Modifiable behavioral risk factors for NCDs and sleep in Brazilian adolescents

Authors

  • Raina Jansen Cutrim Propp Lima Instituto Federal de Educação. Ciência e Tecnologia do Maranhão. Departamento de Ensino. Açailândia, MA, Brasil https://orcid.org/0000-0003-4925-5648
  • Mônica Araujo Batalha Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil https://orcid.org/0000-0003-0961-5151
  • Cecília Cláudia Costa Ribeiro Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Odontologia II. São Luís, MA, Brasil https://orcid.org/0000-0003-0041-7618
  • Pedro Martins Lima Neto Universidade Federal do Maranhão. Centro de Ciências Sociais, Saúde e Tecnologia. Imperatriz, MA, Brasil https://orcid.org/0000-0001-5711-6280
  • Antônio Augusto Moura da Silva Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil https://orcid.org/0000-0003-4968-5138
  • Rosângela Fernandes Lucena Batista Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil https://orcid.org/0000-0002-1529-0165

DOI:

https://doi.org/10.11606/s1518-8787.2023057004957

Keywords:

Sleep, Adolescent Health, Sleepiness, Sedentary Behavior, Alcohol Consumption, Sugar-Sweetened Beverages

Abstract

OBJECTIVE: To analyze the association between modifiable behavioral risk factors for non-communicable diseases and sleep parameters in Brazilian adolescents. METHODS: This was a cross-sectional study that used data from the RPS Cohort Consortium, São Luís, Brazil for the follow-up of adolescents aged 18–19 years (n = 2,515). The outcomes were excessive daytime sleepiness (Epworth Sleepiness Scale – ESS) and sleep quality (Pittsburgh Sleep Quality Index – PSQI). The exposures of interest were the behavioral risk factors for non-communicable diseases (NCDs): screen time, physical inactivity, alcohol, smoking, illicit drugs, caffeine intake, and consumption of sugar-sweetened beverages. Excess weight was considered a possible mediator of this association between the exposures of interest and the outcomes. The models were analyzed by modeling with structural equations. RESULTS: Physical inactivity (standardized coefficient, SC = 0.112; p = 0.001), higher consumption of alcohol (SC = 0.168; p = 0.019) and of sugar-sweetened beverages (SC = 0.128; p < 0.001) were associated with excessive daytime sleepiness in adolescents; better socioeconomic status was also associated with this outcome (SC = 0.128; p < 0.001). Physical inactivity (SC = 0.147; p < 0.001) and higher consumption of sugar-sweetened beverages (SC = 0.089; p = 0.003) were also associated with poor sleep quality. Overweight was neither a mediator nor associated with sleep quality or excessive daytime sleepiness. CONCLUSIONS: T he m ain m odifiable b ehavioral r isk f actors f or N CDs a re a ssociated with worse sleep parameters already in adolescence, which serves as a warning toward the accumulation of risks for sleep disorders in the future.

References

Matricciani L, Bin YS, Lallukka T, Kronholm E, Dumuid D, Paquet C, et al. Past, present, and future: trends in sleep duration and implications for public health. Sleep Health. 2017 Oct;3(5):317-23. https://doi.org/10.1016/j.sleh.2017.07.006

Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016 Jun;12(6):785-6. https://doi.org/10.5664/jcsm.5866

Shochat T, Cohen-Zion M, Tzischinsky O. Functional consequences of inadequate sleep in adolescents: a systematic review. Sleep Med Rev. 2014 Feb;18(1):75-87. https://doi.org/10.1016/j.smrv.2013.03.005

Barbosa SM, Batista RF, Rodrigues LD, Bragança ML, Oliveira BR, Simões VM, et al. Prevalência de sonolência diurna excessiva e fatores associados em adolescentes da coorte RPS, em São Luís (MA). Rev Bras Epidemiol. 2020;23:e200071. https://doi.org/10.1590/1980-549720200071

Owens J, Au R, Carskadon M, Millman R, Wolfson A, Braverman PK, et al. Insufficient sleep in adolescents and young adults: an update on causes and consequences. Pediatrics. 2014 Sep;134(3):e921-32. https://doi.org/10.1542/peds.2014-1696

