Sleeping difficulties among adolescents constitute a pressing public health issue, and it is of the utmost importance that these are approached from a health-promotion perspective. This study explores adolescents' suggestions on how their sleep could be supported. Data were collected via eight focus group interviews with 43 adolescents aged 15-16, in Sweden, and analyzed using qualitative content analysis. The results describe the adolescents' suggestions on how their sleep could be supported in three themes: being supported by involved parents- routines, engagement, and warmth are vital; being supported to achieve knowledge on the "whys" and "hows" of sleep-increased knowledge gives the ability to make well-grounded sleep choices; and being guided into finding balance-balance in life is difficult to achieve and adolescents desire support. Parents, school nurses, health professionals, and anyone who has the opportunity to improve and promote sleep should consider adolescents' suggestions.

Background: Sleeping difficulties have become increasingly prevalent among adolescents and have negative consequences on their health, well-being, and education.

Aim and methods: The overall aim of this thesis was to explore adolescents’ sleep and the factors that impede and promote their sleep. Study I describes the prevalence of self-reported sleep duration and sleeping difficulties and explores their associations with school stress, self-perception, and technology use among adolescents based on a questionnaire of n = 937 adolescents, aged 15–16. Study II describes reasons for sleeping difficulties as perceived by adolescents based on an open-ended question answered by n = 475 adolescents, aged 15–16. Study III illuminates adolescents’ lived experiences of sleeping difficulties based on narrative interviews with n = 16 adolescents, aged 14–15. Study IV explores adolescents’ suggestions on how their sleep could be supported, based on eight focus groups with n = 43 adolescents, aged 15–16.

Results: Fifty-five percent of the adolescents slept less than the recommended eight hours per night. School stress and technology use were associated with short sleep duration, whereas school stress and self-perception were associated with sleeping difficulties (I). Stress, technology use, poor sleep habits, existential thoughts, needs, and suffering were all perceived as reasons for sleeping difficulties (II). Having sleeping difficulties makes it challenging to go through the night and cope with the following day. It also implies a feeling of being trapped by circumstances (III). To improve sleep, adolescents suggested receiving support from involved parents, achieving knowledge about on the “whys” and “hows” of sleep, and being guided into finding balance (IV).

Conclusions: Sleeping difficulties affect adolescents’ daily lives and constitute a pressing health issue. In order to deal with sleeping difficulties, adolescents need to be encouraged to narrate their experiences and circumstances, be respectfully listened to and supported by their parents, school nurses, and other significant adults.

Objectives:

Now recognized as a public health issue, sleeping difficulties among adolescents, mainly involving insufficient sleep, are common (Gradisar et al., 2011; Louzada, 2019; Saxvig et al., 2020). To avoid persistent sleeping difficulties, health-related problems, and school failure, it is of utmost importance to promote good sleep among adolescents. This study explores adolescents’ suggestions on how their sleep could be supported.

Methods:

Data were collected via eight focus group interviews with 43 adolescents aged 15–16 from different demographic areas in a Swedish city, 42% boys and 58% girls. Data were analyzed using qualitative content analysis (Lindgren et al., 2020). 

Results:

The results describes the adolescents’ suggestions about how their sleep can be supported in three themes. 

Being supported by involved parents

Even though adolescents are starting to become independent individuals, they want support to sleep better. Above all, they want support from their parents in the form of routines, security, and knowledge about sleep.

Being supported to achieve knowledge on the “whys” and “hows” of sleep

Adolescents value knowledge and advice that they receive from those they trust because it is then perceived as targeted and personal. Adolescents also want school education about sleep to be more activity-based, as they find that learning and motivation increase with this type of pedagogy.

Being guided into finding balance 

By being encouraged into activity, learning to deal with silence, as well as by receiving support by structures in school, the adolescents believe they can be guided to finding balance. 

