The Assessment Tools and Influencing Factors of Insomnia in Chinese Adolescents: a Scoping Review

Background Previous research has indicated that adolescence is associated with physiological changes in sleep patterns. And there are significant variations in sleep duration among adolescents from different regions. Chinese adolescents face short sleep durations and intense academic pressures, which can lead to insomnia and affect their physical and mental health development. Objective To systematically review the assessment tools and influencing factors of insomnia in Chinese adolescents, and provide guidance for future research in this field. Methods Initiated in October 2022, this study conducted a systematic search in 5 databases: Web of Science Core Collection, PubMed, China National Knowledge Infrastructure, Wanfang Data, and VIP Database. Two researchers screened articles related to insomnia in Chinese adolescents aged 12 to 18. And then they extracted the following information independently: authors, publication year, region, type of research design, size of study sample, assessment tools, prevalence, and influencing factors. Results A total of 1 440 articles were retrieved from the databases, with 39 articles ultimately included in the study-34 in English and 5 in Chinese-covering 23 studies. The sample sizes ranged from 62 to 33 692. Cross-sectional studies were the most common method (15 studies) among the included research. Analysis revealed that the 23 studies utilized 8 kinds of insomnia assessment tools. Only 1 study provided objectively measured sleep features. Three studies involved localized assessment or development of 5 self-report tools, and provided reliability and validity data. The internal consistency of the 5 tools ranged from 0.50 to 0.83, test-retest reliability after two weeks ranged from 0.40 to 0.82, and area under the curve ranged from 0.79 to 0.85. The influencing factors of insomnia in Chinese adolescents were diverse and complicated, which included demographic factors (age, gender, etc.), physiological factors (genetics, health status, etc.), psychological factors (anxiety, depression, etc.), and behavioral factors (exercise, smoking, etc.) . Conclusion The assessment tools and influencing factors of insomnia in Chinese adolescents are diverse. However, there is insufficient validation of the reliability and validity of the assessment tools. Few studies have provided objectively measured sleep features of insomnia in Chinese adolescents. And the causal relationship between insomnia and its influencing factors remains unclear. Further research is still required in the future.