Association Between Substance Use and Insufficient Sleep in U.S. High School Students

Abstract

Multidimensional causes of insufficient sleep among adolescents are not fully explored, particularly, the association between substance use and sleep duration. The 2017 Youth Risk Behavior Surveillance System (YRBSS) of high school students (N = 14,638; 51% female, 14–18 years old) was used to examine the association between substance use, namely cigarette, electronic vapor, alcohol, and marijuana use in the past 30 days, and insufficient sleep (<8 hr) using logistic regression analyses. Findings suggest that the use of alcohol (adjusted odds ratio [AOR], 1.42; 95% CI [1.22, 1.65]) and marijuana (AOR, 1.19; 95% CI [1.00, 1.41]) was significantly associated with having insufficient hours of sleep adjusting for age, sex, race, and computer use ≥3 hr per day. Moreover, interaction effects were examined for sex and age, which revealed that the association between marijuana use and having insufficient sleep was stronger for male and younger students. It highlights the potential value of sleep assessment among adolescent substance users.

Keywords

adolescent sleep tobacco use alcohol drinking marijuana use substance use electronic vapor use school nurse

Get full access to this article

View all access options for this article.

References

Angold

Erkanli

Copeland

Goodman

Fisher

P. W.

Costello

E. J.

(2012). Psychiatric diagnostic interviews for children and adolescents: A comparative study. Journal of American Academy of Child & Adolescent Psychiatry, 51, 506–517. https://doi.org/10.1016/j.jaac.2012.02.020

Beebe

D. W.

(2011). Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatric Clinics, 58, 649–665. https://doi.org/10.1016/j.pcl.2011.03.002

Carskadon

M. A.

Vieira

Acebo

(1993). Association between puberty and delayed phase preference. Sleep, 16, 258–262. https://doi.org/10.1093/sleep/16.3.258

Center for Disease Control and Prevention. (2014). Youth Risk Behavior Surveillance Systems (YRBSS): A guide to conducting your own youth risk behavior survey. Center for Disease Control and Prevention website. https://www.cdc.gov/healthyyouth/data/yrbs/faq.htm

Center for Disease Control and Prevention. (2018). CDC features: Sleep in middle and high school students. Center for Disease Control and Prevention website. https://www.cdc.gov/features/students-sleep/index.html

Center for Disease Control and Prevention. (2019a). CDC features: Teen substance use and risks. Center for Disease Control and Prevention website. https://www.cdc.gov/features/teen-substance-use/index.html

Center for Disease Control and Prevention. (2019b). Vital signs: Tobacco use by youth is rising. https://www.cdc.gov/vitalsigns/youth-tobacco-use/index.html

Colrain

I. M.

Nicholas

C. L.

Baker

F. C.

(2014). Alcohol and the sleeping brain. Handbook of Clinical Neurology, 125, 415–431. https://doi.org/10.1016/B978-0-444-62619-6.00024-0

Conroy

D. A.

Arnedt

J. T.

(2014). Sleep and substance use disorders: An update. Current Psychiatry Reports, 16, 487. https://doi.org/10.1007/s11920-014-0487-3

10.

Council on Communications and Media. (2013). Children, adolescents, and the media. Pediatrics, 132, 958–961. https://doi.org/10.1542/peds.2013-2656

11.

Cuttler

Mischley

L. K.

Sexton

(2016). Sex differences in cannabis use and effects: A cross-sectional survey of cannabis users. Cannabis and Cannabinoid Research, 1, 166–175. https://doi.org/10.1089/can.2016.0010

12.

Daly

B. P.

Jameson

J. P.

Patterson

McCurdy

Kirk

Michael

K. D.

(2015). Sleep duration, mental health, and substance use among rural adolescents: Developmental correlates. Journal of Rural Mental Health, 39, 108–122. https://doi.org/10.1037/rmh0000033

13.

Deleanu

O. C.

Pocora

Mihălcuţă

Ulmeanu

Zaharie

A. M.

Mihălţan

F. D.

(2016). Influence of smoking on sleep and obstructive sleep apnea syndrome. Pneumologia, 65, 28–35.

14.

Dunbar

M. S.

Tucker

J. S.

Ewing

B. A.

Pedersen

E. R.

Miles

J. N.

Shih

R. A.

D’amico

E. J.

(2017). Frequency of e-cigarette use, health status, and risk and protective health behaviors in adolescents. Journal of Addiction Medicine, 11, 55–62. https://doi.org/10.1097/ADM.0000000000000272

15.

Eaton

D. K.

Kann

Kinchen

Shanklin

Ross

Hawkins

Harris

W. A.

Lowry

McManus

Chyen

Lim

Whittle

Brener

N. D.

Wechsler

. (2010). Youth risk behavior surveillance—United States, 2009. Morbidity and Mortality Weekly Report: Surveillance Summaries, 59, 1–142.

16.

Ebrahim

I. O.

Shapiro

C. M.

Williams

A. J.

Fenwick

P. B.

(2013). Alcohol and sleep I: Effects on normal sleep. Alcoholism: Clinical and Experimental Research, 37, 539–549. https://doi.org/10.1111/acer.12006

17.