Conclusions:

Designing interventions and health promotions in line with what the adolescents suggest will create the conditions to successfully support adolescents’ sleep. These suggestions should be used by parents, health professionals, and the school, all of whom have the opportunity to influence adolescents; these strategies also need to be evaluated

En vanlig uppfattning i samhället är att ungdomar som sover för lite är slarviga med rutiner och att skärmarna tar deras tid. Men är problematiken så enkel? Hur är det egentligen att ha sömnsvårigheter? En ny studie från Högskolan Borås ger en inblick i ungdomars egna upplevelser.

Bakgrund 

Det är idag välkänt att en stor del av världens ungdomar sover mindre än de borde. Andelen ungdomar som får tillräckligt med sömn varierar över hela världen (32-86%) [1]. Att ha en bristande sömn påverkar ungdomars möjligheter till hälsa, välbefinnande och utbildning. Forskning utifrån olika perspektiv behövs för att inhämta ytterligare kunskap och förståelse för ungdomars sömn. Hittills finns det få studier med kvalitativ ansats. Syftet med denna studie var därför att belysa innebörden av ungdomars levda upplevelse av sömnsvårigheter. 

Metod

Data samlades in via enskilda intervjuer med 16 ungdomar i årskurs nio, 14-15 år, med självupplevda sömnsvårigheter. De transkriberade intervjuerna analyserades med fenomenologisk hermeneutisk metod.

Resultat

Fyra teman som belyser innebörden av ungdomars upplevelse av sömnsvårigheter uppstod: att känna sig uppgiven av att inte somna, att uppleva natten som en kamp, att söka efter bättre sömn och att påverkas nästa dag. Den övergripande förståelsen belyser att ungdomar med sömnsvårigheter kan uppleva natten som en obarmhärtigt lång väntan på att somna. Det blir en kamp där de behöver hantera känslor som frustration, irritation, oro, stress, sorg och rädsla. Ungdomarna upplever även att det blir en kamp att hantera nästa dag då sömnbristen gör sig påmind. Att ha sömnsvårigheter upplevs vanligt, som att det tillhör åldern, därför berättar de inte om sömnsvårigheterna eller ber om råd utan provar olika strategier på egen hand. Ungdomar upplever också att det finns omständigheter, så som familj, vänner, skola, betyg, sociala medier, ideal och normer påverkar deras sömn i positiv eller negativ riktning, och kan känns sig fångade i dessa omständigheter.

Slutsats

För att förstå ungdomars sömnsvårigheter behövs en förståelse för det sammanhang där ungdomarna lever. Ungdomar måste navigera och hitta balans i förhållande till de omständigheter som kan påverka deras sömn, och som ofta ligger utanför deras kontroll. Genom att verkligen lyssna på ungdomars berättelser om deras sömnsvårigheter och sammanhang kommer föräldrar, professionella vårdgivare och forskare att öka sin förståelse.

[1]. Gariepy, G. et al. (2020). How Are Adolescents Sleeping? Adolescent Sleep Patterns and Sociodemographic Differences in 24 European and North American Countries. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2020.03.013

Bakgrund

De senaste åren har forskningen alarmerat om ungdomars sömnsvårigheter och att ungdomar får för få timmars sömn per natt, vilket kan medföra många negativa konsekvenser för hälsa, välbefinnande och utbildning. Denna utveckling är bekymrande och det är av största vikt att arbeta hälsofrämjande och förebyggande med ungdomars sömnsvårigheter. För att tillföra ytterligare kunskap i det hälsofrämjande och förebyggande arbetet behövs forskning där ungdomar ges utrymme att berätta. Vad uppfattar ungdomar själva stör deras sömn?

Metod

Data samlades in med hjälp av en öppen fråga i ett frågeformulär; Om du upplever att du sover för lite, har svårt att somna, vaknar på natten eller att sömnen inte gör dig utvilad så skriv gärna vad du tror att dina sömnsvårigheter kan bero på. Deltagarna bestod av 475 ungdomar i årskurs nio. Data analyserades med kvalitativ och kvantitativ innehållsanalys.

