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Sleepless in Fairfax: The Difference One More Hour of Sleep Can Make for Teen Hopelessness, Suicidal Ideation, and Substance Use

Abstract

Insufficient sleep is a risk factor for depression, suicidality, and substance use, yet little is known about gender, ethnic, and community-level differences in sleep and its associated outcomes, especially during adolescence. Further, much of the prior work has compared groups of teens getting plenty as opposed to insufficient amounts of sleep rather than examine sleep hours continuously. The present study examined adolescent weekday self-reported sleep duration and its links with hopelessness, suicidality, and substance use in a suburban community with very early high school start times. We utilized a large (N = 27,939, 51.2 % female) and ethnically diverse sample of adolescents from the 2009 Fairfax County (Virginia) Youth Survey, an anonymous, self-report, population-level survey administered to all 8th, 10th and 12th grade students in public schools in the county. High-school students reported an average 6.5 h of sleep per school night, with 20 % obtaining ≤5 h, and only 3 % reporting the recommended 9 h/night. Females and minority youth obtained even less sleep on average, and the reduction in sleep in the transition from middle school to high school was more pronounced for females and for Asian students. Hierarchical, multivariate, logistic regression analyses, controlling for background variables, indicated that just 1 h less of weekday sleep was associated with significantly greater odds of feeling hopeless, seriously considering suicide, suicide attempts, and substance use. Relationships between sleep duration and suicidality were stronger for male teens, and sleep duration was more associated with hopelessness for white students compared to most ethnic minority groups. Implications for intervention at multiple levels are discussed.

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Notes

  1. 1.

    We also ran regression models with the substance use composites treated continuously and found the same pattern of results as reported here, with no particular type of substance showing a noticeably different pattern.

  2. 2.

    It is worth noting, however, that whereas we used hours of sleep reported, Maslowsky and Ozer (2014) calculated youth sleep hours on the basis of reported bedtime and waketime. It is not known whether this methodological difference also contributes to the difference observed.

  3. 3.

    Supplemental and parallel logistic regression analyses to those reported here were also done to see if the difference in receiving 9 vs. 10+ hours of sleep mattered for the outcomes. In all cases, the demographic predictors behaved the same as what is reported below. Moving from 9 to 10+ hours of sleep night was not significantly associated with increased hopelessness, but was significantly associated with increased odds of the other four negative health outcomes.

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Author contributions

A.W. conceived of the study, coordinated the project, conducted the final data analyses, reviewed the literature, and drafted most of the manuscript and revisions. R.V. contributed to the conceptualization of the project and writing of the manuscript. P.P. helped conceive of the study and acquire the data, gathered collaborators, and provided input on the writing. A.D. conducted most of the original data analyses, prepared earlier conference presentation versions of the work, and provided input on the writing. M.S.C. contributed to the conceptualization of the project and interpretation of results, reviewed the literature, wrote the first partial draft of the manuscript, and contributed substantially to the writing of subsequent drafts. M.S.C. and R.V. provided critical revisions of the manuscript for important intellectual content. All authors read and approved the final manuscript.

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Winsler, A., Deutsch, A., Vorona, R.D. et al. Sleepless in Fairfax: The Difference One More Hour of Sleep Can Make for Teen Hopelessness, Suicidal Ideation, and Substance Use. J Youth Adolescence 44, 362–378 (2015). https://doi.org/10.1007/s10964-014-0170-3

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Keywords

  • Sleep
  • Adolescents
  • Depression
  • Suicide
  • Substance use