Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 15 nº 4 - Oct/Dec - 2018

Original Article Imprimir 

Páginas 44 a 52


Sleep quality, physical activity and use of portable tecnologies among high school students

Calidad del sueño, actividad física y uso de tecnologías portátiles entre alumnos de enseñanza media

Qualidade do sono, atividade física e uso de tecnologias portáteis entre alunos do ensino médio

Autores: Ana Clara Soares Lima1; Iaggo Raphael David Dantas dos Santos2; Larissa Alves Guimarães3; Bruno Morbeck de Queiroz4

1. Bachelor in Physical Education by the Faculty of Technology and Sciences (FTC). Researcher in the Research Nucleus of the Faculty of Technology and Sciences (FCT). Vitória da Conquista, BA, Brazil
2. Specialization in Physiology of the Exercise by the Faculty of Technology and Sciences (FTC). Researcher in the Research Nucleus of the Faculty of Technology and Sciences (FCT). Vitória da Conquista, BA, Brazil
3. Graduation in Dentistry by the Independent Faculty of the Northeast (FAINOR). Researcher at the Dentistry Collegiate on the FAINOR. Vitória da Conquista, BA, Brazil
4. Master´s degree in Physical Education by the Federal University of Santa Catarina (UFSC). Professor of the Physical Education Course of the Faculty of Technology and Sciences (FTC). Vitória da Conquista, BA, Brazil

Iaggo Raphael David Dantas dos Santos
Avenida Itabuna, casa nº 141, bairro Brasil
Vitória da Conquista, Bahia, Brasil. CEP: 45.051-300
(iaggoraphaell@gmail.com)

PDF Portuguese      


Scielo

Medline


How to cite this article

Keywords: Sleep, technology, motor activity, adolescent.
Palabra Clave: Sueño, tecnología, actividad motriz, adolescente.
Descritores: Sono, tecnologia, atividade motora, adolescente.

Abstract:
OBJECTIVE: This study investigated the relation of the use of portable technologies with sleep quality and practice of physical activity in high school students of the state education system in the city of Cândido Sales, Bahia.
METHODS: This is a quantitative, descriptive, and associative study. Participated in the study a total of 207 adolescents enrolled in high school, with ages between 16 and 17 years. It was used a self-administered and semi-structured questionnaire adapted from COMPAQ. To evaluate the use of technologies it was used the Questionnaire of Portable Technologies and Mobile Internet. The quality of sleep was assessed using the Pittsburgh Sleep Quality Index. The physical activity was verified regarding the frequency and duration of the activities during a usual week. The association between the variables was tested using linear regression technique. Statistical significance level was set at 95% (p< 0,05).
RESULTS: Most of the interviewees had a smartphone (92.6%), the average time spent using portable technologies was 8.59 (± 5.38) hours/day. The average time spent in physical activities was 356 min / wk. Of the interviewees, 39% were classified as bad sleepers. There was a relation between the use of technologies during the weekends and quality of sleep.
CONCLUSION: The use of portable technologies during the weekend was related to poor sleep quality in adolescents from the interior of Bahia.

Resumen:
OBJETIVO: Este estudio investigó la relación del uso de tecnologías portátiles con la calidad del sueño y práctica de actividad física en estudiantes de la enseñanza media de la red estadual de enseñanza del municipio de Cándido Sales, Bahía.
MÉTODOS: Se trata de un estudio cuantitativo, descriptivo y de asociación. Participaron del estudio 207 adolescentes matriculados en enseñanza media, con edades entre 16 y 17 años. Se utilizó un cuestionario autoaplicable y semiestructurado adaptado del COMPAQ. Para la evaluación del uso de tecnologías se utilizó el Cuestionario de Tecnologías Portátiles e Internet Móvil. En cuanto a la evaluación de la calidad del sueño se empleó el Índice de Calidad de Sueño de Pittsburgh. La actividad física fue verificada en cuanto a la frecuencia y duración de las actividades durante una semana habitual. La asociación entre las variables fue probada por medio de la técnica de regresión lineal. En todos los análisis se fijó un nivel de significancia estadístico del 95% (p <0,05).
RESULTADOS: La mayoría de los pacientes poseían un celular del tipo smartphone (92,6%); el tiempo medio de permanencia en el uso de tecnologías portátiles fue 8,59 (± 5,38) horas / día. En cuanto al tiempo promedio gastado en actividades físicas fue de 356 min/sem. De los entrevistados, el 39% fueron clasificados como mal dormidores. Hubo relación entre el uso de tecnologías durante los fines de semana y la calidad del sueño.
CONCLUSIÓN: El uso de tecnologías portátiles durante el fin de semana fue relacionado a la mala calidad del sueño en adolescentes del interior de Bahía.

