title: Quality of life, sleepiness and depressive symptoms in adolescents with insomnia: A cross-sectional study.
abstract: OBJECTIVE
  To determine the prevalence of insomnia in a sample of Portuguese adolescents and assess its repercussions on HRQoL, daytime sleepiness and depressive symptomatology.
  
  
  METHODS
  We carried out a cross-sectional school-based study evaluating students from Viseu.
  
  
  METHODS
  Students from twenty-six public secondary schools in the county of Viseu, Portugal.
  
  
  METHODS
  Of 9237 questionnaires distributed, 7581 were collected (82.1%). We excluded from analysis all questionnaires from adolescents younger than 12 or older than 18 years of age (211) and unfilled forms (451). The sample comprised 6919 adolescents, the 7th to 12th grade, from 26 public secondary schools.
  
  
  METHODS
  None.
  
  
  METHODS
  Data gathering was done using a self-applied questionnaire. Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders - IV criteria. HRQoL was evaluated with the Quality of Life Health Survey SF-36, depressive symptomatology with BDI-II and daytime sleepiness with the Epworth Sleepiness Scale.
  
  
  RESULTS
  Prevalence of insomnia was 8.3% and the prevalence of adolescents with symptoms of insomnia without daytime impairment (disturbed sleepers) was 13.1%. HRQoL was significantly reduced among adolescents with insomnia compared to normal sleepers (p<0.001) and even when compared to disturbed sleepers (p<0.001). There was an increase in daytime sleepiness from normal sleepers to disturbed sleepers and to adolescents with insomnia (p<0.001). There was also an increase in the prevalence and severity of depressive symptoms (p<0.001).
  
  
  CONCLUSIONS
  Our results show that insomnia is associated with a significantly lower health related quality of life among adolescents.
authors.affiliation: Escola Superior de Saúde de Viseu, Instituto Politécnico de Viseu, Viseu, Portugal. Electronic address: mopamaral@gmail.com.
authors.forename: Maria Odete Pereira
authors.initials: MO
authors.lastname: Amaral
authors.affiliation: Casa de Saúde de São Mateus, Viseu, Portugal.
authors.forename: António José
authors.initials: AJ
authors.lastname: de Almeida Garrido
authors.affiliation: Escola Superior de Saúde de Viseu, Instituto Politécnico de Viseu, Viseu, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: de Figueiredo Pereira
authors.affiliation: Universidade Católica Portuguesa de Viseu, Portugal.
authors.forename: Nélio Veiga
authors.initials: NV
authors.lastname: Master
authors.affiliation: Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: de Rosário Delgado Nunes
authors.affiliation: Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal.
authors.forename: Constantino Theodor
authors.initials: CT
authors.lastname: Sakellarides
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000209:etiology*
keywords: Adolescentes; Adolescents; Calidad de vida; Daytime sleepiness; Depressive symptoms; Insomnia; Insomnio; La somnolencia diurna; Los síntomas depresivos; Quality of life