Journal of Urban Health

, Volume 88, Issue 6, pp 1130–1142

Sleep Disturbance and Risk Behaviors among Inner-City African-American Adolescents

  • Mary Grace Umlauf
  • John M. Bolland
  • Brad E. Lian


Adolescents tend to experience more problems with sleep loss as a natural consequence of puberty, whereas teens from impoverished urban areas are likely to witness neighborhood violence and/or engage in risk behaviors that may affect sleep. Data from the Mobile Youth Survey, a longitudinal study of impoverished inner-city African-American adolescents (1998–2005; N = 20,716; age range = 9.75–19.25 years), were used to compare paired years of annual surveys elicited by questions about how sleep was affected when bad things happen to friends or family. Using a cross-lagged panel multivariate approach comparing reports for two sequential years and controlling for age/gender plus exposure to traumatic stress and violence, prior sleep disturbance was associated with carrying a knife/gun, brandishing a knife/gun, using a knife/gun, quick temperedness, warmth toward mother, worry, and belief in the neighborhood street code in the latter year. Conversely, seeing someone cut, stabbed, or shot, using alcohol, worry, and internalized anger were associated with sleep disturbance in a latter year. Although a limited measure of sleep disturbance was used, these findings support further research to examine sleep disturbance and risk behaviors among low-income adolescents.


