Abstract
Background Lifestyle factors are important determinants of adequate sleep among adolescents. However, findings on sleep duration relative to lifestyle factors are conflicting. Therefore, this study examined the association of self-reported sleep duration with physical activity, sedentary behaviours and dietary habits among Saudi adolescents. Methods A multicentre school-based cross-sectional study was conducted in three major cities in Saudi Arabia. The sample included 2868 secondary-school students (51.9% girls) aged 15-19 years, randomly selected using a multistage stratified cluster sampling technique. In addition to anthropometric measurements, sleep duration, physical activity, sedentary behaviours and dietary habits were assessed using self-reported questionnaire. Results Several lifestyle factors were associated with sleep duration in adolescents. While controlling for some potential confounders, the findings showed that high screen time [>5h/day; adjusted odds ratio (aOR) = 1.505, 95% confidence interval (CI) = 1.180-1.920, P = 0.001] and low (aOR = 1.290, 95% CI = 1.064-1.566, P = 0.010) to medium (aOR = 1.316, 95% CI = 1.075-1.611, P = 0.008) physical activity levels were significantly related to daily sleep of 8h or longer. Furthermore, having low intake of breakfast (<3 day/week compared with 5 days or more per week) decreased the odd of having adequate sleep duration by a factor of 0.795 (95% CI = 0.667-0.947, P < 0.010). Conclusions Short sleep duration (<8h/day) among Saudi adolescents 15-19 year olds was significantly associated with several lifestyle factors. Intervention programs aiming for improving sleeping habits among adolescents need to consider such potential association of lifestyle variables with sleep duration.