Beyond counting sheep: social and behavioral determinants of adolescent sleep quality in the Czech Republic.

Girls showed clinically meaningfully lower overall sleep quality compared to boys.

• Non-standardized b = -2.1, 95% CI [-2.6, -1.6]
• This met the threshold for clinically meaningful association, defined as ≥0.2 SD in absolute value
• Sample consisted of 4,508 adolescents aged 13-15 years from the 2021/22 HBSC survey in the Czech Republic
• Sleep quality was assessed using the Short Adolescent Sleep Wake Scale (ASWS)

Adolescents reporting longer sleep duration showed higher overall sleep quality.

• Standardized β = 1.8, 95% CI [1.6, 2.1]
• This met the threshold for clinically meaningful association (≥0.2 SD in absolute value)
• Sleep duration was one of only two variables meeting the higher clinical significance threshold alongside sex
• Assessed via multivariate linear regression models

Academic pressure was associated with lower sleep quality in a consistent but smaller magnitude association.

• Standardized β = -1.7, 95% CI [-1.9, -1.5]
• Met the threshold for smaller but consistent association (≥0.1 SD in absolute value)
• Academic pressure was among the psychosocial stressors assessed in the study
• The negative direction indicates higher academic pressure corresponded with lower sleep quality

Perceived family support was positively associated with adolescent sleep quality.

• Standardized β = 1.3, 95% CI [1.0, 1.6]
• Met the threshold for smaller but consistent association (≥0.1 SD in absolute value)
• In contrast, friend support showed no meaningful association with overall sleep quality
• Family support was assessed as part of the social environment variables

Overall health was positively associated with sleep quality at a smaller but consistent magnitude.

• Standardized β = 1.3, 95% CI [1.1, 1.6]
• Met the threshold of ≥0.1 SD in absolute value
• Assessed among health and health behavior variables in the multivariate model

Older age within the 13-15 year range was associated with higher sleep quality.

• Non-standardized b = 1.5, 95% CI [1.0, 2.0]
• Met the threshold for smaller but consistent association (≥0.1 SD in absolute value)
• Sample was restricted to adolescents aged 13-15 years from the 2021/22 HBSC survey

Neither friend support nor physical activity showed meaningful associations with overall adolescent sleep quality.

• Both variables fell below the threshold of ≥0.1 SD in absolute value in multivariate analyses
• Physical activity is commonly hypothesized to benefit sleep, making this a notable null finding
• This contrasts with the significant association found for family support
• Findings were derived from multivariate linear regression controlling for multiple sociodemographic and behavioral variables

The study used a large nationally representative sample of Czech adolescents to assess sleep quality via a validated scale.

• Sample size was 4,508 adolescents aged 13-15 years
• Data came from the 2021/22 Health Behaviour in School-aged Children (HBSC) survey in the Czech Republic
• Sleep quality was measured using the Short Adolescent Sleep Wake Scale (ASWS)
• Multivariate linear regression models were employed; clinically meaningful thresholds were set at ≥0.2 SD (larger) and ≥0.1 SD (smaller but consistent)