{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:42:11Z","timestamp":1789180931233,"version":"build-2803163510"},"reference-count":43,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Purpose: Insomnia affects up to one in four adolescents and has been shown to have a negative impact on their mental and physical health. This study aimed to investigate the association between insomnia, academic performance, self-reported health, physical activity, school start time, and substance use among adolescents. Methods: A survey with a cross-sectional design was completed by adolescents (15\u201317 years old; n = 1504) in southern Sweden. The Minimal Insomnia Symptoms Scale (MISS) was used to operationalize insomnia. A multiple logistic regression analysis was used to analyze the relationship between insomnia and self-reported health, failed school courses, substance use, school start time, family financial situation, screen time, and gender. Results: Insomnia (MISS \u2265 6) was associated with poor self-reported health (OR: 4.35), failed school courses (OR: 1.47), and use of alcohol and\/or cigarettes (OR: 1.43). When the combined effect of self-reported health and physical activity were investigated, a combination of low physical activity (\u22641 time\/week) and poor self-reported health was strongly associated with insomnia (OR: 18.87). Conclusions: Insomnia was associated with other problems that in themselves are risk factors for poor health. This highlights the need for a holistic health-promoting approach to prevent insomnia, such as efforts to promote physical activity, school success, and the reduction of alcohol\/cigarette use.<\/jats:p>","DOI":"10.3390\/ijerph17176433","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T11:22:43Z","timestamp":1599132163000},"page":"6433","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Insomnia in Relation to Academic Performance, Self-Reported Health, Physical Activity, and Substance Use Among Adolescents"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6807-7704","authenticated-orcid":false,"given":"Gita","family":"Hedin","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden"},{"name":"Clinical Health Promotion Centre, WHO-CC, Department of Health Sciences, Faculty of Medicine, Lund University, SE-221 85 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2008-0784","authenticated-orcid":false,"given":"Annika","family":"Norell-Clarke","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden"},{"name":"Department of Social and Psychological Studies, Karlstad University, SE-651 88 Karlstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hagell","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7161-3416","authenticated-orcid":false,"given":"Hanne","family":"T\u00f8nnesen","sequence":"additional","affiliation":[{"name":"Clinical Health Promotion Centre, WHO-CC, Department of Health Sciences, Faculty of Medicine, Lund University, SE-221 85 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4820-6203","authenticated-orcid":false,"given":"Albert","family":"Westergren","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden"},{"name":"Health-Promoting Complex Interventions, Department of Health Sciences, Lund University, SE-221 85 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1643-0171","authenticated-orcid":false,"given":"Pernilla","family":"Garmy","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden"},{"name":"Clinical Health Promotion Centre, WHO-CC, Department of Health Sciences, Faculty of Medicine, Lund University, SE-221 85 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). 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