terms: D000124:Achievement; D000293:Adolescent; D015992:Body Mass Index; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012574:Schools; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires