Insufficient sleep, impaired sleep and medically treated injury in Canadian adolescents: a national cross-sectional study

Insufficient and impaired sleep are common in adolescents and can adversely impact health and well-being. One likely consequence of poor sleep is a risk of unintentional injuries, yet the evidence base is limited for such relationships. We, therefore, documented contemporary sleeping behaviours of young people in Canada and examined relationships between these behaviours and risks for injury.

A cross-sectional study was employed using records from the 2017/2018 Canadian Health Behaviour in School-aged Children study (n=21 745). Indicators of poor sleep (insufficient sleep on school and non-school days, impaired sleep, daytime sleepiness) and annual reports of medically treated injuries (any, serious) were obtained. Descriptive and hierarchical modified Poisson regression analyses were performed to explore these relationships, while controlling for potential confounders.

Insufficient sleep, impaired sleep and daytime sleepiness were reported by 11.3-35.3% of adolescents; variations in these estimates were observed by gender. Sleep indicators were modestly but consistently associated with risks for the occurrence of 'any injury', whereas impaired sleep and daytime sleepiness were the only meaningful and significant risk factors for 'serious injuries' in adjusted models (prevalence ratio range: 1.18-1.30). The analysis of interactions revealed boys with insufficient sleep on non-school days as well as impaired sleep to have higher injury risks compared with girls.

Impaired sleep and its effects have emerged as a quiet epidemic, affecting up to one-third of Canadian adolescents and being associated with risks for injury. Sleep hygiene may therefore act as a plausible focus for clinical and public health initiatives to mitigate injury risks.