Resumo:
OBJETIVO: Este estudo investigou a relação do uso de tecnologias portáteis com a qualidade do sono e prática de atividade física em estudantes do ensino médio da rede estadual de ensino, do município de Cândido Sales, Bahia.
MÉTODOS: Trata-se de um estudo quantitativo, descritivo e de associação. Participaram do estudo 207 adolescentes matriculados no ensino médio, com idades prevalentes entre 16 e 17 anos. Foi utilizado um questionário autoaplicável e semiestruturado adaptado do COMPAQ. Para avaliação do uso de tecnologias foi utilizado o Questionário de Tecnologias Portáteis e Internet Móvel. Quanto a avalição da qualidade do sono foi empregado o Índice de Qualidade de Sono de Pittsburgh. A atividade física foi verificada quanto a frequência e duração das atividades durante uma semana habitual. A associação entre as variáveis foi testada por meio da técnica de regressão linear. Em todas as análises foram fixados nível de significância estatística de 95% (p < 0,05).
RESULTADOS: A maioria dos entrevistados possuía celular do tipo smartphone (92,6%), o tempo médio dispendido no uso de tecnologias portáteis foi de 8,59 (±5,38) horas/dia. Quanto o tempo médio gasto em atividades físicas foi de 356 min/sem. Dos entrevistados 39% foram classificados como mal dormidores. Houve relação entre uso de tecnologias durante os finais de semana e qualidade do sono.
CONCLUSÃO: O uso de tecnologias portáteis, durante o final de semana, foi relacionado à má qualidade do sono em adolescentes do interior da Bahia.

INTRODUTION

Adolescence is defined as a significant development phase transformations characterized by biological and psychological, as social signals1. The World Health Organization (WHO) defines adolescence as the period between 10 and 19 years of age, which marks the passage from childhood to adulthood2. In this phase, the formation of new habits occurs, which may be relevant for the development and maintenance of the individual's lifestyle.

Among the health - related habits, even acquired during adolescence, sleep quality has been the subject of investigations2. The dream is part of a cycle whose function is restore and preserve the balance for the correct functioning of various biological functions, which under natural conditions is synchronized with environmental factors, as well as the consolidation of memory3.

The adolescent tends to sleep less than necessary, both due to biological factors, as well as hormonal changes and mechanisms of generation and synchronization of circadian rhythm1. The demands to which they are subjected, the activities of independence and autonomy, in addition to school obligations, can contribute to sleep-related habits. In addition, the current use of the Internet4 may be related to poor sleep practices, mood and feelings of dependence4 ,5.

The innovative technology allows the use of more light and portable equipment, which makes it easier to access, especially in the hours that would be apt to s for rest, for example of the time to sleep6. The intensive use of digital devices affects the various activities of daily life, including the quantity and quality of sleep7. However, that relationship is not yet fully understood, especially when considering the adolescent audience.

Studies have highlighted the direct relationship between health conditions, behaviors and habits that a person takes in life. Regular physical activity can help improve the quality of life by promoting benefits such as control of body mass, reduced anxiety attacks and depression, improved cognitive and act positively on the quality and efficiency of dream8. Therefore, sleep 3 and physical activity contribute positively in improving the physical and intellectual components of children and adolescents8.

In contrast to the information presented, the study aimed to evaluate the relationship between the use of portable technologies, the level of physical activity and the quality of sleep in adolescents.


METHODS

The work presents a quantitative nature, of transversal, exploratory, descriptive delineation and field research procedure. Exploratory research seeks to study the subject in more detail, understanding the problem, its classification and its definition. As descriptive research, it is characterized by the use of techniques is standard accessories data collection, and the questionnaire and systematic observation. Finally, field research consist in recollection data carried out in natural s conditions under which events occur, thus being directly observed without the intervention and manipulation of the investigator9.

This research was carried out in Cándido Sales, a municipality with about 26 thousand inhabitants, located in the southwest region of Bahia, which it has border with the state of Minas Gerais. This site had, in the period of the investigation, a single middle school in the state teaching network, with three-shift operation that served 881 students.

For the selection of the sample were considered all 881 adolescents, of both genders, regularly enrolled in the Middle School of the municipality, according to data provided by the local Ministry of Education. The sampling procedure was per cluster (groups), with the random drawings conducted in two stages: the first phase constituted by the draw of the classes considering the proportion of students in the morning (morning and evening) and night shift.

