Journal of Preventive Medicine

Extended Abstract
Introduction
The number of hours of short sleep and the decrease in sleep quality cause problems in daily work and also decrease the overall performance of a person. The quantity and quality of sleep are influenced by individual (age and gender), psychological, and environmental factors. Sleep affects children’s emotional development, cognitive performance, learning, and concentration, and therefore the effect of sleep on the growth and development process doubles the importance of childhood sleep. The topic of sleep is of particular importance among health science experts due to its physical and psychological importance because it is a part of the biological cycle that is influenced by biological rhythms. Considering the importance of sleep in children, we decided to focus on the effect of sleep hygiene education on students who have low sleep quality.
Adequate sleep plays a vital role in the mental and cognitive development of children. Lack of sleep can have adverse effects on the body’s endocrine and metabolic functions, as well as the body’s inflammatory responses. On the other hand, too much sleep can affect mental health, impulsive behaviors, drug use, weight gain, and academic performance. Children with sleep problems experience cognitive and emotional conditions, such as depression, anxiety, cognitive impairment, learning disability, and mental development disability. Lack of attention to sleep problems starts from childhood; therefore, its continuation until school age requires follow-up and treatment.
Part of the unfavorable academic performance of students is attributed to their insufficient sleep. The quality and quantity of sleep are closely related to learning capacity and academic performance. Persistent lack of sleep is associated with learning in students.
Methods
The current practical quasi-experimental research had a pre-test and post-test design with a control group. The statistical population of this research included 7-12-year-old male and female students of Bandar Abbas city, 349 of whom participated in this project. Sampling in the first stage of this research was done by the available method and in the second stage, the random method was used. In the first stage, children between the ages of 7 and 12 years old in Bandar Abbas primary schools were selected using the available sampling method. After filling out the questionnaires and analyzing the data, the students who had sleep problems according to the score obtained in the questionnaire, in coordination with the school principal and having the number that was recorded in the questionnaire with their consent, were divided into two groups on WhatsApp. The experimental group and the control group were formed and the students were randomly placed in two groups of 30 people, test and control. An orientation session was held for both groups and then the experimental group underwent five training sessions in one month. In order to maintain the principles of research ethics, at the end of the sessions, training was also provided for the control group. A short sleep quality measurement questionnaire was used in this research, and its validity and reliability were confirmed. This questionnaire included ten questions about sleep quality, including difficulty falling asleep, morning headache, waking up in the morning, daytime sleepiness, waking up in the middle of the night, and the use of sleeping pills, as well as the student’s daily performance.
Results
Among the 349 students who participated in this research, 156 cases were boys (44.7%) and 193 cases were girls (55.3%). Their average age was 9.7±1.5 years. According to the results of Table 1, there are sleep problems in the studied population of boys, and the data of 156 boys showed that this problem existed in all age groups, but the chi-square test showed no significant difference between different age groups of boys (P=0.513).



According to the results of Table 2, there were sleep problems in the girls of all ages; however, it was more in the age group of 11 and 12 years, and according to the chi-square test, this difference was significant (P=0.001).



 In general, the results indicated that out of 349 students, 246 students (70.5%) had good and appropriate sleep quality and 103 students (29.5%) had poor sleep quality. In both groups of girls and boys, there was a problem with sleep, although the rate of this frequency was higher in girls than in boys. Among the different components of sleep quality, the highest score that was obtained and caused a decrease in sleep quality was “difficult waking up in the morning” and “tossing and turning in sleep”.
The results of Table 3 show that according to the obtained significance level (0.079), the null hypothesis of homogeneity of variances in the two control and experimental groups was accepted at the 5% level, and the hypothesis of equality of variances was confirmed.



According to the results of Table 4, the significance level of the variable (multiplication research group in the pre-test) is equal to 0.6, which is greater than 0.050, and it shows that the assumption of homogeneity of the regression slope was accepted.



As the results of Table 5 show, the f value obtained for groups with a degree of freedom of df=1 was significant at P<0.001. In other words, there was a significant difference between the post-test scores of the group that received sleep hygiene training and the control group, and it improved the quality of sleep. In general, sleep hygiene education has an effect on students’ sleep quality, with an effect size of 0.493 (P<0.001).



The results obtained from the data analysis showed that the score of sleep quality in the post-test decreased compared to the pre-test, which indicates that the sleep quality of students improved after receiving sleep hygiene training. Since sleep in children is an important factor in their physical and mental health, more attention should be paid to this factor. Inadequate sleep is very effective on physical health, including the child’s growth rate and mood, as well as the power of thinking, memory, and then their academic performance. In this regard, perhaps with more investigations at the community level and in different situations, it will be possible to identify the problems and incorrect sleeping habits and plan for them, as well as take action to solve the problems. Children and teenagers can be brought to a higher level of physical, mental, and social health and provide a better future for them.
Discussion 
Since sleep is one of the health factors in all people, especially school students, this study aimed to assess the effect of sleep hygiene education on the sleep quality of primary school students. Sleep disorders in people (both children and adults) can cause mood changes and can indicate the existence of physical problems such as changes in thyroid function as well as mental disorders such as depression. Lack of sleep in school students can cause reduce their learning ability, negatively affect their growth rate, mood, thinking, memory, and academic performance, and cause a lot of damage to the health of students and the education system. Therefore, sleep hygiene education for parents and students is very important. The results showed that the score of sleep quality in the post-test phase decreased compared to its pre-test score, which indicates that the sleep quality of students improved after presenting sleep hygiene education to their parents. Since sleep in children is an important factor in their physical and mental health, more attention should be paid to this factor.
Ethical Considerations
Compliance with ethical guidelines
This study has ethical approval code IR.PMU.REC.1400.130 from Payame Noor University (PNU).
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors' contributions
Sampling and writing the article: Zahra Moalemzadegan; Proposal editing: Hossein Zare; Final review of the article: Akram Malekzadeh.
Conflicts of interest
The authors declared no conflict of interest.
 

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