{'fraction_non_alphanumeric': 0.02771493212669683, 'fraction_numerical': 0.013009049773755657, 'mean_word_length': 5.317857142857143, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Insomnia among Japanese adolescents: a nationwide representative survey.

STUDY OBJECTIVES
Although a number of previous studies have examined the prevalence of insomnia among adolescents, there have been very few nationwide studies. The objectives of this nationwide study were to clarify the prevalence of insomnia, its symptoms, and associated factors among Japanese adolescents.


DESIGN AND SETTING
This study was designed as a cross-sectional sampling survey. The targets were junior and senior high schools throughout Japan. Sample schools were selected by cluster sampling. Self-reported anonymous questionnaires were sent to schools for all students to fill out.


PARTICIPANTS
A total of 103,650 adolescents responded, and 102,451 questionnaires were subjected to analysis.


INTERVENTION
N/A.


MEASUREMENTS AND RESULTS
The prevalence of difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening was 14.8%, 11.3%, and 5.5%, respectively. Insomnia was defined as the presence of one or more of these three symptoms. The prevalence of insomnia was 23.5%. Multivariate analyses revealed that, among junior high school students, male sex, poor mental health, skipping breakfast, drinking alcohol, smoking, not participating in extracurricular activities, and late bedtime had significantly higher odds ratios for insomnia. Among senior high school students, the same characteristics were associated with a significantly higher odds ratio for insomnia, as was the additional factor of having no intent to study at university.


CONCLUSION
Insomnia in Japanese adolescents is common and associated with multiple factors. The results of this study suggest the need for comprehensive program to prevent insomnia in Japanese adolescents.