Fucito

L. M.

DeMartini

K. S.

Hanrahan

T. H.

Whittemore

Yaggi

H. K.

Redeker

N. S.

(2015). Perceptions of heavy-drinking college students about a sleep and alcohol health intervention. Behavioral Sleep Medicine, 13, 395–411. https://doi.org/10.1080/15402002.2014.919919

18.

Grant

J. D.

Lynskey

M. T.

Scherrer

J. F.

Agrawal

Heath

A. C.

Bucholz

K. K.

(2010). A Cotwin-control analysis of drug use and abuse/dependence risk associated with early-onset cannabis use. Addictive Behaviors, 35, 35–41. https://doi.org/10.1016/j.addbeh.2009.08.006

19.

Grant

J. D.

Scherrer

J. F.

Lynskey

M. T.

Agrawal

Duncan

A. E.

Haber

J. R.

Heath

A. C.

Bucholz

K. K.

(2012). Associations of alcohol, nicotine, cannabis, and drug use/dependence with educational attainment: Evidence from Cotwin-control analyses. Alcoholism: Clinical & Experimental Research, 36, 1412–1420. https://doi.org/10.1111/j.1530-0277.2012.01752.x

20.

Hagenauer

M. H.

Perryman

J. I.

Lee

T. M.

Carskadon

M. A.

(2009). Adolescent changes in the homeostatic and circadian regulation of sleep. Developmental Neuroscience, 31, 276–284. https://doi.org/10.1159/000216538

21.

Hale

Guan

(2015). Screen time and sleep among school-aged children and adolescents: A systematic literature review. Sleep Medicine Reviews, 21, 50–58. https://doi.org/10.1016/j.smrv.2014.07.007

22.

Hall

W. D.

Patton

Stockings

Weier

Lynskey

Morley

K. I.

Degenhardt

(2016). Why young people’s substance use matters for global health. Lancet Psychiatry, 3, 265–279. https://doi.org/10.1016/S2215-0366(16)00013-4

23.

Hasler

B. P.

Soehner

A. M.

Clark

D. B.

(2015). Sleep and circadian contributions to adolescent alcohol use disorder. Alcohol, 49, 377–387. https://doi.org/10.1016/j.alcohol.2014.06.010

24.

Haynie

D. L.

Lewin

Luk

J. W.

Lipsky

L. M.

O’Brien

Iannotti

R. J.

Liu

Simons-Morton

B. G.

(2017). Beyond sleep duration: Bidirectional associations among chronotype, social jetlag, and drinking behaviors in a longitudinal sample of US high school students. Sleep, 41, 1–14. https://doi.org/10.1093/sleep/zsx202

25.

Hirshkowitz

Whiton

Albert

S. M.

Alessi

Bruni

DonCarlos

Hazen

Herman

Katz

Kheirandish-Gozal

Neubauer

D. N.

O’Donnell

A. E.

Ohayon

Peever

Rawding

Sachdeva

R. C.

Setters

Vitiello

M. V.

Ware

J. C.

Neubauer

D. N.

(2015). National Sleep Foundation’s sleep time duration recommendations: Methodology and results summary. Sleep Health, 1, 40–43. https://doi.org/10.1016/j.sleh.2014.12.010

26.

Hysing

Pallesen

Stormark

K. M.

Jakobsen

Lundervold

A. J.

Sivertsen

(2015). Sleep and use of electronic devices in adolescence: Results from a large population-based study. BMJ Open, 5, e006748. https://doi.org/10.1136/bmjopen-2014-006748

27.

Jacobus

Bava

Cohen-Zion

Mahmood

Tapert

S. F.

(2009). Functional consequences of marijuana use in adolescents. Pharmacology Biochemistry and Behavior, 92, 559–565. https://doi.org/10.1016/j.pbb.2009.04.001

28.

Johnston

L. D.

Miech

R. A.

O’Malley

P. M.

Bachman

J. G.

Schulenberg

J. E.

Patrick

M. E.

(2018). Monitoring the future national survey results on drug use, 1975-2018: Overview, key findings on adolescent drug use. Institute for Social Research, University of Michigan. http://hdl.handle.net/2027.42/148123

29.

Kann

McManus

Harris

W. A.

Shanklin

S. L.

Flint

K. H.

Queen

Lowry

Chyen

Whittle

Thornton

Lim

Bradford

Yamakawa

Leon

Brener

Lim

(2018). Youth risk behavior surveillance—United States, 2017. Morbidity and Mortality Weekly Report: Surveillance Summaries, 67, 1–114. https://doi.org/10.15585/mmwr.ss6708a1

30.

Kwon

Park

Dickerson

S. S.

(2019). Adolescent substance use and its association to sleep disturbances: A systematic review. Sleep Health, 5, 382–394. https://doi.org/10.1016/j.sleh.2019.06.001

31.

Marshall

E. J.

(2014). Adolescent alcohol use: Risks and consequences. Alcohol and Alcoholism, 49, 160–164. https://doi.org/10.1093/alcalc/agt180

32.

