PURPOSE: Insufficient and poor sleep patterns are common among adolescents worldwide. Up to now, the evidence on adolescent sleep has been mostly informed by country-specific studies that used different measures and age groups, making direct comparisons difficult. Cross-national data on adolescent sleep that could inform nations and international discussions are lacking. We examined the sleep patterns of adolescents across 24 countries and by gender, age, and affluence groups. METHODS: We obtained sleep data on 165,793 adolescents (mean age 13.5 years; 50.5% girls) in 24 European and North American countries from the recent cross-sectional Health Behaviour in School-aged Children surveys (2013-2014 and 2017-2018). For each country, we calculated the age-standardized mean in sleep duration, timing, and consistency and the proportions meeting sleep recommendations on school and nonschool days from self-reported bedtimes and wake times. We conducted stratified analyses by gender, age, and family affluence group. RESULTS: Adolescent sleep patterns varied cross-nationally. The average sleep duration ranged between 7:47 and 9:07 hours on school days and between 9:31 and 10:22 hours on nonschool days, and the proportion of adolescents meeting sleep recommendations ranged between 32% and 86% on school days and between 79% and 92% on nonschool days. Sleep patterns by gender and affluence groups were largely similar, but older adolescents slept less and went to bed later on school days than younger adolescents in all countries. CONCLUSIONS: The sleep patterns of adolescents vary across countries and sociodemographic groups. Insufficient sleep on school days is common in many countries. Public health and policy efforts to promote healthy adolescent sleep are encouraged.

Department of Health Psychology Faculty of Medicine PJ Safarik University Kosice Slovakia

Department of Public health and Epidemiology Institute of Public Health Riga Stradins University Riga Latvia

Department of Public Health and Epidemiology Institute of Public Health Riga Stradins University Riga Latvia

Department of Public Health and Epidemiology Riga Stradins University Riga Latvia

Department of Public Health Sciences School of Kinesiology and Health Studies Queen's University Kingston Canada

Department of Public Health University of Copenhagen Copenhagen Denmark

Department of Recreation and Leisure Studies Faculty of Physical Culture Palacky University Olomouc Olomouc Czech Republic

Department of Social and Preventive Medicine University of Montreal Montreal Canada

Douglas Mental Health University Institute Montreal Canada

Faculty of Sport and Health Sciences University of Jyvaskyla Jyvaskyla Finland

Health Research Institute Lithuanian University of Health Sciences Kaunas Lithuania

Institute for Health and Social Policy McGill University Montreal Canada

Institute of Environmental Health School of Human Kinetics University of Lisbon Lisbon Portugal

National Institute of Public Health University of Southern Denmark Copenhagen Denmark

Office of the Deputy Vice Chancellor Research University of Technology Sydney Ultimo Sydney Australia

Psychology and Educational Sciences Institute Lusiada University CLISSIS ISAMB Lisbon University Lisbon Portugal

J Adolesc Health. 2021 Apr;68(4):830. doi: 10.1016/j.jadohealth.2020.12.137. PubMed

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