Evidence map›Paper›PMID 40101756›Full record

ArticleEuropean journal of public health2025

Sleep difficulties as a consistent risk factor for medically treated injuries among adolescents in 46 countries.

Valerie F Pagnotta, Peter D Donnelly, Inese Gobina, Frank Elgar, Kwok Ng, William Pickett

Abstract read
In one paragraph

Article in European journal of public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Childhood Trauma, Perceived Stress, and Developmental Trajectories of Sleep Problems in Adolescents.Stress and health : journal of the International Society for the Investigation of Stress · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Valerie F PagnottaDepartment of Health Sciences, Brock University, St Catharines, ON, Canada.ORCID 0000-0001-7892-501X
Peter D DonnellySchool of Medicine, University of St Andrews, St Andrews, Fife, United Kingdom.
Inese GobinaInstitute of Public Health, Children's Clinical University Hospital, Riga, Latvia.
Frank ElgarDepartment of Psychiatry, McGill University, Montreal, QC, Canada.
Kwok NgFaculty of Education, University of Turku, Turku, Finland.
William PickettDepartment of Health Sciences, Brock University, St Catharines, ON, Canada.

Funding

Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate ScholarshipCentre for Surveillance and Research, Public Health Agency of CanadaMichael Smith Foreign Study SupplementThe 2017/2018 Canadian Health Behaviour in School-aged Children Study
6 · The paper itself

Abstract

Adolescent poor sleep is common and has been associated with unintentional injury risks. Yet the comparability of evidence is limited by differences in measures of sleep and injury implemented across studies. We examined the potential cross-national consistency of relationships between poor sleep and unintentional injury using self-reports from 239 816 adolescents (50.8% girls) in 46 countries collected using a common survey procedure. A cross-sectional study was conducted using nationally representative records from the 2017/2018 International Health Behaviour in School-aged Children study. The prevalence of sleep indicators (difficulties in falling asleep, insufficient sleep, social jetlag) and annual medically treated injuries (any, multiple) were described cross-nationally and by gender. Multivariable modified Poisson regression analyses were conducted within and across countries to test the consistency of associations between sleep and injury. 16.3%-48.3% of adolescents reported an indicator of poor sleep and 44.0% sustained any injury. We observed striking cross-national variations in sleep, yet consistent gendered patterns across countries [e.g. sleep difficulties more prevalent among girls vs. insufficient sleep (non-school days) more prevalent among boys]. Country-level models displayed relatively consistent and positive associations. Multi-country (pooled) models demonstrated a consistency of effects, with the strongest association observed between difficulties in falling asleep and multiple injuries (prevalence ratio: 1.58, 95% CI: 1.55-1.61); these effects were especially pronounced in girls. Using standard indicators, this novel cross-national study demonstrated that poor sleep is a consistent risk factor for adolescent injuries. Given the recent epidemic of adolescent sleep problems, sleep hygiene represents a novel target for injury prevention.

Indexed as

Sleep Wake DisordersWounds and InjuriesAdolescentChildCross-Sectional StudiesFemaleHumansMalePrevalenceRisk FactorsSelf ReportSurveys and Questionnaires

Identifiers

PMID40101756
PMCPMC12190805

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.