Later, a census was conducted in the class. To participate in the study the adolescent should be enrolled in one of the series of the Secondary Education (1st, 2nd or 3rd year) of the school. All the students present in the room were eligible. The criteria adopted like exclusion were stay outside the research group age (<14 or >19 years) and/or manifest inability for to auto fill.

To determine the sample size it was used the criteria proposed by Luiz Magnanini for ones finite population10  being adopted a level of significance of 5%, 95% of confidence interval and tolerable error of 3%. In addition to total recommended, there are in the final sample 10% more individuals to offset potential losses and rejections. The prevalence of the unknown outcome considered was 50% and a final sample of 336 students was considered.

For the collection of information, a semi-structured questionnaire adapted from COMPAQ was used , second version, composed of the following sections: personal information, physical activity and sedentary behavior, alcohol and tobacco consumption, health perception and preventive behavior. Also were applied a questionnaire to evaluate the use of technologies (Tecno-Q)11.12 and a questionnaire to evaluate the quality of sleep (Quality Index of the dream of Pittsburgh - PSQI13).

For the evaluation of the use of smartphones, the Portable Technology and Mobile Internet Questionnaire (Tecno-Q) was used, which was previously validated for adolescents, in order to be evaluated in terms of face and content validity process (consult panel of specialists), clarity and ck test-re - test (application adolescents) with seven days interval between applications. The variable from Tecno-Q presented a low measurement bias in the Bland-Altman test: 8.38 minutes/day (95% CI: 336.4, -319.7).

The Tecno-Q is composed of 17 questions divided into two sections: section 1 = socio-demographic information; section 2 = portable technologies and Internet access. The instrument was developed to auto-fill in group and up to 40 subjects in the presence of at least one applicator12.

The PSQI instrument is used to quantify sleep quality and is standardized and validated in Portuguese, being trusted and of international use. The PSQI questionnaire evaluates the quality of sleep during the last month and consists of 19 self-evaluation elements. Your overall score ranges from 0 to 20, where the lower the score, the better the quality of sleep. Those who obtain scores less than five and those who obtain scores higher than five are considered good sleepers. In PSQI, elements are evaluated: subjective quality of sleep, sleep latency, sleeps duration, habitual efficiency of sleep, sleep disorders, medication and daytime sleepiness14.

For the evaluation of the level of physical activity was considered the answer to the following questions: "During a normal (typical) week, in how many days you practice moderate to vigorous physical activities (physical activity in the recreation, at work and on the move)"; "During a normal (typical) week, how much time per day do you practice moderate to vigorous physical activities (physical activity in the recreation, at work and on the move). The time in hours and minutes was considered continuously. Subsequently the score brut or It was separated into more active (≥ 300 min/week in physical activity) and insufficiently active (<300 minutes per week in physical activities in the recreation). The adopted cut-off point (300 minutes) is in accordance with the guidelines specific to the study population13.

The exploratory variables of the study were: demographic and socioeconomic indicators: age (14 and 15, 16 or 18 years), series (1st, 2nd and 3rd year), study period (day or night), family income (up to two salaries, three to five salaries and six salaries or more), and the work situation (yes or no). Behavioral variables: participation in Physical Education classes (yes or no); and, finally, health variable: self-assessment of health (positive or negative).

A descriptive analysis of the study variables was performed through the distribution of absolute and relative frequencies for categorical variables and measures of central tendency (mean, median and mode) and dispersion (standard deviation and amplitude) for the continuously variables. Linear regression models were also used to examine the association between the variables. All analyzes set a confidence value of 5% (α = 0.05). For data analysis, it is used ra do the statistical program SPSS® version 22.0.

Parents and/or guardians of teens received the Term of Consent (TCLE) and only with the return of this duly signed the teenager was included in the sample for evaluation. This research was previously approved by the Committee of Research Ethics of the Faculty of Technology and Science (CEP / FTC) under Opinion No. 2.392.211.


RESULTS

Participated in the study were 207 students duly enrolled in the Secondary School of Cándido Sales State School, with a predominance of women (64.7%). The age of greatest prevalence was between 16 and 17 years (57.1%) and the majority of adolescents attended the first series of secondary education (40.1%) (Table 1).




We found a higher prevalence of residents in the urban area (85.5%) who frequent the school day shift (82.1%). With regard to the socio-demographic scenario, there was a greater number of single adolescents (89.4%) residing with the family (97.1%) and dealing primarily with school activities (76.3%). Regarding the shift they study. A significant part of the families of the students lived with an average monthly income of up to 2 (two) minimum wages (Table 1).

