Percepção do estresse acadêmico, padrões de sono e desfechos em saúde mental em estudantes do ensino médio no turno matutino

Abstract

The academic environment of high school is conducive to triggering stress in students, becoming more evident the higher the expectations of parents, the school curriculum, the fear of failure and the difficulties in making decisions. Adolescence is marked by physiological changes in the sleep-wake cycle, in which individuals sleep and wake up later. In contrast, schools often start classes very early in the morning, leading to daytime sleepiness, concentration difficulties, and worse cognitive processing. In this context, psychological suffering has been increasing in several countries and can have a significant impact on the development of young people. Therefore, this study aims to analyse the relationship between the perception of academic stress, sleep patterns and mental health outcomes in high school adolescents in the morning shift at private schools. The sample included 78 participants of both sexes enrolled in the morning shift in the first, second and third years of high school at two private schools in Juazeiro do Norte/CE. Participants completed the following online questionnaires: “The Health and Sleep”, The Perceptions of Academic Stress Scale, Pittsburgh Sleep Quality Index, Munich Chronotype Questionnaire, Pediatric Daytime Sleepiness Scale and Depression Anxiety and Stress Scale. The data were analysed using a Structural Equation Model after defining a final model composed by 1) Perception of Academic Stress; 2) a latent variable representing adolescents' sleep, consisting of sleeping and waking up times during school and free days, chronotype, social jetlag and irregularity in sleep duration; 3) daytime sleepiness; 4) and the latent variable representing mental health formed by levels of stress, anxiety and depression. Higher levels of perception of academic stress were associated with: higher scores in the mental health construct (B=0.638; p<0.001), with a greater frequency of symptoms of stress, anxiety and depression; higher levels of daytime sleepiness (B=0.252; p=0.026); and impact on the variables of the sleep construct (B=0.162; p=0.046), with later sleeping and waking up times on school and free days, greater trend to eveningness, higher levels of social jetlag and greater irregularities for sleep duration. The damage to mental health associated with high levels of perceived academic stress is enhanced when the sleep construct is added as an intermediary factor (B=0.731; p<0.001). We further demonstrated that the sleep construct was related to daytime sleepiness (B=0.444; p<0.001), and that higher levels of daytime sleepiness were associated with higher the scores of the mental health construct (B=0.361; p<0.001). Therefore, the perception of academic stress directly influenced, in a negative way, aspects related to adolescents' sleep, as well as mental functioning. The damage to mental health related to the perception of academic stress was enhanced when aspects related to sleep were added as intermediary factors in a single analysis. This study could contribute to expanding knowledge about the relationship between academic stress, sleep and mental health problems in adolescents, and thus help teachers and health professionals to take this discussion into their work environments.