Resultat

Resultatet beskrivs i ett tema och sex kategorier. På en tematisk nivå kan anledningarna till sömnsvårigheterna förstås som en obalans mellan krav och förutsättningar. Krav handlade om att prestera i skolan, ha aktiviteter, att vara sociala både digitalt och i verkligheten, att alltid ha roligt, att duga och lägga sig i tid. Förutsättningar handlade om att ha tid, struktur, föräldrastöd och en förmåga att sätta sina egna gränser, till exempel för mobilanvändning eller hur olika sociala ideal tilläts påverka dem. När förutsättningarna inte var tillräckliga för att väga upp kraven uppstod en obalans som störde ungdomarnas sömn. De sex kategorier som framkom i analysen och beskriver vad ungdomarna själva uppger stör deras sömn var; stress, följt av teknikanvändning, dåliga sovvanor, existentiella tankar, behov och lidande.

Slutsats

Utifrån studiens resultat kan ungdomar behöva stöd för att hitta balans i vardagen och för att kunna hantera stress, teknikanvändning, icke-existerande sömnvanor, existentiella tankar, behov och olika former av lidande. Eftersom hälsovanor ofta etableras i familjen, bör hälsofrämjande arbete även omfatta en dialog med föräldrar. Även om ungdomar verkligen behöver stöd från sina föräldrar, kan de också behöva bli lyssnade till och få stöd från skolsköterskan eller annan vårdande instans

Introduction: Sleeping difficulties, including insufficient sleep, trouble falling asleep, waking up at night, or sleep that does not leave an individual rested, are increasingly prevalent among adolescents and have negative consequences for their’ health, well-being, and education. It is of utmost importance to research adolescents’ sleep. A range of studies with different methodological perspectives are needed to inform and understand adolescents’ sleep. To date, there are few studies in sleep research that take a qualitative approach. Therefore, it is important to illuminate adolescents’ own experience of sleeping difficulties to acquire broader knowledge and the necessary evidence in order to provide preventive care interventions.

Method: The data were obtained from narrative interviews with 16 adolescents aged 14–15 in a Swedish city and were analyzed using the phenomenological hermeneutic method.

Results: Four themes that illustrate the meaning of adolescents experience of sleeping difficulties emerged: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates what being an adolescent with sleeping difficulties means; it is a challenge to go through the night; cope with the next day; and to harbor a panorama of emotions that emerge during the night, such as frustration, annoyance, concern, dejection, sadness, and fear. These emotions arise when the adolescent is unable to unwind and has concerns that grow during the night. The adolescent experience a feeling of being trapped in circumstances, all of which are incompatible with getting a good night’s sleep.

Conclusions: In order to understand adolescents’ sleeping difficulties, a comprehensive understanding of the context in which the adolescents live is needed. Adolescents need to navigate and find balance in relation to circumstances that may affect their sleep and that are often beyond their control, such as norms and values in society, in social media, in school, and in family and friend groups. By genuinely listening to the adolescents’ narratives about their sleeping difficulties and the context in which they interact will parents, professional caregivers, and researchers increase their understanding.

Objectives/Introduction: Sleeping difficulties, including insufficient sleep, trouble falling asleep, waking up at night, or sleep that does not leave an individual rested, are increasingly prevalent among adolescents and have negative consequences for their’ health, well‐being, and education. It is of utmost importance to research adolescents’ sleep. A range of studies with different methodological perspectives are needed to inform and understand adolescents’ sleep. To date, there are few studies in sleep research that take a qualitative approach. Therefore, it is important to illuminate adolescents’ own experience of sleeping difficulties to acquire broader knowledge and the necessary evidence in order to provide preventive care interventions.

Methods: The data were obtained from narrative interviews with 16 adolescents aged 14–15 in a Swedish city and were analyzed using the phenomenological hermeneutic method.

