IMPACTO DOS ESTRESSORES SOCIAIS NA QUALIDADE DO SONO DE ADOLESCENTES: UM ESTUDO DE BASE POPULACIONAL

Abstract

Adolescence is a period of intense changes, where the sleep-wake cycle plays a crucial role in both mental and physical health. Poor sleep quality can impact the immune, cardiovascular, and endocrine systems, as well as affect mood, academic performance, and overall health. This study aims to investigate the association between sleep quality and social stressors, such as bullying, aggression, discrimination, and insults, in adolescents. The hypothesis is that these stressors negatively affect sleep, with the influence of sex and socioeconomic status. This study used data from the third phase of the São Luís Birth Cohort (1997/1998), a population-based sample that initially included 2,831 births. After excluding twins, stillbirths, and non-residents of the municipality, the final sample consisted of 2,443 participants. In the third follow-up, conducted in 2016, 687 participants from the original cohort were recruited through military enlistment records, school and university databases, and media outreach. To enhance statistical power, the cohort was expanded to include other individuals born in 1997, totaling 2,515 adolescents. Data collection took place at UFMA, conducted by trained professionals using questionnaires covering socioeconomic and demographic variables (family head’s and adolescent’s education level, household income, and economic class), social stressors (bullying, aggression, insults, and discrimination), and sleep quality. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), which measures aspects such as subjective sleep quality, latency, duration, habitual efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. The proposed theoretical model analyzed the association between social stressors and sleep quality, considering socioeconomic status as a distal latent variable, exerting an indirect influence on the outcome. Social stressors were positioned as exposure variables, directly affecting sleep quality. Sex was treated as an adjustment variable, with a direct impact on both social stressors and the outcome. The analysis was performed using structural equation modeling, allowing for the assessment of direct and indirect relationships between the investigated variables. The results indicate that social stress significantly impacted sleep quality (CP=0.242; p<0.001), and girls exhibited poorer sleep quality (CP=0.149; p<0.001).