Investigation of the impact of sleep quality on executive functions in Hong Kong adolescents

Abstract

Executive function is a top-down mental process including three core functions – inhibition and attention, working memory, and cognitive flexibility. It is known that there are associations between the cognitive and psychological conditions and sleep. In global context, poor sleep quality could negatively affect executive functions. Most of those literature explored the relationship between sleep quality or deprivation and executive function in adults. In Hong Kong, many adolescents were found to have sleep problem. However, it is uncertain if sleep quality has an impact on the executive functions in Hong Kong adolescents. This study aims to investigate the association between sleep quality and the executive functions of secondary school students using various neuropsychological tests and find out the factors that influence sleep quality. In this exploratory cross-sectional study, 119 secondary school students aged from 13 to 16 studying secondary 1 to 3 were recruited from local secondary schools. Participants were requested to wear a motionlogger watch (Actigraph) for seven consecutive days, followed by filling in a questionnaire comprising of Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI), Sleep Quality Index (SQI) and Epworth Sleepiness Scale (ESS). Students were asked to complete 5 neuropsychological tests - Psychomotor Vigilance Task (PVT), Trail Making Test A and B (TMT-A and TMT-B), Visuospatial 2-back task (2-back), Stroop Test and Tower of London Test (TOL) to assess their executive function. In factor prediction, factors with p < 0.1 in simple linear regression were included in multiple linear regression. Results demonstrated that there was small correlation between sleep quality and executive functions and the major factors influencing sleep quality are gender, father’s occupation and the average time for social networking (p < 0.05). This research implies that further interventions could be targeted on reducing the use of electronic devices for social networking, enhancing the family communication to weaken the effect of father’s occupation and emotional problems in teenage, especially female.