To examine non-restorative sleep and its impact on quality of life (QOL) in Chinese adolescents, this cross-sectional study included 2827 students aged 12–20 who were selected from 15 secondary schools in Hong Kong, China. Non-restorative sleep was assessed by a single item, rated on a 0–10 scale: “To what extent did you feel refreshed upon awakening over the past month?”. QOL was evaluated by the World Health Organization Quality of Life Measure—Abbreviated Version Hong Kong Chinese Version. Univariable and multivariable linear mixed-effects regressions were conducted to examine the influence of non-restorative sleep (NRS) on QOL. In the present sample, the mean overall QOL was 13.83, and the extent of feeling refreshed upon awakening was 4.75 on average. In multivariable linear mixed-effects regression, one unit feeling less refreshed upon awakening was associated with 0.37 units of poorer overall QOL after adjusting for age, gender, medical conditions, parental education and occupation, weekly hours of aerobic exercises, smoking and drinking habits. Additionally, adolescents with a significantly poorer overall QOL were more likely to be older, have medical problems, have parents with an educational level of primary school or below, have an unemployed father, engage in less weekly aerobic exercise, and be current smokers or former drinkers. Adolescents who experienced non-restorative sleep had a poorer QOL. Future studies are needed to alleviate non-restorative sleep to improve health outcomes in adolescents.

This study developed a short form of the traditional Chinese version of the Weinstein Noise Sensitivity Scale (WNSS) through optimal test assembly (OTA). A total of 1069 Chinese adults (64.8% female) completed the territory-wide cross-sectional study. We first removed Items 12 and 5 which had negative factor loading and gender-related differential item functioning (DIF), respectively. The optimal length was then determined as the minimal one that reasonably resembled the reliability and validity of the scale without DIF items. OTA identified an 8-item WNSS (WNSS-8) which retained 67.2% of the test information of the original 21-item scale and had a Cronbach’s alpha of 0.83. It also showed significant correlations of 0.272 and −0.115 with the neuroticism and extraversion scales of Chinese NEO-Five Factor Inventory, respectively. Adequate model fit of the WNSS-8 was demonstrated by the confirmatory factor analysis. The Chinese WNSS-8 can be used to assess noise sensitivity without compromising reliability and validity.

Previous studies showed that nonrestorative sleep (NRS) was associated with various adverse outcomes. This study aimed to explore whether NRS was associated with self-injury behavior, suicidal ideation, and suicide attempts. Adolescents attending Grades 7–12 in Nanjing, China, were invited to participate in this longitudinal school-based survey from January 11 to 23, 2024 (T1) and from May 16 to 26, 2024 (T2). The Nonrestorative Sleep Scale (NRSS), Perceived Stress Scale, Center for Epidemiologic Studies Depression-10, and Family APGAR Index were employed to assess NRS, stress, depression, and family function at T1, respectively. The self-injury behavior, suicidal ideation, and suicide attempts during the last four months were measured at T2. Multivariable logistic regressions were applied to investigate the associations of NRS with self-injury behavior, suicidal ideation, and suicide attempts. Stratified analyses were conducted to explore gender-specific effects, and the area under curve was calculated to explore the predictive ability of NRS. Totally, 322 adolescents (57.1% male, mean age 15.4 ± 1.86 years) completed the two-wave surveys. The prevalence of self-injury behavior, suicidal ideation, and suicide attempts in adolescents was 9.3%, 12.7%, and 5.9%, respectively. Reduced NRS symptoms (higher scores of NRSS) were associated with a decreased likelihood of self-injury (odds ratio, OR = 0.89, P < 0.001), suicidal ideation (OR = 0.90, P < 0.001), and suicide attempts (OR = 0.93, P = 0.015). After accounting for sociodemographics, stress, depression, and family function, reduced NRS symptoms significantly decreased the odds of self-injury behavior (adjusted odds ratio, AOR = 0.88, P = 0.002) and suicidal ideation (AOR = 0.92, P = 0.009) but not suicide attempts (AOR = 0.93, P = 0.082). Subgroup analysis showed that the associations of NRS symptoms reached statistical significance exclusively in female participants. The optimal risk-screening threshold of NRSS was 36.5. Reduced NRS symptoms might decrease the risk of self-injury and suicidal ideation. Relieving NRS symptoms with appropriate interventions would be advantageous for adolescents’ health.

This study aimed to assess the measurement properties of a simplified Chinese version of the Nonrestorative Sleep Scale (NRSS) among adolescents. We obtained a simplified Chinese NRSS by the standard forward‐backward translation procedures and administered it to 486 students who were attending Grade 7–11 in Nanjing, China. Furthermore, Pittsburgh Sleep Quality Index, Athens Insomnia Scale, Centre for Epidemiological Studies Depression Scale, and Toronto Hospital Alertness Test were also self‐completed for measuring sleep quality, insomnia, depression and alertness respectively. The sample was randomly split into two halves, with the first half used to explore the scale structure by exploratory factor analysis (EFA), and the second half used to confirm the identified structure by confirmatory factor analysis (CFA). A total of 481 adolescents (49% male) with a mean age of 16 years (range: 13–18) completed this study. In the other half of 250 adolescents, the root mean square error of approximation (RMSEA), standardised root mean square residual, and comparative fit index (CFI) in CFA, which tested the four‐factor structure obtained from EFA, were 0.062, 0.051 and 0.975, respectively. Convergent validity was demonstrated from a significant correlation of the simplified Chinese NRSS with sleep quality (r = −0.62), insomnia (r = −0.71), depression (r = −0.60) and alertness (r = 0.54). The internal consistency and test‐retest reliability for the global scale were 0.83 and 0.86 respectively. Measurement invariance was established between males and females with the changes of both CFI and RMSEA < 0.01. The simplified Chinese NRSS is valid and reliable for measuring NRS among Chinese adolescents.

Objectives This study aimed to examine the psychometric properties of the traditional Chinese version of the Youth Attitude to Noise Scale (YANS) in a large representative sample. Design Cross-sectional study. Setting 15 secondary schools in Hong Kong, China. Participants 2842 adolescents aged 12–20 years participated in this study between April and July 2016. Methods The standard forward–backward validation procedures were followed to obtain the traditional Chinese version of the YANS. Prior to the formal investigation, the YANS was evaluated by cognitive debriefing. The sample was randomly divided into two halves for exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs), respectively. The number of factors was determined by comparison data approach using EFAs, and the factor structure was confirmed by CFAs using the one-factor, four-factor and bifactor models. The scale’s internal reliability, dimensionality and measurement invariance across gender and age groups were also examined. Results EFAs (n=1338) showed that four factors were extracted, and CFAs (n=1337) demonstrated the bifactor model fitted better to the sample than the other models. Additionally, the traditional Chinese version of the YANS showed high reliability (ω=0.84), a general factor, scale multidimensionality, and gender and age invariance. Conclusions The findings of the current study indicate that the traditional Chinese version of the YANS is a feasible instrument to assess attitude to noise in Chinese adolescents, regardless of their gender and age. Given the presence of a general factor, the YANS is not merely multidimensional, and whether to use the total or subscale scores is recommended to rely on research objectives.