It is observed that the great majority of the adolescents participating in the survey (94.2%) have mobile telephones, and of these, 92.6% are of the smartphone type. Most adolescents use the Internet on their cell phone every day of the week (88.8%). Many of the students interviewed (87%) don´t have tablet, and the 13% that indicated being owner make use for two (2) days a week (Table 2).




Table 3 presents descriptive values for the variables of time of use of portable technologies and level of physical activity in the students evaluated. The average time in the use of portable technologies per day was 8.59 (± 5.38) hours during the working days of the week. As for the level of physical activity, the average time spent on activities in different domains was 356.57 minutes per week.




It was observed that more than half of adolescents classify their sleep quality as good (61%). With regard to sleep hours, only 3,9% of the sample sleeps less than 5 hours a day, while 71.2% of the adolescents interviewed sleep 7 hours or more per day. In the analysis of the seven components of the PSQI was evident that a substantial proportion of adolescents surveyed (51.8%) have a good sleep quality (PSQI <5) according to reports last month.

Table 4 presents the values for the linear regression analysis between the scale of assessing sleep quality and independent variables using mobile technology in the week (weekdays and end days is week) plus activity level physical. There was a significant positive relationship between sleep quality and the use of technology on the weekends. The increase in the time of use of the hour technologies was evaluated positively associated (β = 0.48; p-value- 0.001) with higher scores of Pittsburgh questionnaire and therefore worst indicators for behavior evaluated. There was no association between physical activity level and sleep quality.




DISCUSSION

The results of this study indicate that 92.6% of adolescents had a cell phone of the type smartphone and 88.8% use that device every day of the week to access the Internet with average consumption of 8.59 (± 5.38) daily hours. 71% of the population studied d sleeps seven hours or more per day and there was a relationship between the use of mobile technology on weekends and poor sleep quality among the adolescents investigated.

The results presented are consistent with the study by Oliveira (2016) that evaluated the quality of sleep of adolescents, observed correlations between parameters NDO sleep during the day and the estimated daily use of the same one. In contrast, a study of 2400 iranian adolescents (12-18 years) found that cell phone use at night is associated with poorer sleep quality2, results that were also observed in a study conducted with Scottish teenagers3.

The use of portable technology has been you relate or poor sleep quality, especially when used before bedtime2 3.15, although the association between these variables was not observed in this study for the days of the week. Another factor to be considered is related to the turn in which the students study. Study in the morning and afternoon periods was related to shorter than studying ban on night shift sleep15.

Duarte et al., (2007)16 conducted a study of 160 adolescents aged 15 to 18, in which 66.25% was classified with bad sleep, superior value to found in the present study (39%). Some factors may have contributed to the results observed like characteristics of the city investigated, small size of the municipality, in addition to the factors profile lifestyle.

In addition, the association between sleep-learning and new information technologies was explored previously. Learning difficulties and poor school performance in adolescents have been directly you relate as to the quality of sleep, since one of the functions of sleep is related to the consolidation of learning 5. Also, teenagers who spend much of the night in the use of such technologies may have affected their sleep quality1, which reduces school performance5.

Although the relationship between the use of technology and the quality of sleep has been suggested, there seems to be no consensus on the subject in the scientific literature. The use of electronic media quality and sleep showed no statistically significant correlation1. However, other studies have shown the harmful effects of using the technologies before bed3.15, which can cause negative impacts on performance tasks that require attention and occupational memory among adolescents1.

The adolescents of the present investigation practice an average of 325 minutes per week of physical activity, which predisposes to average values that classify the adolescents investigated as sufficiently active. When the association between the scores of the level of physical activity and sleep quality was evaluated, no significant association was observed between the variables.

Issues related to the effects of physical activity on sleep quality have been approach in the literature, so training sessions at different times can provide a positive impact on the quality of sleep of adolescents17. However, this relationship has to be investigated more thoroughly, since there is no consensus on the real influence of the magnitude of physical activity on the quality of sleep of adolescents18,19.

Although this information is not included in the aforementioned research, especially because of the sub-notification, taking into account the self- questionnaire, it can be said that the children often follow the routines of the parents, and these, establishing rules for the routine and the car care, they make possible a better understanding of better sleep and health habits, especially in younger adolescents20.


CONCLUSION

This study presents the results on the use of the smartphone by adolescents and their quality of sleep. The excessive use of cell phones may be related to poor sleep quality in adolescents in the Northeast, especially on weekends, with new studies covering the national scope being important.


NOTE OF AGRADECIMIENTOS

We thank the Secretary of Education of the Municipality for the support, and the adolescents and people in charge that made this research possible.


