Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes.

Abstract

Sleep is essential for the healthy development of adolescents. Changes in sleep patterns can have their effects accumulated throughout life, associated with harmful consequences to health. The main modifiable behavioral risk factors for noncommunicable diseases (NCDs) – harmful use of alcohol, smoking, unhealthy diet and physical inactivity, according to the World Health Organization (WHO) – would be associated with poor sleep quality and excessive daytime sleepiness in adolescents. Objective: to analyze the associations between modifiable behavioral risk factors for NCDs and sleep in adolescents. Methods: crosssectional study nested in a cohort study developed in São Luís, Maranhão. 2,515 adolescents participating in the second cohort follow-up were evaluated. In the proposed theoretical model, estimated by structural equation modeling, socioeconomic status and behavioral risk factors for NCDs, including use of legal (alcohol and cigarette) and illicit drugs, consumption of an unhealthy diet (caffeine and sugar-sweetened beverages), screen time and physical inactivity were tested as predictors of worsening sleep in adolescents, assessed by sleep quality (Pittsburgh Sleep Quality Index - PSQI) and excessive daytime sleepiness (Epworth Sleepiness Scale - ESS). Excess weight was considered a mediator in the analysis, with all variables having an effect on him to reach the outcome, which may influence the effects of these on adolescents' sleep. Results: physical inactivity (Standardized coefficient, SC=0.112; p=0.001), higher consumption of alcohol (SC=0.168; p=0.019) and sugar-sweetened beverages (SC=0.128; p<0.001), in addition to better socioeconomic status (SC=0.128; p<0.001), were associated with excessive daytime sleepiness in adolescents. Physical inactivity (SC=0.147; p<0.001) and higher consumption of sugar-sweetened beverages (SC=0.089; p=0.003) were also associated with poor sleep quality. However, in this sample of adolescents, excess weight was not a mediator, nor was it associated with sleep quality and excessive daytime sleepiness. Conclusion: the main modifiable behavioral risk factors for NCDs are associated, at the same time, with poor sleep quality and excessive daytime sleepiness in adolescents, being independent of overweight.