Sleep Adolescent Risk behaviors Poverty Area African Americans 


  1. 1.
    Colten HR, Altevogt BM, eds. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: Institute of Medicine, National Academies Press; 2006.Google Scholar
  2. 2.
    Ohayon MM. Prevalence and correlates of nonrestorative sleep complaints. Arch Intern Med. 2005; 165(1): 35–41.PubMedCrossRefGoogle Scholar
  3. 3.
    O’Brien LM, Ivanenko A, Crabtree VM, et al. The effect of stimulants on sleep characteristics in children with attention deficit/hyperactivity disorder. Sleep Med. 2003; 4(4): 309–316.PubMedCrossRefGoogle Scholar
  4. 4.
    Bass JL, Corwin M, Gozal D, et al. The effect of chronic or intermittent hypoxia on cognition in childhood: a review of the evidence. Pediatrics. 2004; 114(3): 805–816.PubMedCrossRefGoogle Scholar
  5. 5.
    Wolfson AR, Carskadon MA. Understanding adolescents’ sleep patterns and school performance: a critical appraisal. Sleep Med Rev. 2003; 7(6): 491–506.PubMedCrossRefGoogle Scholar
  6. 6.
    Patten CA, Choi WS, Gillin JC, Pierce JP. Depressive symptoms and cigarette smoking predict development and persistence of sleep problems in US adolescents. Pediatrics. 2000; 106(2): E23.PubMedCrossRefGoogle Scholar
  7. 7.
    Pagel JF, Forister N, Kwiatkowki C. Adolescent sleep disturbance and school performance: the confounding variable of socioeconomics. J Clin Sleep Med. 2007; 3(1): 19–23.PubMedGoogle Scholar
  8. 8.
    Ivanenko A, Johnson K. Sleep disturbances in children with psychiatric disorders. Semin Pediatr Neurol. 2008; 15(2): 70–78.PubMedCrossRefGoogle Scholar
  9. 9.
    Roane BM, Taylor DJ. Adolescent insomnia as a risk factor for early adult depression and substance abuse. Sleep. 2008; 31(10): 1351–1356.PubMedGoogle Scholar
  10. 10.
    Dahl RE. Biological, developmental, and neurobehavioral factors relevant to adolescent driving risks. Am J Prev Med. 2008; 35(3, Supplement 1): S278–S284.PubMedCrossRefGoogle Scholar
  11. 11.
    Ozminkowski RJ, Wang S, Walsh JK. The direct and indirect costs of untreated insomnia in adults in the United States. Sleep. 2007; 30(3): 263–273.PubMedGoogle Scholar
  12. 12.
    Bolland JM. Hopelessness and risk behaviour among adolescents living in high-poverty inner-city neighbourhoods. J Adolesc. 2003; 26(2): 145–158.PubMedCrossRefGoogle Scholar
  13. 13.
    Bolland JM, Bryant CM, Lian BE, McCallum DM, Vazsonyi AT, Barth JM. Development and risk behavior among African American, Caucasian, and mixed-race adolescents living in high poverty inner-city neighborhoods. Am J Community Psychol. 2007; 40(3–4): 230–249.PubMedCrossRefGoogle Scholar
  14. 14.
    Bolland JM, Lian BE, Formichella CM. The origins of hopelessness among inner-city African-American adolescents. Am J Community Psychol. 2005; 36(3–4): 293–305.PubMedCrossRefGoogle Scholar
  15. 15.
    Bolland JM, McCallum DM. Preventing risk behaviors among inner-city adolescents: a community-based approach to risk reduction. Paper presented at Annual Meeting, American Psychological Association 1998; San Francisco, CA.Google Scholar
  16. 16.
    Bolland JM, McCallum DM. Neighboring and community mobilization in high-poverty inner-city neighborhoods. Urban Aff Rev. 2002; 38(1): 42–69.CrossRefGoogle Scholar
  17. 17.
    Bolland JM, McCallum DM, Lian B, Bailey CJ, Rowan P. Hopelessness and violence among inner-city youths. Matern Child Health J. 2001; 5(4): 237–244.PubMedCrossRefGoogle Scholar
  18. 18.
    Patel SR, Malhotra A, Gottlieb DJ, White DP, Hu FB. Correlates of long sleep duration. Sleep. 2006; 29(7): 881–889.PubMedGoogle Scholar
  19. 19.
    Dahl RE, Lewin DS. Pathways to adolescent health sleep regulation and behavior. J Adolesc Health. 2002; 31(6, Supplement 1): 175–184.PubMedCrossRefGoogle Scholar
  20. 20.
    Carskadon MA, Vieira C, Acebo C. Association between puberty and delayed phase preference. Sleep. 1993; 16(3): 258–262.PubMedGoogle Scholar
  21. 21.
    Ohayon MM, Roberts RE, Zulley J, Smirne S, Priest RG. Prevalence and patterns of problematic sleep among older adolescents. J Am Acad Child Adolesc Psychiatry. 2000; 39(12): 1549–1556.PubMedCrossRefGoogle Scholar
  22. 22.
    Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Med. 2007; 8(6): 602–612.PubMedCrossRefGoogle Scholar
  23. 23.
    Wolfson AR, Carskadon MA. Sleep schedules and daytime functioning in adolescents. Child Dev. 1998; 69(4): 875–887.PubMedGoogle Scholar
  24. 24.
    National Sleep Foundation. 2006 Sleep in America Poll: America’s Sleepy Teens. Washington, DC: National Sleep Foundation; 2006.Google Scholar
  25. 25.
    Scarpa A. Community violence exposure in young adults. Trauma Violence Abuse. 2003; 4(3): 210–227.PubMedCrossRefGoogle Scholar
  26. 26.
    Dahl R. The regulation of sleep-arousal, affect, and attention in adolescence: some questions and speculations. In: Carskadon MA, ed. Adolescent Sleep Patterns: Biological, Social and Psychological Influences. Cambridge, England: Cambridge University Press; 2002: 269–284.Google Scholar
