Regularity and Timing of Sleep Patterns and Behavioral Health Among Adolescents.

Journal Article (Journal Article)

OBJECTIVE: Sleep is vital to supporting adolescent behavioral health and functioning; however, sleep disturbances remain under-recognized and undertreated in many health care settings. One barrier is the complexity of sleep, which makes it difficult for providers to determine which aspects-beyond sleep duration-may be most important to assess and treat to support adolescent health. This study examined associations between 2 sleep indices (regularity and timing) and adolescent behavioral health and functioning over and above the impact of shortened/fragmented sleep. METHOD: Eighty-nine adolescents recruited from the community (mean age = 14.04, 45% female participants) completed 7 days/nights of actigraphy and, along with a parent/guardian, reported on behavioral health (internalizing and externalizing symptoms) and psychosocial functioning. Stepwise linear regressions examined associations between sleep timing and regularity and behavioral/functional outcomes after accounting for shortened/fragmented sleep. RESULTS: Delayed sleep timing was associated with greater self-reported internalizing (F[6,82] = 11.57, p = 0.001) and externalizing (F[6,82] = 11.12, p = 0.001) symptoms after accounting for shortened/fragmented sleep. Irregular sleep was associated with greater self-reported and parent-reported externalizing symptoms (self: F[7,81] = 6.55, p = 0.01; parent: F[7,80] = 6.20, p = 0.01) and lower psychosocial functioning (self: F[7,81] = 6.03, p = 0.02; parent: F[7,78] = 3.99, p < 0.05) after accounting for both shortened/fragmented sleep and delayed sleep timing. CONCLUSION: Sleep regularity and timing may be critical for understanding the risk of poor behavioral health and functional deficits among adolescents and as prevention and intervention targets. Future work should focus on developing and evaluating convenient, low-cost, and effective methods for addressing delayed and/or irregular adolescent sleep patterns in real-world health care settings.

Full Text

Duke Authors

Cited Authors

  • Lunsford-Avery, JR; Wang, KW; Kollins, SH; Chung, RJ; Keller, C; Engelhard, MM

Published Date

  • May 1, 2022

Published In

Volume / Issue

  • 43 / 4

Start / End Page

  • 188 - 196

PubMed ID

  • 34698705

Pubmed Central ID

  • PMC9035469

Electronic International Standard Serial Number (EISSN)

  • 1536-7312

Digital Object Identifier (DOI)

  • 10.1097/DBP.0000000000001013


  • eng

Conference Location

  • United States