Sleep hygiene practices and its impact on sleep quality and mood.

Introduction: Shift in circadian clock of adolescence with delayed bedtime and early awakening to catch morning school effects their sleep. Present study elucidated sleep hygiene practices of school-going adolescents and explored its association with their sleep quality and mood.

Methods: Students of 6^th to 12^th grade were enrolled after requisite permissions, parental consent, and written informed assent from students. Standardized questionnaires were used to evaluate for sleep hygiene practices-Adolescent Sleep Hygiene Scale (ASHS), sleep quality- Pittsburgh Sleep Quality Index (PSQI), daytime sleepiness-Pediatric Daytime Sleepiness Scale (PDSS) and mood (DASS-21-Depression Anxiety Stress Scale-21). CTRI/2022/06/043556 is the study number in Clinical Trial Registry of India.

Results: Adolescents with mean age 14.28 ± 1.86 years, including 48.7% (479) males and 51.2% (503) females participated in this study. Mean sleep hygiene score was 4.37 ± 0.60, with no difference between males and females. On ASHS subscales comparison, females had poorer sleep quality (0.009), higher daytime sleepiness (P = 0.001), poorer cognitive/emotional factor (P = 0.001) and higher depression, anxiety, and stress (DASS-21). Young adolescents (10-14 years; N = 528) had better total sleep hygiene scores (P = 0.016), better bedtime routine, cognitive/emotional factor (P = 0.001), but had poor sleep environment factor (P = 0.001). Younger adolescents also exhibited better quality of sleep (P = 0.003), lesser daytime sleepiness, and lesser mood derangements compared to older adolescents (15-19 years; N = 453). Sleep hygiene scores showed a significantly negative correlation with mood and sleep quality.

Conclusion: A clear relationship between sleep hygiene practices, mood and sleep quality has been observed among adolescents. Young adolescents who followed better sleep hygiene practices had lesser mood derangements and better sleep quality. Though ASHS scores were same among both genders but females had poor sleep quality, higher daytime sleepiness and mood.