McGlinchey

E. L.

Harvey

A. G.

(2015). Risk behaviors and negative health outcomes for adolescents with late bedtimes. Journal of Youth and Adolescence, 44, 478–488. https://doi.org/10.1007/s10964-014-0110-2

33.

McKnight-Eily

L. R.

Eaton

D. K.

Lowry

Croft

J. B.

Presley-Cantrell

Perry

G. S.

(2011). Relationships between hours of sleep and health-risk behaviors in US adolescent students. Preventive Medicine, 53, 271–273. https://doi.org/10.1016/j.ypmed.2011.06.020

34.

Meldrum

R. C.

Restivo

(2014). The behavioral and health consequences of sleep deprivation among US high school students: Relative deprivation matters. Preventive Medicine, 63, 24–28. https://doi.org/10.1016/j.ypmed.2014.03.006

35.

National Center for Chronic Disease Prevention and Health Promotion. (2018, March). Do you children get enough sleep? Centers for Disease Control and Prevention website. https://www.cdc.gov/chronicdisease/resources/infographic/children-sleep.htm

36.

National Sleep Foundation. (2017). Why do we need sleep? National Sleep Foundation website. https://www.sleepfoundation.org/articles/why-do-we-need-sleep

37.

Owens

, Adolescent Sleep Working Group, & Committee on Adolescence. (2014). Insufficient sleep in adolescents and young adults: An update on causes and consequences. Pediatrics, 134, e921–e932. https://doi.org/10.1542/peds.2014-1696

38.

Owens

J. A.

Weiss

M. R.

(2017). Insufficient sleep in adolescents: Causes and consequences. Minerva Pediatrica, 69, 326–336. https://doi.org/10.23736/S0026-4946.17.04914-3

39.

Paiva

Gaspar

Matos

M. G.

(2016). Mutual relations between sleep deprivation, sleep stealers and risk behaviours in adolescents. Sleep Science, 9, 7–13. https://doi.org/10.1016/j.slsci.2016.02.176

40.

Pasch

K. E.

Latimer

L. A.

Cance

J. D.

Moe

S. G.

Lytle

L. A.

(2012). Longitudinal bi-directional relationships between sleep and youth substance use. Journal of Youth and Adolescence, 41, 1184–1196. https://doi.org/10.1007/s10964-012-9784-5

41.

Patte

K. A.

Qian

Leatherdale

S. T.

(2018). Modifiable predictors of insufficient sleep durations: A longitudinal analysis of youth in the COMPASS study. Preventive Medicine, 106, 164–170. https://doi.org/10.1016/j.ypmed.2017.10.035

42.

Popovici

French

M. T.

(2013). Binge drinking and sleep problems among young adults. Drug and Alcohol Dependence, 132, 207–215. https://doi.org/10.1016/j.drugalcdep.2013.02.001

43.

Reichenberger

D. A.

Hilmert

C. J.

Irish

L. A.

Secor-Turner

Randall

B. A.

(2016). Associations between sleep and health-risk behaviors in a rural adolescent population. Journal of Pediatric Health Care, 30, 317–322. https://doi.org/10.1016/j.pedhc.2015.08.003

44.

Riehm

K. E.

Rojo-Wissar

D. M.

Feder

K. A.

Mojtabai

Spira

A. P.

Thrul

Crum

R. M.

(2019). E-cigarette use and sleep-related complaints among youth. Journal of Adolescence, 76, 48–54. https://doi.org/10.1016/j.adolescence.2019.08.009

45.

Roberts

R. E.

Duong

H. T.

(2014). The prospective association between sleep deprivation and depression among adolescents. Sleep, 37, 239–244. https://doi.org/10.5665/sleep.3388

46.

Shain

Committee on Adolescence. (2016). Suicide and suicide attempts in adolescents. Pediatrics, 138, e20161420. https://doi.org/10.1542/peds.2016-1420

47.

Singleton

R. A.

Jr Wolfson

A. R.

(2009). Alcohol consumption, sleep, and academic performance among college students. Journal of Studies on Alcohol & Drugs, 70, 355–363. https://doi.org/10.15288/jsad.2009.70.355

48.

Stea

T. H.

Knutsen

Torstveit

M. K.

(2014). Association between short time in bed, health-risk behaviors and poor academic achievement among Norwegian adolescents. Sleep Medicine, 15, 666–671. https://doi.org/10.1016/j.sleep.2014.01.019

49.

Sun

Ling

Zhu

Lee

T. M. C.

S. X.

(2019). Associations of weekday-to-weekend sleep differences with academic performance and health-related outcomes in school-age children and youths. Sleep Medicine Reviews, 46, 27–53. https://doi.org/10.1016/j.smrv.2019.04.003

50.

Zhabenko

Austic

Conroy

D. A.

Ehrlich

Singh

Epstein-Ngo

Cunningham

R. M.

Walton

M. A.

(2016). Substance use as a risk factor for sleep problems among adolescents presenting to the emergency department. Journal of Addiction Medicine, 10, 331–338. https://doi.org/10.1097/adm.0000000000000243