Relação entre os hábitos de sono, uso de mídias eletrônicas e atenção: um comparativo entre adolescentes da área urbana e suburbana da Região Metropolitana de Natal/RN

Abstract

The objective of this research was to evaluate the relation between the use of electronic media and the degree of urbanization with sleep-wake cycle and attention components in adolescents. Participated in the study, 214 adolescents between 12 and 18 years-old of both sexes, being 111 from the city with lower degree of urbanization and 103 from that with higher degree, enrolled in the 8th and 9th years of Elementary School II in the morning shift of the public school system of RN. The sleep-wake cycle was assessed by the questionnaires “Health and Sleep”, “Pittsburgh Sleep Quality Index”, “Morningness-Eveningness questionnaire” and “Pediatric Daytime Sleepiness Scale”; in addition to Sleep Diaries and actigraphy for 10 days. Besides, attention was assessed by the Continuous Execution Task. Most adolescents that have electronic devices in the bedroom, being cell phones the majority, have the habit of sending messages before sleep, listening to music, and using it when waking up at night. Most people who share the bedroom with these adolescents report the use of cell phones in bedroom. In the city with higher degree of urbanization, a greater proportion of adolescents have TV in the bedroom and the habit of watching it before bed; internet at home and on their cell phones; and a greater proportion of internet access at home, but less access on their cell phones. In addition, they have greater irregularity in get up time and more reports, during the weekdays, of waking up only when someone calls them, in relation to those that live in the city with lower degree of urbanization, who mostly wake up with alarm clock aid. There was also a greater tendency to eveningness and higher levels of daytime sleepiness in the city with higher degree of urbanization. Regardless of the city, adolescents showed poor sleep quality and reported to use an electronic device before sleep, at least one day, considering weekdays and weekend, with the highest frequency on week. Regarding the components of attention, there was a higher percentage of correct responses in all components, greater general stability during the task, lower percentage of omissions in tonic alertness and selective attention and a tendency to lower percentage of omissions in phasic alertness, in the city with higher degree of urbanization. Considering the relation between the use of electronic media and the degree of urbanization with sleep variables, the general multivariate linear model did not show associations between the media use and the sleep variables. On the other hand, the higher degree of urbanization was associated with lower efficiency of sleep on weekdays (β = - 0.64; p <0.01) and weekend, (β = - 0.70; p <0.01), lower latency of sleep (β = - 0.31; p <0.01), greater number of awakenings at night on weekdays (β = - 0.69; p = 0.00) and weekend (β = - 0.64; p <0.01), greater irregularity in bedtime (β = 0.38; p <0.01) and get up time (β = 0.66; p <0.01) and a higher percentage of correct responses in selective attention (β = 0.26; p <0.01). In addition, the model pointed out that girls have higher levels of daytime sleepiness (β = - 0.18; p = 0.04), lower efficiency of sleep on weekdays (β = 0.17; p = 0.02), and fewer nighttime awakenings on weekend (β = 0.22; p <0.01) when compared to the boys. Thus, in both cities, teens use media device before sleep at least one day, considering weekdays and weekend, with the highest frequency during week; and have bad sleep habits. The higher degree of urbanization was associated with greater irregularity in sleep times, worse sleep quality, greater daytime sleepiness and tendency to eveningness, but with better attentional performance