Household Basic Needs Support and Insufficient Sleep Among United States High School Students: Evidence From the 2023 National Youth Risk Behavior Survey

Abstract

Background

Insufficient school-night sleep is common among U.S. adolescents. The 2023 Youth Risk Behavior Survey (YRBS) includes a basic-needs support item about adult effort to ensure safety, clean clothes, and food.

Methods

We conducted a cross-sectional secondary analysis of the 2023 national YRBS. Insufficient sleep was defined as fewer than 8 hours on an average school night. Support was coded as present versus lacking. Survey-weighted models adjusted for demographic, behavioral, mental-health, and BMI covariates.

Results

Among students with nonmissing sleep data (n = 17,441), 76.8% reported insufficient sleep. In the sleep/support frame (n = 15,607), prevalence was 76.0% with support present and 82.0% with support lacking. In the multiply-imputed primary model (m = 20), lacking support was associated with a small, statistically detectable increase in insufficient sleep (aPR = 1.052, 95% CI 1.007 to 1.098; ARD = +4.3 percentage points, 95% CI + 0.5 to +8.1). A complete-case sensitivity model gave a comparable but less precise estimate (aPR = 1.036, 95% CI 0.990 to 1.085).

Conclusions

Lacking perceived basic-needs support marked higher unadjusted insufficient-sleep prevalence, but adjusted estimates were modest. Sleep screening and basic-needs assessment may be clinically useful together; longitudinal work is needed to clarify directionality.

Plain Language Summary

Many high-school students sleep less than the recommended amount on school nights. This study used 2023 national Youth Risk Behavior Survey data to examine whether sleep differed by students’ reports that an adult in their household tried hard to make sure their basic needs were met, such as safety, clean clothes, and enough to eat. Students who reported lacking this support had higher insufficient-sleep prevalence than students who reported support. After adjustment, the difference was small; the primary model was statistically detectable, while the complete-case sensitivity estimate was less precise. These findings do not prove that household support causes better sleep, but they suggest that sleep screening and basic-needs assessment may be useful together in adolescent care.