Results: Four themes that illustrate the meaning of adolescents experience of sleeping difficulties emerged: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates what being an adolescent with sleeping difficulties means; it is a challenge to go through the night; cope with the next day; and to harbor a panorama of emotions that emerge during the night, such as frustration, annoyance, concern, dejection, sadness, and fear. These emotions arise when the adolescent is unable to unwind and has concerns that grow during the night. The adolescent experience a feeling of being trapped in circumstances, all of which are incompatible with getting a good night's sleep.

Conclusions: In order to understand adolescents’ sleeping difficulties, a comprehensive understanding of the context in which the adolescents live is needed. Adolescents need to navigate and find balance in relation to circumstances that may affect their sleep and that are often beyond their control, such as norms and values in society, in social media, in school, and in family and friend groups. By genuinely listening to the adolescents’ narratives about their sleeping difficulties and the context in which they interact will parents, professional caregivers, and researchers increase their understanding.

Sleeping difficulties are increasingly prevalent among adolescents and have negative consequences for their health, well-being, and education. The aim of this study was to illuminate the meanings of adolescents’ lived experiences of sleeping difficulties. The data were obtained from narrative interviews with 16 adolescents aged 14–15 in a Swedish city and were analyzed using the phenomenological hermeneutic method. The findings revealed four themes: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates that being an adolescent with sleeping difficulties means it is challenging to go through the night and to cope the next day. It also means a feeling of being trapped by circumstances. As the adolescents’ lived experiences become apparent, the possibility for parents, school nurses, and other professional caregivers to support adolescents’ sleep increases.

Background

Sleeping difficulties are increasingly prevalent among adolescents worldwide and have negative consequences for health, well-being, and education. In order to develop and implement health promotion about sleep, additional knowledge is required, especially knowledge based on adolescent´s own experiences. This kind of research is currently limited. This study aimed to describe reasons for sleeping difficulties as perceived by adolescents.

Methods

This was a descriptive study, analyzing the data with qualitative and quantitative content analysis. Data was collected using an open ended question in a questionnaire; If you experience that you sleep too short, have trouble falling asleep, wake up at night or sleep not rested, please write what you think your sleeping difficulties may be due to. The participants consisted of 475 adolescents in grade nine (15-16 year), in 13 secondary schools, in a Swedish city.

Results

The adolescent´s descriptions of reasons for sleeping difficulties are understood as an imbalance between requirements and preconditions. Requirements are about performing at school, doing activities, being social both digitally and in real life, having fun, taking care of their health, reflecting on the existence and the future. Preconditions can be about having time, structure and parental support, but also an ability to set your own limits. When the preconditions are insufficient to match the requirements, an imbalance occurs where sleep loses out. Six different categories described reasons for adolescents sleeping difficulties. The most prominent reason was stress followed by technology use and then poor sleep habits, existential thoughts, needs, and suffering.

Conclusions

In order to avoid sleeping difficulties, adolescents need to deal with reasons such as stress, technology use, non-existent sleeping habits, existential considerations, needs and various forms of suffering. Adolescents need support to find a functioning balance in everyday life, dealing with these reasons. The support is needed from especially parents but also from professional caregivers. All health professionals caring for adolescents should remain vigilant regarding the important issue of sleeping difficulties, as good sleep hygiene optimizes adolescents’ capability for health and development.

Objectives/Introduction: Sleeping difficulties are increasingly prevalent among adolescents worldwide and have negative consequences for health, well‐being, and education. In order to develop and implement health promotion about sleep, additional knowledge is required, especially knowledge based on adolescent´s own experiences. This kind of research is currently limited. This study aimed to describe reasons for sleeping difficulties as perceived by adolescents.

Methods: This was a descriptive study, analyzing the data with qualitative and quantitative content analysis. Data was collected using an open ended question in a questionnaire; If you experience that you sleep too short, have trouble falling asleep, wake up at night or sleep not rested, please write what you think your sleeping difficulties may be due to. The participants consisted of 475 adolescents in grade nine (15–16 year), in 13 secondary schools, in a Swedish city.