Sampasa-Kanyinga H, Hamilton HA, Chaput JP. Sleep duration and consumption of sugarsweetened beverages and energy drinks among adolescents. Nutrition. 2018 Apr;48:77-81. https://doi.org/10.1016/j.nut.2017.11.013

Chang VC, Chaput JP, Roberts KC, Jayaraman G, Do MT. Factors associated with sleep duration across life stages: results from the Canadian Health Measures Survey. Health Promot Chronic Dis Prev Can. 2018 Nov;38(11):404-18. https://doi.org/10.24095/hpcdp.38.11.02

Hrafnkelsdottir SM, Brychta RJ, Rognvaldsdottir V, Chen KY, Johannsson E, Gudmundsdottir SL, et al. Less screen time and more physical activity is associated with more stable sleep patterns among Icelandic adolescents. Sleep Health. 2020;S2352-7218(20):30070-X. https://doi.org/10.1016/j.sleh.2020.02.005

Felden ÉP, Leite CR, Rebelatto CF, Andrade RD, Beltrame TS. [Sleep in adolescents of different socioeconomic status: a systematic review].Rev Paul Pediatr. 2015 Dec;33(4):467-73. Portuguese. https://doi.org/10.1016/j.rpped.2015.01.011

Birhanu TE, Getachew B, Gerbi A, Dereje D. Prevalence of poor sleep quality and its associated factors among hypertensive patients on follow up at Jimma University Medical Center. J Hum Hypertens. J Hum Hypertens. 2021 Jan;35(1):94-100. https://doi.org/10.1038/s41371-020-0320-x

World Health Organization. Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018.

Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017 Dec;390(10113):2627-42.

https://doi.org/10.1016/S0140-6736(17)32129-3

Ogilvie RP, Patel SR. The epidemiology of sleep and obesity. Sleep Health. 2017 Oct;3(5):383-8. https://doi.org/10.1016/j.sleh.2017.07.013

Simões VM, Batista RF, Alves MT, Ribeiro CC, Thomaz EB, Carvalho CA, et al. Saúde dos adolescentes da coorte de nascimentos de São Luís, Maranhão, Brasil, 1997/1998. Cad Saude Publica. 2020;36(7):e00164519. https://doi.org/10.1590/0102-311x00164519

Associação Brasileira de Empresas de Pesquisas. Critério Brasil 2015. Alterações na aplicação do Critério Brasil 2016. São Paulo: Associação Brasileira de Empresas de Pesquisas; 2015.

Moretti-Pires RO, Corradi-Webster CM. Adaptação e validação do Alcohol Use Disorder Identification Test (AUDIT) para população ribeirinha do interior da Amazônia, Brasil. Cad Saude Publica. 2011 Mar;27(3):497-509. https://doi.org/10.1590/S0102-311X2011000300010

Schneider BC, Motta JV, Muniz LC, Bielemann RM, Madruga SW, Orlandi SP, et al. Desenho de um questionário de frequência alimentar digital autoaplicado para avaliar o consumo alimentar de adolescentes e adultos jovens: coortes de nascimentos de Pelotas, Rio Grande do Sul. Rev Bras Epidemiol. 2016;19(2):419-32. https://doi.org/10.1590/1980-5497201600020017

World Health Organization. Guideline: sugars intake for adults and children. Geneva: World Health Organization; 2015.

US Department of Agriculture. Nutrient database for standard reference - SR14. Washington, DC: US Department of Agriculture; 2011.

Sallis JF, Strikmiller PK, Harsha DW, Feldman HA, Ehlinger S, Stone EJ, et al. Validation of interviewer- and self-administered physical activity checklists for fifth grade students. Med Sci Sports Exerc. 1996 Jul;28(7):840-51. https://doi.org/10.1097/00005768-199607000-00011

World Health Organization. WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: World Health Organization; 2006.

