Journal of Youth and Adolescence

, Volume 30, Issue 1, pp 1–18 | Cite as

Functioning of Adolescents With Symptoms of Disturbed Sleep

  • Robert E. Roberts
  • Catherine R. Roberts
  • Irene G. Chen


The objective of the study was to examine the association between disturbed sleep and the functioning of adolescents, in particular cumulative effects on functioning across multiple life domains. Data from a large, school-based survey (n = 5,423) were used to examine the association between eight indicators of psychological, interpersonal, and somatic functioning and symptoms of insomnia and hypersomnia among adolescents. The strongest correlates of insomnia were disturbed mood (OR = 5.9), fatigue (OR = 7.4), and suicidal ideation (OR = 3.4). The same pattern held for hypersomnia, although the associations were not as strong for fatigue (OR = 6.8), mood disturbance (OR = 3.5), and suicide ideation (OR = 2.8). Youths who experienced both insomnia and hypersomnia had greater odds of psychological, interpersonal, and somatic dysfunction than youths who had experienced only one sleep disturbance. Cumulative effects of sleep problems were pronounced, with 27.6% of those with hypersomnia, 41.7% of those with insomnia, and 59.2% of those with both sleep problems reporting three or more types of dysfunction. The results suggest that adolescents experiencing disturbed sleep also experience a range of deficits in functioning. Further, youths with disturbed sleep are more likely to manifest multiple deficits in functioning. From the available evidence, however, it is not possible to specify what the causal pathways are. What are needed are cohort studies designed to examine the association of disturbed sleep and functional impairment among adolescents prospectively.


