Association of problem behavior with sleep problems and gastroesophageal reflux symptoms.
BACKGROUND
There are few large-scale epidemiologic studies examining the associations between sleep problems, gastroesophageal reflux disease (GERD) symptoms, lifestyle and food habits and problem behaviors (PB) in adolescents. The aim of this study was to evaluate the associations among these factors in Japanese adolescents.


METHODS
A cross-sectional survey of 1840 junior high school students was carried out using questionnaires. The subjects were classified into PB or normal behavior (NB) groups using the Pediatric Symptom Checklist (PSC). The scores of the sleep-related factors, sleep bruxism, lifestyle and food habits, and GERD symptoms were compared. Logistic regression analysis was used to determine the factors related to PB.


RESULTS
Mean subject age was 13.3 ± 1.8 years. The PB group had significantly longer sleep latency and higher GERD symptom score (P < 0.001). Furthermore, the PB group was significantly more likely to experience absence of the mother at dinner time, skip breakfast, and have <30 min of conversation among family at dinner time. The PB group had significantly higher frequencies of sleep bruxism, difficulty falling asleep within 30 min, nightmares, feeling of low sleep quality, daytime somnolence, and daytime lack of motivation. Feelings of low sleep quality had the strongest association with PB, with an adjusted odds ratio of 12.88 (95% confidence interval: 8.99-18.46).


CONCLUSIONS
PB in adolescents are associated with sleep problems, including sleep bruxism, as well as lifestyle and food habits and GERD symptoms.
Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Katsuyoshi
K
Sakaguchi
Takakazu
T
Yagi
Aya
A
Maeda
Kunihiro
K
Nagayama
Sawako
S
Uehara
Yoko
Y
Saito-Sakoguchi
Kyoko
K
Kanematsu
Shouichi
S
Miyawaki
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D020187:REM Sleep Behavior Disorder / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D012189:Retrospective Studies; D012890:Sleep; D011795:Surveys and Questionnaires
behavioral symptom; gastroesophageal reflux disease; psychology; sleep bruxism; sleep problem