Homework, sleep insufficiency and adolescent neurobehavioral problems: Shanghai Adolescent Cohort

Ting Yu; Dongqing Xu; Jue Fan; Hui Hua; Xiangrong Guo; Yijing Zhang; Shiwei Jiang; Lihua Huang; Yining Jiang; Yuefen Wang; Chonghuai Yan; Jian Xu

doi:10.1016/j.jad.2023.04.008

Homework, sleep insufficiency and adolescent neurobehavioral problems: Shanghai Adolescent Cohort

J Affect Disord. 2023 Jul 1:332:273-282. doi: 10.1016/j.jad.2023.04.008. Epub 2023 Apr 12.

Authors

Ting Yu¹, Dongqing Xu², Jue Fan³, Hui Hua¹, Xiangrong Guo⁴, Yijing Zhang⁵, Shiwei Jiang⁶, Lihua Huang⁶, Yining Jiang¹, Yuefen Wang⁷, Chonghuai Yan⁶, Jian Xu⁸

Affiliations

¹ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
² Institute of Higher Education, Fudan University, Shanghai 200433, China.
³ Shanghai Changning Maternity & Infant Health Institute, Shanghai 200051, China.
⁴ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
⁵ The Children's Hospital of Zhejiang University School of Medicine, Zhejiang 310005, China.
⁶ MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
⁷ Shanghai Municipal Education Commission Department, Shanghai 200070, China.
⁸ Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China. Electronic address: sonia0616@sjtu.edu.cn.

PMID: 37059191
DOI: 10.1016/j.jad.2023.04.008

Abstract

Background: The prospective associations between homework burdens and adolescent neurobehavioral problems, and whether sleep-durations mediated and sex modified such associations remained unclear.

Methods: Using Shanghai-Adolescent-Cohort study, 609 middle-school students were recruited and investigations took place at Grade 6, 7 and 9. Information on homework burdens (defined by homework completion-time and self-perceived homework difficulty), bedtime/wake-up-time and neurobehavioral problems was collected. Two patterns of comprehensive homework burdens ('high' vs. 'low') were identified by latent-class-analysis and two distinct neurobehavioral trajectories ('increased-risk' vs. 'low-risk') were formed by latent-class-mixture-modeling.

Results: Among the 6th-9th graders, the prevalence-rates of sleep-insufficiency and late-bedtime ranged from 44.0 %-55.0 % and 40.3 %-91.6 %, respectively. High homework burdens were concurrently associated with increased-risks of neurobehavioral problems (IRRs: 1.345-1.688, P < 0.05) at each grade, and such associations were mediated by reduced sleep durations (IRRs for indirect-effects: 1.105-1.251, P < 0.05). High homework burden at the 6th-grade (ORs: 2.014-2.168, P < 0.05) or high long-term (grade 6-9) homework burden (ORs: 1.876-1.925, P < 0.05) significantly predicted increased-risk trajectories of anxiety/depression and total-problems, with stronger associations among girls than among boys. The longitudinal associations between long-term homework burdens and increased-risk trajectories of neurobehavioral problems were mediated by reduced sleep-durations (ORs for indirect-effects: 1.189-1.278, P < 0.05), with stronger mediation-effects among girls.

Limitations: This study was restricted to Shanghai adolescents.

Conclusions: High homework burden had both short-term and long-term associations with adolescent neurobehavioral problems, with stronger associations among girls, and sleep-insufficiency may mediate such associations in a sex-specific manner. Approaches targeting appropriate homework-load/difficulty and sleep restoration may help prevent adolescent neurobehavioral problems.

Keywords: Adolescent neurobehavioral problems; Homework burden; Mediation; Modification; Sleep.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
China / epidemiology
Cohort Studies
Educational Status
Female
Humans
Male
Sleep
Sleep Deprivation* / epidemiology
Sleep Wake Disorders* / epidemiology