Research article
Sleep Patterns and Risk of Injury Among Adolescent Farm Residents

https://doi.org/10.1016/j.amepre.2005.11.010Get rights and content

Background

Sleep patterns have been associated with decreased alertness among adolescents and to a limited extent, increased risk of injuries. The purpose of this study is to describe the relationship between sleep patterns and injury occurrence among adolescents aged 13 to 18 years living on farms in Colorado.

Methods

A cross-sectional survey of randomly selected Colorado farm residents aged 13 to 18 years was conducted between August 2003 and April 2004. A total of 262 youth completed the study. Information was obtained on injuries within the preceding year, sleep patterns, sleep hours, daytime sleepiness, and a number of social and demographic variables. Univariate analyses were done to describe relationships of study variables with injuries. Multivariate modeling was done to assess sleep patterns that were associated with injuries controlling for other variables.

Results

Sleep patterns associated with increased risk of injuries (p <0.05) included oversleeping and having been late for class; falling asleep in afternoon classes; ever being up past 3 am; sleeping less than an average of 9.25 hours per night on weekends, and on school nights and weekends combined; and sleeping less than an average of 8.5 hours on weekends, and on school nights and weekends combined.

Conclusions

Sleep patterns were significantly associated with occurrence of injuries.

Introduction

In 1999, the National Research Council convened a group of policymakers, researchers, and practitioners to examine research on adolescence and sleep, to address issues related to the amount of sleep needed, typical sleep patterns, factors that influence sleep problems and disturbances, and the consequences of insufficient sleep.1 Factors influencing sleep patterns among adolescents are biological and behavioral. The biological factors are represented by changes in natural sleep demands and cycles. Since adolescence is a time of transition, there are biological changes that differ from the early period of adolescence to the later period.2, 3, 4 Younger children were observed to sleep an average of 9 hours and 20 minutes and to wake spontaneously.1 The amount of sleep needed by adolescents has been reported to be the same, but they no longer wake spontaneously, and by midpuberty, adolescents become sleepy during the day even with 9 hours and 20 minutes of sleep.1, 4, 5, 6 Behavioral patterns that influence the hours and patterns of sleep include increased involvement in sports, paid employment, chores, social opportunities and obligations, and more demanding academic requirements.1

Consequences of sleepiness include involuntary napping, gaps in processing information, and gaps in reliable behavior.1 These problems may lead to increased injury risk. A number of studies have documented a relationship between falling asleep while driving and motor vehicle crashes.7, 8, 9 A high rate of fall-asleep crashes among drivers aged less than 20 years has been reported, which was attributed to sleep deprivation secondary to lifestyle.9 In a case-crossover study, investigators found that sleeping less than 10 hours a day was associated with an 86% increased risk of injury among children aged 0 to more than 14 years.10 This is an area that warrants further investigation as a cause of injuries among adolescents, since loss of sleep has been shown to lead to diminished function and work capacity in this group.11, 12

Adolescents living on farms may be a high-risk population for injuries related to sleep pattern disturbances. Even though youth aged less than 16 years are legally prohibited from performing hazardous jobs on nonfamily farms, there are no age or hazard restrictions for youth working on their own parents’ farms, and many help with chores around the farm.13, 14, 15, 16 If the farm youth are also involved in school-related activities such as sports, they may be struggling to complete their school activities, farm chores, and school work. Their sleep patterns may be disrupted as a result of competing pressures to complete all of their social obligations, which in turn may contribute to a high risk of injury.

Based on the evidence that usual sleep patterns do influence functional capability and may thereby increase the risk of injuries, a study was conducted among adolescents living on farms. The purpose of this study was to evaluate the relationship between self-reported injuries and sleep patterns among adolescents living on farms in Colorado.

Section snippets

Study Sample

The target population for the study was adolescents aged 13 to 18 years who lived on farms in Colorado. The primary sampling unit was the farm. The sampling frame for the study was property value assessment lists from randomly selected counties in Colorado. A list of all counties in Colorado, excluding counties with <20 farms (Denver County, n =16, and Broomfield County, no farms) to increase the efficiency of the sampling frame was used. The names and number of farms in the remaining 61

Results

A total of 262 youth aged 13 to 18 years were enrolled in the study. Table 1 contains demographic and social characteristics of the youth. A total of 46 (17.6%) of the adolescents reported having had an injury that restricted their activities for ≥4 hours or required medical attention within a 4-month period. A total of 131 (50.0%) adolescents had sustained an injury during the previous 12 months. For analyses, all injuries (n =131) were used.

Kendall’s tau correlations between the sleep pattern

Discussion and Conclusions

This paper reports the results from a study to assess the relationship between injuries and sleep patterns among adolescents living on farms. Although sleep may be a modifiable risk factor, little work has been done on the association between usual sleep patterns and injuries among adolescents. Despite an extensive literature on sleep patterns among adolescents, injury researchers have not often assessed sleepiness in areas of research other than motor vehicle injuries.5, 6, 7, 8, 9

This study

References (16)

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