Teen Sleep Problems Linked To Later Drug Use

Jared Kaltwasser

Study shows an association between greater "eveningness" (being awake and alert at night) and cannabis use and binge drinking.

Teens and young adults who stay up late or do not get enough sleep have a greater risk of using cannabis or binge drinking, according to a new report.

The study, which is being presented at the Virtual Sleep 2021 meeting, is one of several new studies to describe the health and behavioral consequences of poor sleep habits.

Lead author Brant P. Hasler, Ph.D., of the University of Pittsburgh’s Center for Sleep and Circadian Science, and colleagues, used data from multiple years from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study to identify 831 teens and young adults between the ages of 12 and 21 for whom sleep and drug use data were available. Just over half (423) were females.

The participants were asked about a number of sleep variables — including sleep quality, daytime sleepiness, and Circadian pattern Those data were compared to responses related to substance use the following year.

Overall, Hasler and colleagues found greater eveningness (being awake and alert at night) and later weekend midsleep (the midpoint between sleep onset and end) were associated with a greater likelihood of cannabis use the following year. Greater eveningness and shorter sleep duration correlated with greater number of days of cannabis use the following year.

Likewise, greater eveningness, increased daytime sleepiness, and shorter sleep duration correlated with more severe alcohol binge drinking the following year.

When the data were broken up by age group, the link between sleep patterns and cannabis use disappeared for college-age students, but persisted for middle and high school students.

In a press release, Hasler said the data suggest middle and high school students are at a particularly high risk for sleep-related substance-abuse risk, in part because of their school schedules.

“The particular pattern of sleep predictors in the middle school and high school sample is consistent with the ‘circadian misalignment’ caused by early school start times,” he said.

The American Academy of Sleep Medicine, which is hosting the Sleep 2021 conference, recommends that school start times for middle and high schools be no earlier than 8:30 a.m. in order to give teenagers adequate time to sleep.

Hasler and colleagues’ findings align with earlier research. A separate longitudinal study of teenagers, published in 2012, found sleep patterns were predictive of future alcohol, marijuana, and cigarette use, with less sleep correlating to a greater likelihood of using those substances 2 years later.

Only about one quarter of US high schoolers get sufficient sleep at night, according to the Centers for Disease Control and prevention.

Other research has shown links between sleep and substance abuse in adults.

A 2019 study of adults found that sleep disorders were predictive of drug use, with as many as 1 in 5 patients treated for sleep disorders also reporting being treated for a drug use disorder and 12% being treated for alcohol use disorder.

Hasler said the good news is that these types of behaviors are reversible with intervention.

“Sleep is modifiable behavior, and perhaps easier to modify than going after substance use directly,” he said, adding that studies of college-age teens suggest they are more willing to consider changing sleep habits than substance-use habits, which may create an opportunity to address both.

“[F]ocusing on improving teen sleep—including through delaying school start times—may be an underutilized but effective approach to reducing risk for problematic substance use.”