Cohort Study Strong Correlate Suicidal Ideation Sleep Disturbance Functional Impairment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th Ed.). Author, Washington, DC.Google Scholar
  2. Breslau, N., Roth, T., Rosenthal, L., and Andreski, P. (1996). Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young adults. Biol. Psychiat. 39: 411–418.Google Scholar
  3. Canino, G., Bird, H., Rubio-Stipec, M., and Bravo, M. (1995). Child psychiatric epidemiology: What we have learned and what we need to learn. Int. J. Meth Psychiat. Res. 5: 79–92.Google Scholar
  4. Caron, C., and Rutter, M. (1991). Comorbidity in child psychopathology: Concepts, issues, and research strategies. J. Child Psychol. Psychiat. 32: 1063–1080.Google Scholar
  5. Carskadon, M. A. (1990). Patterns of sleep and sleepiness in adolescents. Pediatrician 17: 5–12.Google Scholar
  6. Choquet, M., Kovess, V., and Poutignat, N. (1993). Suicidal thoughts among adolescents: An intercultural approach. Adolescence 28(111): 649–659.Google Scholar
  7. Choquet, M., and Menke, H. (1987). Development of self-perceived risk behavior and psychosomatic symptoms in adolescents: A longitudinal approach. J. Adolesc. 10: 291–308.Google Scholar
  8. Dahl, R. E. (1996). The impact of inadequate sleep on children's daytime cognitive function. Seminars Pediat. Neurol. 3(1): 44–50.Google Scholar
  9. Donovan, J. E., Jessor, R., and Coast, F. M. (1993). Structure of health-enhancing behavior in adolescence: A latent-variable approach. J. Health Soc. Behav. 34: 346–362.Google Scholar
  10. Dryman, A., and Eaton, W.W. (1991). Affective symptoms associated with the onset of major depression in the community: Findings from the US National Institute of Mental Health Epidemiologic Catchment Area Program. Acta Psychiat. Scan. 84: 1–5.Google Scholar
  11. Dubnoff, S. (1985). How much income is enough? Measuring public judgments. Pub. Opinion Q. 19: 285–299.Google Scholar
  12. Ford, D. E., and Kamerow, D. B. (1989). Epidemiologic study of sleep disturbances and psychiatric disorders: An opportunity for prevention? JAMA 262: 1479–1484.Google Scholar
  13. Gore, S., Aseltine, R. H., and Colton, M. E., Jr. (1992). Social structure, life stress, and depressive symptoms in high school-aged population. J. Health Soc. Behav. 33: 97–113.Google Scholar
  14. Hauri, P., and Sobel, R. (1977). Sleep and sleep pathology in rural 19-year olds. Sleep Res. 6: 96.Google Scholar
  15. Hosmer, D. W., and Lemeshow, S. (1989). Applied logistic regression. John Wiley and Sons, New York.Google Scholar
  16. Jessor, R. (1993). Successful adolescent development among youth in high-risk settings. Am. Psychol. 48: 117–126.Google Scholar
  17. Jessor, R., and Jessor, S. L. (1977). Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth. Academic Press, New York.Google Scholar
  18. Kirmil-Gray, K., Eagleston, J. R., Gibson, E., and Thoresen, C. E. (1984). Sleep disturbance in adolescents: Sleep quality, sleep habits, beliefs about sleep, and daytime functioning. J. Youth Adolesc. 13(5): 375–384.Google Scholar
  19. Kripke, D. F., Simons, R. N., Garfinkel, L., and Hammond, E. C. (1979). Short and long sleep and sleeping pills: Is increased mortality associated? Arch. Gen. Psychiat. 36: 103–116.Google Scholar
  20. Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. P., and Andrews, J. A. (1993). Adolescent psychopathology 1: Prevalence and incidence of depression and other DSM-III-R disorders in high school students. J. Abnorm. Psychol. 102: 133–144.Google Scholar
  21. Liu, X., Uchiyama, M., Okawa, M., and Kurita, H. (2000). Prevalence and correlates of self-reported sleep problems among Chinese adolescents. Sleep 23: 27–34.Google Scholar
  22. Mahon, N. E. (1995). The contributions of sleep to perceived health status during adolescence. Pub. Health Nurs. 12(2): 127–133.Google Scholar
  23. Marks, P. A., and Monroe, L. J. (1976). Correlates of adolescent poor sleepers. J. Abnorm. Psychol. 85(2): 243–246.Google Scholar
  24. McGee, L., and Newcomb, M. D. (1992). General deviance syndrome: Expanded hierarchical evaluations at four ages from early adolescence to adulthood. J. Consul. Clin. Psychol. 60: 766 776.Google Scholar
  25. Mercer, R. T. (1979). The well adolescent. In Mercer, R. T. (ed.), Perspectives on Adolescent Health Care. Lippincott, Philadelphia, PA.Google Scholar
  26. Montgomery, G. K. (1983). Uncommon tiredness among college undergraduates. J. Consul. Psychol. 51(4): 517–525.Google Scholar