REFERENCES

1. Oliveira MLC. Relação entre o uso de "mídias eletrônicas" e os hábitos de sono, sonolência diurna e processos cognitivos em adolescentes. 2016;116p.

2. Amra B, Shahsavari A, Shayan-Moghadam R, Mirheli O, Moradi-Khaniabadi B, Bazukar M, et al. Associação entre o sono e o uso noturno de celular entre adolescentes. J Pediatr. 2017;93(6):560-7.

3. De Souza  TV, Bittencourt LRA, Tufik S, Moreira GA. Factors influencing excessive daytime sleepiness in adolescents. J Pediatr. 2016;92(2):149-55.

4. Silva RA, Silva PMF, Pereira JF de M, dos Santos DCD, Raposo JC dos S, Gomes B da MR. Adolescentes e abuso de tecnologias: Um indicativo de problemas comportamentais? Adolesc e Saude. 2017;14(3):77-82.

5. Azevedo D. A relação do sono-aprendizagem e as novas tecnologias de informação e comunicação: um desafio na educação dos adolescentes. 2014:1-6.

6. Brunborg GS, Mentzoni RA, Molde H, Myrseth H, Skouverøe KJM, Bjorvatn B, et al. The relationship between media use in the bedroom, sleep habits and symptoms of insomnia. J Sleep Res. 2011;20(4):569-75.

7. Orzech KM, Grandner MA, Roane BM, Carskadon MA. Digital media use in the 2 h before bedtime is associated with sleep variables in university students. Comput Human Behav. 2016;55:43-50.

8. Vin P, Silva C, Jr LC.  Efeitos da atividade física para a saúde de crianças e adolescentes The effects of physical activity on the health of children and adolescents . Psicol argumentos Curitiba. 2011;29(64):41-50.

9. Pereira LM, Silva PA. Relato de experiência: a pesquisa de campo no âmbito da extensão universitária. 2015;6(1):149-55.

10. Luiz RR, Magnanini MMF. A lógica da determinação do tamanho da amostra em investigações epdemiológicas. Cad Saúde Coletiva. 2000;8(2):9-28.

11. Sociedade Brasileira de Pediatria. Saúde de crianças e adolescentes na era Digital. 2016;(1):1-13. Disponível em: http://www.sbp.com.br/src/uploads/2016/11/19166d-MOrient-Saude-Crian-e-Adolesc.pdf

12. Lourenço CLM. Fatores associados ao comportamento sedentário em adolescentes: uma análise do estudo de 'avaliação de comportamentos em saúde e estilo de vida dos adolescentes em uberaba - ACtVU' [dissertação]. Uberaba: Universidade Federal do Triângulo Mineiro; 2016.

13. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Report. Washingt DC US. 2008;67(2):683.

14. Smith MT, Wegener ST. Measures of Sleep. Arthritis Care & Res. 2003;49(5):0-7.

15. Felden ÉPG, Filipin D, Barbosa DG, Andrade RD, Meyer C, Louzada FM. Factors associated with short sleep duration in adolescents. Rev Paul Pediatr. 2016;34(1):64-70.

16. Duarte GGM. A qualidade do sono, o aproveitamento escolar e o stress em adolescentes que permanecem em frente ao computador durante a noite. [dissertação]. Universidade Estadual de Campinas; 2007.

17. Santiago L da CS, Lyra MJ, Cruz PW da S, Santos MAM, Falcão APST. Efeito de uma sessão de treinamento de força sobre a qualidade do sono de adolescentes. 2015;21:148-52.

18. José A, Gonc D. Indicadores da prática de atividade física e da qualidade do sono em escolares adolescentes. Rev Bras Ciênc Esporte. 2016;38(3):290-6.

19. Souza AG, Adriazola MM, Martins RH, Bigliazzi R, Anna S, Weber T. Efeito da atividade física na qualidade do sono e qualidade de vida: revisão sistematizada. Arch Health Invest. 2017;6:561-6.

20. Andrade MMM. Rotina de sono em adolescentes e regras familiares. Adolesc Saude. 2017;14(2):76-84.
adolescencia adolescencia adolescencia
GN1 © 2004-2019 Revista Adolescência e Saúde. Fone: (21) 2868-8456 / 2868-8457
Núcleo de Estudos da Saúde do Adolescente - NESA - UERJ
Boulevard 28 de Setembro, 109 - Fundos - Pavilhão Floriano Stoffel - Vila Isabel, Rio de Janeiro, RJ. CEP: 20551-030.
E-mail: revista@adolescenciaesaude.com