Insomnia in Relation to Academic Performance, Self-Reported Health, Physical Activity, and Substance Use Among Adolescents

Int J Environ Res Public Health. 2020 Sep 3;17(17):6433. doi: 10.3390/ijerph17176433.


Purpose: Insomnia affects up to one in four adolescents and has been shown to have a negative impact on their mental and physical health. This study aimed to investigate the association between insomnia, academic performance, self-reported health, physical activity, school start time, and substance use among adolescents.

Methods: A survey with a cross-sectional design was completed by adolescents (15-17 years old; n = 1504) in southern Sweden. The Minimal Insomnia Symptoms Scale (MISS) was used to operationalize insomnia. A multiple logistic regression analysis was used to analyze the relationship between insomnia and self-reported health, failed school courses, substance use, school start time, family financial situation, screen time, and gender.

Results: Insomnia (MISS ≥ 6) was associated with poor self-reported health (OR: 4.35), failed school courses (OR: 1.47), and use of alcohol and/or cigarettes (OR: 1.43). When the combined effect of self-reported health and physical activity were investigated, a combination of low physical activity (≤1 time/week) and poor self-reported health was strongly associated with insomnia (OR: 18.87).

Conclusions: Insomnia was associated with other problems that in themselves are risk factors for poor health. This highlights the need for a holistic health-promoting approach to prevent insomnia, such as efforts to promote physical activity, school success, and the reduction of alcohol/cigarette use.

Keywords: MISS; adolescents; alcohol; cigarettes; insomnia; physical activity; self-reported health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Academic Performance*
  • Adolescent
  • Amblyopia
  • Cross-Sectional Studies
  • Exercise*
  • Female
  • Growth Disorders
  • Health Status
  • Humans
  • Intellectual Disability
  • Male
  • Self Report
  • Sleep Initiation and Maintenance Disorders*
  • Substance-Related Disorders*
  • Sweden

Supplementary concepts

  • Mental and Growth Retardation with Amblyopia