Insufficient sleep, impaired sleep, and injury in Canadian adolescents: a cross-sectional analysis of the 2017/18 Health Behaviour in School-aged Children study

Abstract

Background. Insufficient and impaired sleep are common in adolescents, and can impact their health and safety. One negative consequence of poor sleep is risks for unintentional injuries, yet evidence addressing this relationship among Canadian adolescents is limited in scope. In this study, we documented contemporary sleeping behaviours of Canadian adolescents and examined their relationship with risks for injuries. Methods. A cross-sectional study was employed, using records from the 2017/18 Canadian Health Behaviour in School-aged Children study (n=21,745). Participants’ usual sleep patterns, including insufficient sleep (on school and non-school days), impaired sleep, and daytime sleepiness, and annual reports of any and serious medically treated injury were obtained. Descriptive and hierarchical multivariable Poisson regression analyses were performed, with adjustment for potential confounders, and tests of interaction by age and gender. Results. Insufficient sleep, impaired sleep, and daytime sleepiness affected 11.3% to 35.3% of adolescents; these estimates varied by age and gender. Sleep indicators displayed modest, but consistent associations with risks for “any injury”, whereas sleep impairment and daytime sleepiness were the only meaningful and statistically significant risk factors for “serious injuries”, after adjustment for potential confounders. The analysis of interactions showed that boys with insufficient sleep on non-school days and impaired sleep had significantly higher injury risks compared to girls without poor sleep in these domains. Conclusion. Indicators of poor sleep affected up to one-third of Canadian adolescents, and were associated with risks for various types of injury. Sleep hygiene may act as a plausible focus for public health and prevention initiatives to mitigate injury risks.