The associations between self-reported sleep duration and adolescent health outcomes: what is the role of time spent on Internet use?
OBJECTIVE
This study aimed to examine the associations of self-reported sleep duration with adolescent health outcomes, taking into account time spent on Internet use.


METHODS
We used data from the 2008-2009 Korea Youth Behavioral Risk Factor Survey, a cross-sectional online survey of middle and high school students aged 13-18years in South Korea (N=136,589) to examine the associations of self-reported sleep duration with four mental and physical health measures, e.g. self-report of depressive symptoms, suicidal ideation, weight status, and self-rated health. The binary logit and generalized ordered logit models controlled for time spent on Internet use for non-study purposes and other factors.


RESULTS
Shorter self-reported sleep duration was associated with a higher likelihood of reporting depressive symptoms, suicidal ideation, and overweight or obese status, and a lower likelihood of reporting better self-rated health, even after accounting for time spent on Internet use. Excessive Internet use was found to be an independent risk factor for these outcomes.


CONCLUSIONS
Among in-school adolescents in South Korea, shorter sleep duration and excessive Internet use are independently and additively associated with multiple indicators of adverse health status. Excessive Internet use may have not only direct adverse health consequences, but also have indirect negative effects through sleep deprivation.
Program in Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore, Singapore. young.do@duke-nus.edu.sg
Young Kyung
YK
Do
Eunhae
E
Shin
Mary Ann
MA
Bautista
Kelvin
K
Foo
D000293:Adolescent; D001294:Attitude to Health; D001835:Body Weight; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D050177:Overweight / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D056910:Republic of Korea; D012307:Risk Factors; D012892:Sleep Deprivation / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D013223:Statistics as Topic; D059020:Suicidal Ideation