Results: The adolescent´s descriptions of reasons for sleeping difficulties are understood as an imbalance between requirements and preconditions. Requirements are about performing at school, doing activities, being social both digitally and in real life, having fun, taking care of their health, reflecting on the existence and the future. Preconditions can be about having time, structure and parental support, but also an ability to set your own limits. When the preconditions are insufficient to match the requirements, an imbalance occurs where sleep loses out. Six different categories described reasons for adolescents sleeping difficulties. The most prominent reason was stress followed by technology use and then poor sleep habits, existential thoughts, needs, and suffering.

Conclusions: In order to avoid sleeping difficulties, adolescents need to deal with reasons such as stress, technology use, non‐existent sleeping habits, existential considerations, needs and various forms of suffering. Adolescents need support to find a functioning balance in everyday life, dealing with these reasons. The support is needed from especially parents but also from professional caregivers. All health professionals caring for adolescents should remain vigilant regarding the important issue of sleeping difficulties, as good sleep hygiene optimizes adolescents’ capability for health and development.

Background

Sleeping difficulties are growing among adolescents worldwide. Research shows relationships between sleeping difficulties and reduced learning ability, memory impairment, hyperactivity, poorer school performance, lower grades, and increased risk of depression and anxiety. In order to develop and implement health promotion about sleep, additional knowledge is required, especially knowledge based on adolescent´s own experiences. This kind of research is currently limited both nationally and internationally. This study aimed to describe reasons for sleeping difficulties as perceived by adolescents.

Methods

This was a descriptive study, analyzing the data with qualitative and quantitative content analysis. Data was collected using an open ended question in a questionnaire; If you experience that you sleep too short, have trouble falling asleep, wake up at night or sleep not rested, please write what you think your sleeping difficulties may be due to. Background information, such as gender, housing, ethnicity and grades were collected too. The participants consisted of 475 adolescents in grade nine (15-16 year), in 13 secondary schools, in a Swedish city.

Results

The adolescent´s descriptions of reasons for sleeping difficulties are understood as an imbalance between requirements and preconditions. Requirements are about performing at school, doing activities, being social both digitally and in real life, having fun, taking care of their health, reflecting on the existence and the future. Preconditions can be about having time, structure and parental support, but also an ability to set your own limits. When the preconditions are insufficient to match the requirements, an imbalance occurs where sleep loses out. Six different categories described reasons for adolescents sleeping difficulties. The most prominent reason was stress followed by technology use and then poor sleep habits, existential thoughts, needs, and suffering.

Conclusions

In order to avoid sleeping difficulties, adolescents need to deal with reasons such as stress, technology use, non-existent sleeping habits, existential considerations, needs and various forms of suffering. Adolescents need support to find a functioning balance in everyday life, dealing with these reasons. The support is needed from especially parents but also from the school nurse and school health services. The school nurses has an important role to prevent sleeping difficulties by addressing reasons for sleeping difficulties.

Sleeping difficulties are increasingly prevalent among adolescents worldwide and have negative consequences for adolescent health and education. The aim of this study was to describe the reasons for sleeping difficulties as perceived by adolescents. Sleeping difficulties include insufficient sleep, trouble falling asleep, waking up at night, or sleep that does not leave an individual rested. Data were collected in 2015 using an open-ended question. The sample consisted of n = 475 adolescents from a city in Sweden, aged 15–16 years, with self-assessed sleeping difficulties. The results described the reasons for the adolescents’ sleeping difficulties, at a general, thematic level, as an imbalance between requirements and preconditions, distributed to stress, technology use, poor sleep habits, existential thoughts, needs, and suffering. To find a balance in their daily lives, adolescents may need support from parents, school nurses, and school health services to deal with their sleeping difficulties.