  27. Morrison, D. N., McGee, R., and Stanton, V. V. R. (1992). Sleep problems in adolescence. J. Am. Acad. Child Adolesc. Psychiat. 31(1): 94–99.Google Scholar
  28. National Institute of Mental Health (1992). Diagnostic Interview Schedule for Children: Child Informant Interview About Self. NIMH Contract No. 278-89-0001.Google Scholar
  29. Newcomb, M. D., and McGee, L. (1991). The influence of sensation seeking on general deviance and specific problem behaviors from adolescence to young adulthood. J. Per. Soc. Psychol. 61: 614–628.Google Scholar
  30. Norusis, M. J./SPSS Inc. (1997). SPSS 7.5. SPSS Professional Statistics 7.5.Google Scholar
  31. Ohayon, M. M., Caulet, M., Priest, R. G., and Guilleminault, C. (1997). DSM-IV and ICD-90 insomnia symptoms and sleep dissatisfaction. Br. J. Psychiat. 171: 382–388.Google Scholar
  32. Ortegon, J. (1998). Sleep Disturbance, Depressive Symptoms, and Suicidal Ideation Among Mexican American and Anglo Youth. Unpublished Master's Thesis, School of Public Health, University of Texas Houston, Houston, Texas.Google Scholar
  33. Pilcher, J. J., Ginter, D. R., and Sadowsky, B. (1997). Sleep quality versus sleep quantity: Relationships between sleep and measures of health, well-being and sleepiness in college students. J. Psychosom. Res. 42(6): 583–596.Google Scholar
  34. Pilcher, J. J., and Huffcutt, A. J. (1996). Effects of sleep deprivation on performance: A meta-analysis. Sleep 19(4): 318–326.Google Scholar
  35. Price, V. A., Coates, T. J., Thorensen, C. E., and Grinstead, O. A. (1978). Prevalence and correlates of poor sleep among adolescents. Am. J. Dis. Child 132: 583–586.Google Scholar
  36. Roberts, R. E., Attkisson, C. C., and Rosenblatt, A. (1998a). Prevalence of psychopathology among children and adolescents. Am. J. Psychiat. 155: 715–725.Google Scholar
  37. Roberts, R. E., and Chen, Y.-W. (1995). Depressive symptoms and suicidal ideation among Mexican origin and Anglo adolescents. J. Am. Acad. Child Adolesc. Psychiat. 34: 81–90.Google Scholar
  38. Roberts, R. E., Roberts, C. R., and Chen, Y.-R. (1995). Ethnicity as a Risk Factor for Adolescent Depression. Presented at the World Psychiatric Association meeting, NY.Google Scholar
  39. Roberts, R. E., Roberts, C. R., and Chen, Y. R. (1997). Ethnocultural differences in the prevalence of adolescent depression. Am. J. Commun. Psychol. 25: 95–110.Google Scholar
  40. Roberts, R. E., Roberts, C. R., and Chen, Y. R. (1998b). Suicidal thinking among adolescents with a history of attempted suicide. J. Am. Acad. Child Adolesc. Psychiat. 37: 1294–1300.Google Scholar
  41. Rodin, J., McAvay, G., and Timko, C. A. (1988). Longitudinal study of depressed mood and sleep disturbances in elderly adults. J. Gerontol. 43: 45–53.Google Scholar
  42. Sadeh, A., McGuire, J. P. D., Sachs, H., Seifer, R., Tremblay, A., Civita, R., and Hayden, R. M. (1995). Sleep and psychological characteristics of children on a psychiatric inpatient unit. J. Am. Acad. Child Adolesc. Psychiat. 34(6): 813–819.Google Scholar
  43. Shaffer, D., Fisher, P., Dulcan, M. K., Davies, M., Piacentini, J., Schwab-Stone, M. E., Lahey, B. B., Bourdon, K., Jensen, P. S., Bird, H. R., Canino, G., and Regier, D.A. (1996). TheNIMHDiagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA study. J. Am. Acad. Child Adolesc. Psychiatr. 35: 865–877.Google Scholar
  44. Strauch, I., and Meier, B. (1988). Sleep needs in adolescence: A longitudinal approach. Sleep 11(4): 378–386.Google Scholar
  45. Tynjälä, J., Kanna, L., and Välimaa, R. (1993). How young Europeans sleep. Health Educ. Res. 8(1): 69–80.Google Scholar
  46. Vignau, J., Bailly, D., Duhamel, A., Bervaecke, P., Beuscart, R., and Collinet, C. (1997). Epidemiologic study of sleep quality and troubles in French secondary school adolescents. J. Adolesc. Health 21: 343–350.Google Scholar
  47. Zimet, C., Dahlem, N., Zimet, S., and Farley, G. (1988). The multidimensional scale of perceived social support. J. Pers. Assess. 52: 30–41.Google Scholar

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Robert E. Roberts
    • 1
  • Catherine R. Roberts
    • 2
  • Irene G. Chen
    • 3
  1. 1.Behavioral Sciences and International and Family Health, School of Public HealthThe University of Texas at HoustonUSA
  2. 2.Department of Psychiatry and Behavioral SciencesThe University of Texas-Houston Health Science CenterUSA
  3. 3.School of Public HealthThe University of Texas at HoustonUSA

Personalised recommendations