Associated factors of habitual midday napping among Chinese adolescents
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ORIGINAL ARTICLE
Associated factors of habitual midday napping among Chinese adolescents Naixue Cui1 · Xiaopeng Ji2 · Junxin Li3 · Naisong Cui4 · Guanghai Wang5 Received: 5 June 2020 / Accepted: 16 October 2020 © Japanese Society of Sleep Research 2020
Abstract Midday napping, a culturally perceived health behavior, is common among adolescents in China. This study aimed to examine the factors associated with habitual midday napping behavior and explore sex differences in these factors. The sample comprised 1549 (62.5% males; mean age 16.29 ± 1.01 years) adolescents from a vocational high school that provided midday napping opportunities. Midday napping and nighttime sleep were measured using self-reported questions, and binary logistic regression was used to examine the associated factors of habitual midday napping. About 78% participants reported midday napping at least three times a week, and were classified as habitual nappers. They were less likely to be female [adjusted OR (aOR) = 0.59 (0.45, 0.78)], to be overweight/obese [aOR = 0.72 (0.53, 0.98)], and to have poor sleep quality [aOR = 0.58 (0.43, 0.77)], and they were more likely to have mothers with middle school or higher education [aOR = 1.35 (1.02, 1.78)]. Separate analyses showed that male habitual nappers were less likely to be overweight/obese [aOR = 0.63 (0.43, 0.92)], perform more physical activity [aOR = 0.59 (0.40, 0.89)], and report poor sleep quality [aOR = 0.55 (0.37, 0.81)], but were more likely to have mothers with higher education [aOR = 1.73 (1.19, 2.51)] than male non-habitual nappers. Female habitual nappers were less likely to report poor sleep quality [aOR = 0.56 (0.36, 0.88)], but more likely to have morning chronotype [aOR = 2.28 (1.21, 4.31)]. Habitual midday napping was associated with multifaceted factors, which provides important information to understand the habitual midday napping behavior of Chinese adolescents. Keywords Nap · Adolescent · Sleep · Behavior · Associated factor
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s41105-020-00292-8) contains supplementary material, which is available to authorized users. * Naixue Cui [email protected] 1
School of Nursing, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxi Road, Jinan 250012, Shandong, China
2
School of Nursing, University of Delaware, Newark, DE, USA
3
School of Nursing, Johns Hopkins University, Baltimore, MD, USA
4
Rizhao Agriculture College, Rizhao, China
5
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
Napping is a common sleep behavior across different age groups [1, 2], particularly in countries with a siesta culture [3, 4]. For example, in most areas of China, taking midday naps after lunch is culturally considered a health behavior [5], and many schools provide students with nap opportunities during a long lunch break. Approximately, 86% of Chinese preadolescents self-reported taking midday naps in
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