Poor self-reported health in association with sleep duration and health complaints among adolescents in Latvia

Self-reported health is a feasible and valid indicator of adolescents' general health, including physical and emotional dimensions. Insufficient sleep and recurrent health complaint may increase the risk of poorer self-reported health in adolescence. The association between poor self-reported health and insufficient sleep, and mediating effect of health complaints among adolescents is not well understood. This study aims to explore the association between poor self-reported health and insufficient sleep duration (on school and non-school days) among 11, 13, 15-years old adolescents in Latvia by assessing  moderation effects of age and gender and by considering the mediating effect of health complaints on association between sleep duration and self-reported health. Data from the Health Behaviour in School-aged Children Study on 2017/2018 of Latvia (n=4412) were used for statistical analysis. Logistic regression models were calculated to assess the main effects of insufficient sleep duration (<7h) adjusted by gender, age and health complaints (HBSC health complaint sum-score); and interaction effects of gender and age on poor self-reported health. 19.3% reported insufficient sleep duration on schooldays and 4.4%on non-school days. Of those with insufficient sleep duration, 5.8% reported poor self-reported health while this proportion was 2%among those with sufficient sleep. Insufficient sleep duration was associated with increased odds of poor self-reported health on schooldays (OR=3.02;95%CI 2.02-4.49), but not on non-schooldays, regardless of adolescent’s gender, age. The association between insufficient sleep and poor self-reported health changed considerably after adjustment with health complaints (OR=1.58;95%CI 1.03-2.43), however, it still remained significant. Adolescents with insufficient sleep are at increased risk of poor self-reported health on schooldays regardless of their gender and age. Insufficient sleep seems to have strong effect on poor self-reported health that cannot be fully explained by having more health complaints.  Further studies are needed to study explanatory mechanisms of the association between sleep duration and self-reported health.