title: Associations of self-reported sleep disturbance and duration with academic failure in community-dwelling Swedish adolescents: sleep and academic performance at school.
abstract: OBJECTIVE
  To examine associations of self-reported sleep disturbance and short sleep duration with the risk for academic failure.
  
  
  METHODS
  A cohort of ~40,000 adolescents (age range: 12-19 years) who were attending high school grades 7, 9, and 2nd year of upper secondary school in the Swedish Uppsala County were invited to participate in the Life and Health Young Survey (conducted between 2005 and 2011 in Uppsala County, Sweden). In addition to the question how many subjects they failed during the school year (outcome variable), subsamples of adolescents also answered questions related to subjective sleep disturbance (n = 20,026) and habitual sleep duration (n = 4736) (exposure variables). Binary logistic regression analysis was utilized to explore if self-reported sleep disturbances and habitual short sleep duration (defined as less than 7-8 h sleep per night) increase the relative risk to fail subjects during the school year (controlled for possible confounders, e.g. body-mass-index).
  
  
  RESULTS
  Adolescents with self-reported sleep disturbances had an increased risk for academic failure (i.e., they failed at least one subject during the school year; OR: boys, 1.68; girls, 2.05, both P < 0.001), compared to adolescents without self-reported sleep disturbances. In addition, adolescents who reported short sleep duration on both working and weekend days were more likely to fail at least one subject at school than those who slept at least 7-8 h per night (OR: boys, 4.1; girls, 5.0, both P < 0.001).
  
  
  CONCLUSIONS
  Our findings indicate that reports of sleep disturbance and short sleep duration are linked to academic failure in adolescents. Based on our data, causality cannot be established.
authors.affiliation: Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden. Electronic address: olga.titova@neuro.uu.se.
authors.forename: Olga E
authors.initials: OE
authors.lastname: Titova
authors.affiliation: Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden.
authors.forename: Pleunie S
authors.initials: PS
authors.lastname: Hogenkamp
authors.affiliation: Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden.
authors.forename: Josefin A
authors.initials: JA
authors.lastname: Jacobsson
authors.affiliation: Uppsala County Council, 751 25 Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden.
authors.forename: Inna
authors.initials: I
authors.lastname: Feldman
authors.affiliation: Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden.
authors.forename: Helgi B
authors.initials: HB
authors.lastname: Schiöth
authors.affiliation: Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden. Electronic address: christian.benedict@neuro.uu.se.
authors.forename: Christian
authors.initials: C
authors.lastname: Benedict
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006184:Habits; D006801:Humans; D008297:Male; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000150:complications* / Q000523:psychology*; D013548:Sweden; D055815:Young Adult
keywords: Academic failure; Adolescents; Cohort study; Internet use at night; Short sleep duration; Sleep disturbance