The hazards of bad sleep-Sleep duration and quality as predictors of adolescent alcohol and cannabis use.

BACKGROUND: Although an association between adolescent sleep and substance use is supported by the literature, few studies have characterized the longitudinal relationship between early adolescent sleep and subsequent substance use. The current study examined the prospective association between the duration and quality of sleep at age 11 and alcohol and cannabis use throughout adolescence.

METHODS: The present study, drawn from a cohort of 310 boys taking part in a longitudinal study in Western Pennsylvania, includes 186 boys whose mothers completed the Child Sleep Questionnaire; sleep duration and quality at age 11 were calculated based on these reports. At ages 20 and 22, participants were interviewed regarding lifetime alcohol and cannabis use. Cox proportional hazard analysis was used to determine the association between sleep and substance use.

RESULTS: After accounting for race, socioeconomic status, neighborhood danger, active distraction, internalizing problems, and externalizing problems, both the duration and quality of sleep at age 11 were associated with multiple earlier substance use outcomes. Specifically, less sleep was associated with earlier use, intoxication, and repeated use of both alcohol and cannabis. Lower sleep quality was associated with earlier alcohol use, intoxication, and repeated use. Additionally, lower sleep quality was associated with earlier cannabis intoxication and repeated use, but not first use.

CONCLUSIONS: Both sleep duration and sleep quality in early adolescence may have implications for the development of alcohol and cannabis use throughout adolescence. Further studies to understand the mechanisms linking sleep and substance use are warranted.