title: Bullying as a risk for poor sleep quality among high school students in China.
abstract: OBJECTIVE
  To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China.
  
  
  METHODS
  A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality.
  
  
  RESULTS
  Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality.
  
  
  CONCLUSIONS
  Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents.
authors: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Center for Disease Control and Prevention of Haizhu District, Guangzhou, China.
authors: Ying
authors: Y
authors: Zhou
authors: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors: Lan
authors: L
authors: Guo
authors: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors: Ci-yong
authors: CY
authors: Lu
authors: Center for ADR monitoring of Guangdong, Guangzhou, China.
authors: Jian-xiong
authors: JX
authors: Deng
authors: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors: Yuan
authors: Y
authors: He
authors: Center for ADR monitoring of Guangdong, Guangzhou, China.
authors: Jing-hui
authors: JH
authors: Huang
authors: Center for ADR monitoring of Guangdong, Guangzhou, China.
authors: Guo-liang
authors: GL
authors: Huang
authors: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors: Xue-qing
authors: XQ
authors: Deng
authors: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors: Xue
authors: X
authors: Gao
mesh_terms: D000293:Adolescent; D058445:Bullying / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012574:Schools / Q000706:statistics & numerical data*; D012890:Sleep; D013334:Students / Q000706:statistics & numerical data*