Sleep quality and its relationship with school schedules and mental health of Nigerian secondary school adolescents

Study Objectives: This study aimed to determine the sleep quality of in-school Nigerian adolescents and its association with their schooling and mental health outcomes. Methods: The study was a descriptive cross-sectional study. It was conducted among adolescents attending public and private secondary schools within the Ife Central Local Government, Osun State, southwestern Nigeria. A multistage sampling technique was used to select study participants. The Pittsburgh Sleep Quality Index, 9-item Patient Health Questionnaire (PHQ-9), and 7-item General Anxiety Disorder questionnaires were used to determine sleep quality, depression, and anxiety, respectively. Results: We studied 448 adolescents aged between 10 and 19 years with a mean age of 15.0 +/- 1.8 years. The majority of our respondents (85.0%) had poor sleep quality. More than half of the respondents (55.1%) had insufficient sleep during weekdays, while only 34.8% had insufficient sleep during weekends. The school closing time and school type showed a statistically significant association with sleep quality (P =.039 and.005, respectively). The odds of having poor sleep quality increased by 2-fold among adolescents in private schools when compared with those in public schools (adjusted odds ratio = 1.97, 95% confidence interval = 1.069-3.627). Using multiple linear regression, only depression showed a statistically significant association with sleep quality at 95% confidence interval (CI = 0.073 to 0.219, P <.001), such that for every unit change in depression scores (PHQ-9), there will be a corresponding increase of 0.103 in sleep quality. Conclusions: Sleep quality is poor in adolescents and adversely associated with their mental health. This should also be addressed in the development of appropriate interventions.