World Health Organization. Physical status : the use of and interpretation of anthropometry. Geneva: World Health Organization; 1995. (WHO technical report series; 854). Available from: https://apps.who.int/iris/handle/10665/37003

Passos MH, Silva HA, Pitangui AC, Oliveira VM, Lima AS, Araújo RC. Reliability and validity of the Brazilian version of the Pittsburgh Sleep Quality Index in adolescents. J Pediatr (Rio J). 2017;93(2):200-6. https://doi.org/10.1016/j.jped.2016.06.006

Bertolazi AN, Fagondes SC, Hoff LS, Pedro VD, Menna Barreto SS, Johns MW. Portuguese language version of the Epworth sleepiness scale: validation for use in Brazil. J Bras Pneumol. 2009 Sep;35(9):877-83. https://doi.org/10.1590/S1806-37132009000900009

Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Análise multivariada de dados. Porto Alegre: Bookman; 2009.

Chennaoui M, Arnal PJ, Sauvet F, Léger D. Sleep and exercise: a reciprocal issue? Sleep Med Rev. 2015 Apr;20:59-72. https://doi.org/10.1016/j.smrv.2014.06.008

Sousa RD, Bragança ML, Oliveira BR, Coelho CC, Silva AA. Bragança MLBM, Oliveira BR, Coelho CCNS, Silva AAM. Association between the degree of processing of consumed foods and sleep quality in adolescents. Nutrients. 2020 Feb;12(2):1-12. https://doi.org/10.3390/nu12020462

St-Onge MP, Roberts A, Shechter A, Choudhury AR. Fiber and saturated fat are associated with sleep arousals and slow wave sleep. J Clin Sleep Med. 2016 Jan;12(1):19-24. https://doi.org/10.5664/jcsm.5384

Bernardo MP, Pereira ÉF, Louzada FM, D’Almeida V. Duração do sono em adolescentes de diferentes níveis socioeconômicos. J Bras Psiquiatr. 2009;58(4):231-7. https://doi.org/10.1590/S0047-20852009000400003

Schaan CW, Cureau FV, Bloch KV, Carvalho KM, Ekelund U, Schaan BD. Prevalence and correlates of screen time among Brazilian adolescents: findings from a country-wide survey. Appl Physiol Nutr Metab. 2018 Jul;43(7):684-90. https://doi.org/10.1139/apnm-2017-0630

Oliveira G, Silva IB, Oliveira ERA. O sono na adolescência e os fatores associados ao sono inadequado. Rev Bras Pesq Saúde. 2019;21(1):135-45. https://doi.org/10.21722/rbps.v21i1.26477

Mak YW, Wu CS, Hui DW, Lam SP, Tse HY, Yu WY, et al. Association between screen viewing duration and sleep duration, sleep quality, and excessive daytime sleepiness among adolescents in Hong Kong. Int J Environ Res Public Health. 2014 Oct;11(11):11201-19. https://doi.org/10.3390/ijerph111111201

Roehrs T, Roth T. Sleep, sleepiness, and alcohol use. Alcohol Res Health. 2001;25(2):101-9.

Pasch KE, Latimer LA, Cance JD, Moe SG, Lytle LA. Longitudinal bi-directional relationships between sleep and youth substance use. J Youth Adolesc. 2012 Sep;41(9):1184-96. https://doi.org/10.1007/s10964-012-9784-5

Beebe DW, Lewin D, Zeller M, McCabe M, MacLeod K, Daniels SR, et al. Sleep in overweight adolescents: shorter sleep, poorer sleep quality, sleepiness, and sleep-disordered breathing. J Pediatr Psychol. 2007;32(1):69-79. https://doi.org/10.1093/jpepsy/jsj104

Sbaraini M, Cureau FV, Ritter JD, Schuh DS, Madalosso MM, Zanin G, et al. Prevalence of overweight and obesity among Brazilian adolescents over time: a systematic review and meta-analysis. Public Health Nutr. 2021 Dec;24(18):6415-26.

https://doi.org/10.1017/S1368980021001464

Published

2023-09-14

Issue

Section

Original Articles

How to Cite

Lima, R. J. C. P., Batalha, M. A., Ribeiro, C. C. C., Lima Neto, P. M. ., Silva, A. A. M. da, & Batista, R. F. L. (2023). Modifiable behavioral risk factors for NCDs and sleep in Brazilian adolescents. Revista De Saúde Pública, 57(1), 60. https://doi.org/10.11606/s1518-8787.2023057004957