  27. 27.
    Dahl RE. Sleeplessness and aggression in youth. J Adolesc Health. 2006; 38(6): 641–642.PubMedCrossRefGoogle Scholar
  28. 28.
    Dahl RE. Adolescent brain development: a period of vulnerabilities and opportunities. Keynote address. Ann NY Acad Sci. 2004; 1021: 1–22.Google Scholar
  29. 29.
    Beebe DW, Gozal D. Obstructive sleep apnea and the prefrontal cortex: towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. J Sleep Res. 2004; 1021: 1–22.PubMedCrossRefGoogle Scholar
  30. 30.
    Harrison Y, Horne JA. Sleep loss and temporal memory. Q J Exp Psychol A. 2000; 53(1): 271–279.PubMedCrossRefGoogle Scholar
  31. 31.
    Harrison Y, Horne JA, Rothwell A. Prefrontal neuropsychological effects of sleep deprivation in young adults—a model for healthy aging? Sleep. 2000; 23(8): 1067–1073.PubMedGoogle Scholar
  32. 32.
    Dahl RE. The impact of inadequate sleep on children's daytime cognitive function. Semin Pediatr Neurol. 1996; 3(1): 44–50.PubMedCrossRefGoogle Scholar
  33. 33.
    Holmberg LI, Hellberg D. Behavioral and other characteristics of relevance for health in adolescents with self-perceived sleeping problems. Int J Adolesc Med Health. 2008; 20(3): 353–365.PubMedCrossRefGoogle Scholar
  34. 34.
    Ireland JL, Culpin V. The relationship between sleeping problems and aggression, anger, and impulsivity in a population of juvenile and young offenders. J Adolesc Health. 2006; 38(6): 649–655.PubMedCrossRefGoogle Scholar
  35. 35.
    Smaldone A, Honig JC, Byrne MW. Sleepless in America: inadequate sleep and relationships to health and well-being of our nation’s children. Pediatrics. 2007; 119(Suppl 1): S29–S37.PubMedCrossRefGoogle Scholar
  36. 36.
    Jargowsky PA. Poverty and Place: Ghettos, Barrios, and the American City. New York, NY: Russell Sage; 1997.Google Scholar
  37. 37.
    Centers for Disease Control. YRBSS National Trends in Risk Behaviors. 1997–2007. Accessed June 1, 2010.
  38. 38.
    Browne DC, Clubb PA, Aubrecht AMB, Jackson M. Minority health risk behaviors: an introduction to research on sexually transmitted diseases, violence, pregnancy prevention and substance use. Matern Child Health J. 2001; 5: 215–224.PubMedCrossRefGoogle Scholar
  39. 39.
    Anderson E. Code of the Street: Decency, Violence, and the Moral Life of the Inner City. New York, NY: Norton; 1999.Google Scholar
  40. 40.
    Bandura A. Aggression: A Social Learning Analysis. Englewood Cliffs, NJ: Prentice Hall; 1973.Google Scholar
  41. 41.
    Lamborn SD, Mounts NS, Steinberg L, Dornbusch S. Patterns of competence and adjustment among adolescents from authoritative, authoritarian, indulgent, and neglectful families. Child Dev. 1991; 62: 1049–1065.PubMedCrossRefGoogle Scholar
  42. 42.
    Spielberger CD, Sydeman SJ. State-trait anxiety inventory and state-trait anger expression inventory. In: Maruish ME, ed. The Use of Psychological Tests for Treatment Planning and Outcome Assessment. Hillsdale, NJ: Erlbaum; 1994.Google Scholar
  43. 43.
    Harter S. The perceived competence scale for children. Child Dev. 1982; 53: 87–97.CrossRefGoogle Scholar
  44. 44.
    Small S, Rodgers KB. Teen Assessment Project Survey Question Bank. Madison, WI: Center for Action, University of Wisconsin; 1995.Google Scholar
  45. 45.
    Wilson WJ. The Truly Disadvantaged: The Inner City, the Underclass, and Public Policy. Chicago, IL: University of Chicago Press; 1987.Google Scholar
  46. 46.
    Van Meter DS. Alternative methods of measuring change: what difference does it make? Polit Methodol. 1974; 1: 125–140.Google Scholar
  47. 47.
    Granger CWJ. Investigating causal relations by econometric models and cross-spectral methods. Econometrica. 1969; 37: 424–438.CrossRefGoogle Scholar
  48. 48.
    Singer JD, Willett JB. Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence. New York, NY: Oxford University Press; 2003.Google Scholar
  49. 49.
    Duncan G, Yeung WJ, Brooks-gunn J, Smith JR. How much does childhood poverty affect the life chances of children? Am Sociol Rev. 1998; 63: 406–423.CrossRefGoogle Scholar
  50. 50.
    Raver C. Placing emotional self-regulation in sociocultural and socioeconomic contexts. Child Dev. 2004; 75: 346–353.PubMedCrossRefGoogle Scholar
  51. 51.
    Kempf AM, Remington PL. New challenges for telephone survey research in the twenty-first century. Ann Rev Public Health. 2007; 28: 113–126.CrossRefGoogle Scholar
  52. 52.
    American Association for Public Opinion Research, Cell Phone Task Force. Guidelines and considerations for survey researchers when planning and conducting RDD and other telephone surveys in the U.S. with respondents reached via cell phone numbers. Accessed June 1, 2010.

Copyright information

© The New York Academy of Medicine 2011

Authors and Affiliations

  • Mary Grace Umlauf
    • 1
  • John M. Bolland
    • 1
  • Brad E. Lian
    • 1
  1. 1.University of AlabamaTuscaloosaUSA

Personalised recommendations