Cross-cultural Differences In Sleep Patterns And Problems in Asian School-aged Adolescents: The ACROSS Study

NCT07577882 | Not Yet Recruiting

• 1 other identifier: ACROSS study
• Study Type: observational
• Target: 15,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

Sleep problems are common in adolescents. Studies have consistently demonstrated that sleep disturbances are prevalent, affecting up to 50% of this population. In this project, the investigators aim to map out sleep patterns, risk factors, and obstacles for sleep in adolescents, capturing the diversity of societal factors that shape the sleeping habits of adolescents. The investigators aim to recruit school-aged adolescents (aged 12-18 years old) in 12 countries across 15 research centres (N = 1000 per centre) to fill in the questionnaire covering sleep-wake patterns, sleep problems, mood, behavioral, daytime functioning and their attitude and perception towards sleep.

Conditions

Characterise Sleep Patterns Across Asia; Examine Barriers to Sleep

Keywords

Adolescents; Sleep; Cross-cultural

Outcome Measures

Primary Outcomes (7)

• Sleep duration

  Sleep duration (nocturnal sleep and nap sleep) on weekdays and weekends is probed in the questionnaire.

  At enrollment

• Sleep timing

  Bedtime and wake time on weekdays and weekends is probed in the questionnaire.

  At enrollment

• Patient Health Questionnarie-2

  A 2-item tool used to screen for depression by assessing the frequency of depressed mood and anhedonia over the past two weeks. It includes the first two items of the PHQ-9, with scores ranging from 0 to 6. A score of 3 or more is considered the cut-off point for identifying potential depression.

  At enrollment

• Generalized Anxiety Disorder-2

  A brief, two-item screening tool used to detect generalized anxiety disorder, with a recommended cut-off score of 3 or higher. A score of 3+ indicates a likely anxiety disorder, suggesting the need for further, more comprehensive assessment.

  At enrollment

• Perceived Stress Scale-4

  The Perceived Stress Scale-4 (PSS-4) is a 4-item questionnaire, a shortened version of the PSS-10, designed to measure the degree to which situations in life are appraised as stressful over the past month. Scores range from 0 to 16, with higher scores indicating higher perceived stress.

  At enrollment

• Time spent on various activities in a day

  Lifestyle factors are assessed using a question asking participants to report the amount of time in a day spent on different activities such as electronic media use, physical activity, homework, and leisure time / entertainment. Participants report the amount of time spent in hours and minutes.

  At enrollment

• Attitude and perception towards sleep

  Adolescent's perception towards sleep, as well as parent, peer, and school practice relating to sleep, are probed using questions such as "My parents think finishing my homework is more important than sleep", "My friends encourage me to stay up late to study", "My teachers encourage me to sleep enough", "I believe sacrificing sleep to get more work/study done is necessary". Participants are to indicate how strongly they agree or disagree with these statements.

  At enrollment

Eligibility Criteria

• Age: 12 Years - 18 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

School-going adolescents aged 12-18 years old will be invited to participate.

You may qualify if:

• School-going adolescents aged 12-18 years old

You may not qualify if:

• Nil.

Sponsors & Collaborators

• National University of Singapore: lead
• Li Chiu Kong Family Sleep Assessment Unit: collaborator
• All India Institute of Medical Sciences, Rishikesh: collaborator
• Universitas Kristen Krida Wacana, Jakarta: collaborator
• Hermina Hospital, Manado: collaborator
• Isfahan university of medical sciences, Bamdad respiratory and sleep research center: collaborator
• Department of Psychology, The Center for Psychobiological Research, The Max Stern Academic College of Emek Yezreel: collaborator
• Japanese Society of Sleep Research: collaborator
• The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China: collaborator
• Department of Psychosomatic Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China: collaborator
• Ewha Womans University Seoul Hospital: collaborator
• CHA bundang hospital/university: collaborator
• Soonchunhyang University Hospital: collaborator
• Yongin Severance Hospital, Yonsei University College of Medicine: collaborator
• Chang Gung Memorial Hospital and University: collaborator
• Sleep Society of Thailand: collaborator
• Vietnam Society of Sleep Medicine: collaborator
• Brawijaya University, Malang, Indonesia: collaborator
• Psychology of Traffic, Urban Society, and Psychological Measurement Laboratory, Faculty of Psychology, Universitas Indonesia: collaborator
• Shanghai Children's Medical Center: collaborator

Related Publications (8)

• Short MA, Gradisar M, Lack LC, Wright HR, Dewald JF, Wolfson AR, Carskadon MA. A cross-cultural comparison of sleep duration between US And Australian adolescents: the effect of school start time, parent-set bedtimes, and extracurricular load. Health Educ Behav. 2013 Jun;40(3):323-30. doi: 10.1177/1090198112451266. Epub 2012 Sep 14.

  PMID: 22984209 BACKGROUND

• Olds T, Blunden S, Petkov J, Forchino F. The relationships between sex, age, geography and time in bed in adolescents: a meta-analysis of data from 23 countries. Sleep Med Rev. 2010 Dec;14(6):371-8. doi: 10.1016/j.smrv.2009.12.002. Epub 2010 Mar 6.

  PMID: 20207558 BACKGROUND

• Mindell JA, Sadeh A, Kohyama J, How TH. Parental behaviors and sleep outcomes in infants and toddlers: a cross-cultural comparison. Sleep Med. 2010 Apr;11(4):393-9. doi: 10.1016/j.sleep.2009.11.011.

  PMID: 20223706 BACKGROUND

• Zhang J, Li AM, Fok TF, Wing YK. Roles of parental sleep/wake patterns, socioeconomic status, and daytime activities in the sleep/wake patterns of children. J Pediatr. 2010 Apr;156(4):606-12.e5. doi: 10.1016/j.jpeds.2009.10.036. Epub 2009 Dec 21.

  PMID: 20022339 BACKGROUND

• Schmidt RE, Van der Linden M. The Relations Between Sleep, Personality, Behavioral Problems, and School Performance in Adolescents. Sleep Med Clin. 2015 Jun;10(2):117-23. doi: 10.1016/j.jsmc.2015.02.007. Epub 2015 Mar 12.

  PMID: 26055859 BACKGROUND

• Dahl RE. The impact of inadequate sleep on children's daytime cognitive function. Semin Pediatr Neurol. 1996 Mar;3(1):44-50. doi: 10.1016/s1071-9091(96)80028-3.

  PMID: 8795841 BACKGROUND

• Owens J; Adolescent Sleep Working Group; Committee on Adolescence. Insufficient sleep in adolescents and young adults: an update on causes and consequences. Pediatrics. 2014 Sep;134(3):e921-32. doi: 10.1542/peds.2014-1696.

  PMID: 25157012 BACKGROUND

• Biggs SN, Lushington K, van den Heuvel CJ, Martin AJ, Kennedy JD. Inconsistent sleep schedules and daytime behavioral difficulties in school-aged children. Sleep Med. 2011 Sep;12(8):780-6. doi: 10.1016/j.sleep.2011.03.017. Epub 2011 Aug 20.

  PMID: 21862401 BACKGROUND

Central Study Contacts

Stijn Massar

CONTACT

+65 66015238; stijn.massar@nus.edu.sg

Rachel Chan

CONTACT

rachel.chan@cuhk.edu.hk

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor Michael Wei Liang Chee

Study Record Dates

• First Submitted: April 24, 2026
• First Posted: May 11, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: May 11, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share