Sleep duration and sleeping difficulties among adolescents: exploring associations with school stress, self-perception and technology use

Sleeping problems are increasing among adolescents worldwide. This study aimed to describe the prevalence of self-reported sleep duration and sleeping difficulties, as well as to explore their associations with school stress, self-perception, that is how adolescents perceive their appearance and happiness, and technology use among adolescents. Data were collected in 2015 using a questionnaire. A total of 937 ninth grade adolescents, 15–16 years, from a city in western Sweden participated, resulting in a response rate of 83%. The result showed that 55% of the adolescents slept less than the recommended 8 hours per night and 11% had sleeping difficulties. School stress and technology use were associated with short sleep duration. School stress and self-perception were associated with sleeping difficulties. The girls had worse outcomes for sleeping difficulties, school stress, self-perception and technology use than the boys. Based on the results, there is a need for school nurses to implement preventive measures to improve adolescents’ sleep.

Sleep-related problems are growing among adolescent word-wide. The sleep recommendation for adolescents is at least 8-10 hours per night[1] . The brain becomes affected even after a few nights sleep loss[2]. This is evident in learning ability, memory, concentration, reaction time and mood changes. Health risks such as self-injury, increased drug use, reckless driving, hyperactivity, aggression and severe sleep problems are effects of recurrent sleep deprivation[3]. Depression, anxiety, concentration difficulties, hyperactivity and poorer performance in school are proven consequences of sleeping problems among children and adolescents[4][5][6].The aims of this study were to describe the prevalence of sleep duration and sleep problems, and their associations to IT/Media use, IT/Media use at bedtime, school stress and self-perception, among adolescents. This was a descriptive cross-sectional questionnaire study. The sample included 937 adolescents in last-year secondary school, in a municipality in the West of Sweden. Statistical analyses showed that 55% of the adolescents sleep less than the recommended eight hours per night and 11% have sleep problems. Based on the background variables, girls show worse outcomes in all measured variables. Adolescents who live with non-cohabiting parents sleep less and have more sleep problems than adolescents who live with cohabiting parents. Short sleep duration correlated with IT/media use and school stress. Sleep problems were also correlated with school stress and self-perception. There is a need to develop and implement adequate sleep prevention measures for adolescents. The results need to be taken seriously in-order to promote adolescents’ opportunities for good health and well-being. This knowledge should be disseminated, discussed and subsequently integrated into prevention and health promotion by School Nurses.

[1] National Sleep Foundation, 2015

[2] Könen, Dirk and Schmiedek,2015

[3] Schmidt & van der Linden, 2015

[4] Titova, Hogenkamp & Jacobsson, 2015

[5] Sivertsen, Harvey, Lundervold & Hysing, 2014

[6] Cleland Woods & Scott, 2016

Psykisk ohälsa hos unga har fördubblats under de senaste 10 åren. Sömnbrist, skolstress och sociala medier pekas ut som riskfaktorer. Vem lyssnar på våra unga och kan vända den skrämmande trenden?

Upplevelser av ökade krav i samhället, ökad stress i skolan, ständigt plingande mobiltelefoner, sociala medier, och utbredd sömnbrist är några av de faktorer som pekas ut som tänkbara orsaker till att unga mår allt sämre. Psykisk ohälsa bland unga har fördubblats under de senaste 10 åren, enligt Socialstyrelsens senaste rapport. Även självmordsförsöken har ökat bland de unga vuxna och fler vårdas inom sluten psykiatrisk vård. Problemet är alarmerande. Unga i dagens samhälle utsätts för en mängd råd avseende hur de ska se ut, hur de ska leva sitt liv och hur livet ska vara. För många unga innebär detta en risk att tappa bort sig själv och därmed sträva mot mål som andra har satt upp.

Vid Högskolan i Borås pågår forskningsprojekt för att undersöka hur vi kan vända den ökande trenden av psykisk ohälsa hos unga. Under seminariet diskuteras resultaten av forskningen tillsammans med politiker och företrädare för Socialstyrelsen, elevhälsan, vården och skolan.