Sleep Well, Study Well: A Systematic Review of Longitudinal Studies on the Interplay between Sleep and School Experience in Adolescence

Data-driven, generalizable prediction of adolescent sleep disturbances in the multisite Adolescent Brain Cognitive Development Study

STUDY OBJECTIVES

Sleep disturbances are common in adolescence and associated with a host of negative outcomes. Here, we assess associations between multifaceted sleep disturbances and a broad set of psychological, cognitive, and demographic variables using a data-driven approach, canonical correlation analysis (CCA).

METHODS

Baseline data from 9093 participants from the Adolescent Brain Cognitive Development (ABCD) Study were examined using CCA, a multivariate statistical approach that identifies many-to-many associations between two sets of variables by finding combinations for each set of variables that maximize their correlation. We combined CCA with leave-one-site-out cross-validation across ABCD sites to examine the robustness of results and generalizability to new participants. The statistical significance of canonical correlations was determined by non-parametric permutation tests that accounted for twin, family, and site structure. To assess the stability of the associations identified at baseline, CCA was repeated using 2-year follow-up data from 4247 ABCD Study participants.

RESULTS

Two significant sets of associations were identified: (1) difficulty initiating and maintaining sleep and excessive daytime somnolence were strongly linked to nearly all domains of psychopathology (r2 = 0.36, p < .0001); (2) sleep breathing disorders were linked to BMI and African American/black race (r2 = 0.08, p < .0001). These associations generalized to unseen participants at all 22 ABCD sites and were replicated using 2-year follow-up data.

CONCLUSIONS

These findings underscore interwoven links between sleep disturbances in early adolescence and psychological, social, and demographic factors.

A meta-analysis of longitudinal studies on the interplay between sleep, mental health, and positive well-being in adolescents

Objective

This review aimed to summarize longitudinal research about the interplay between sleep, mental health, and positive well-being in adolescents.

Method

Multiple search strategies were applied until 28th January 2023 to identify relevant research published in peer-reviewed journal articles or available grey literature. A final set of 63 studies were included in the systematic review and 42 in the meta-analysis.

Results

Results highlighted that long sleep duration, good sleep quality, and low insomnia symptoms were bidirectionally related to lower internalizing (Sleep T1 → Internalizing symptoms T2: r = -.20, p < .001; Internalizing symptoms T1 → Sleep T2: r = -.21, p < .001) and externalizing (Sleep T1 → Externalizing symptoms T2: r = -.15, p < .001; Externalizing symptoms T1→ Sleep T2: r = -.17, p < .001) symptoms, and to higher levels of psychological well-being (Sleep T1 → Psychological well-being T2: r = .15, p < .001; Psychological well-being T1 → Sleep T2: r = .15, p < .05). Moreover, good sleep was positively related to higher subjective well-being at a later time point (r = .18, p < .001).

Conclusions

Overall, these findings suggest a bidirectional relation between different aspects of sleep, mental health, and positive well-being.

The Longitudinal Interplay between Sleep, Anthropometric Indices, Eating Behaviors, and Nutritional Aspects: A Systematic Review and Meta-Analysis

Sleep is fundamental for adolescents' healthy development but undergoes dramatic changes in quantity and quality due to the conflict between biological and social rhythms. Insufficient sleep has been associated with worse physical health status and irregular eating behaviors in adolescents. This review aims to systematically synthesize the longitudinal associations between adolescents' sleep dimensions (i.e., duration, timing, quality, and insomnia symptoms) and physical health indicators (i.e., anthropometric indices, fat percentage, and risk of obesity), eating behaviors, and nutritional aspects (i.e., type of diet related to the intake of specific foods and nutrients, amount and timing of food consumption, energy expenditure). A total of 28 longitudinal studies were included. The meta-analytic results showed that longer sleep duration, better sleep quality, and lower insomnia symptoms were associated with lower BMI and fat percentage and that shorter sleep duration (<7 h) and lower sleep quality were associated with a higher risk of obesity. Conversely, anthropometric indices were not related to sleep over time. Limited literature examined the bidirectional association between adolescents' sleep and their eating behaviors and nutritional aspects. Such knowledge sheds new light on the role of sleep for adolescents' health, highlighting the need to examine further the interplay between these variables.