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Phiri D, Amelia VL, Muslih M, Dlamini LP, Chung MH, Chang PC. Prevalence of sleep disturbance among adolescents with substance use: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2023; 17:100. [PMID: 37633926 PMCID: PMC10464186 DOI: 10.1186/s13034-023-00644-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/24/2023] [Indexed: 08/28/2023] Open
Abstract
PURPOSE Sleep disturbance has become a major challenge among adolescents worldwide. Substance use is among the most common factors contributing to sleep disturbance. This systematic review and meta-analysis examined the prevalence and categories of sleep disturbance among adolescents with substance use. METHODS We comprehensively searched for relevant studies published in the following databases from inception to August 2022: CINHAL (via EBSCOhost), PubMed, Scopus, Ovid Medline, Embase, ProQuest, and Web of Science. Data analysis was performed using Comprehensive Meta-Analysis version 3 software. We used a random-effects model to pool prevalence rates with 95% confidence intervals (CIs). Forest plots and p values for the Cochran Q statistic were used to evaluate heterogeneity among studies. Subgroup and meta-regression analyses were performed to compare the groups and identify the sources of heterogeneity. RESULTS We examined 18 studies that reported insomnia, hypersomnolence, sleep-related breathing disorders as sleep disturbances among adolescents with the use of alcohol, smoking, marijuana, and coffee. The total sample was 124,554. The overall prevalence rate of sleep disturbance was 29% (95% CI: 0.201-0.403). Subgroup analysis revealed that the prevalence rates of insomnia and hypersomnolence were higher among alcohol users (31%; 95% CI: 0.100-0.654) and smokers (46%; 95% CI: 0.232-0.700). The study design and method of assessment groups were the significant moderators that showed the source of variation in the included studies. CONCLUSION Sleep disturbance is highly prevalent among adolescents with substance use. Insomnia and hypersomnolence are more prevalent among alcohol users and smokers, respectively. On the basis of our findings, health-care providers can develop effective targeted interventions to reduce substance use, prevent sleep disturbance, and promote healthy sleep habits among adolescents.
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Affiliation(s)
- Doreen Phiri
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Vivi Leona Amelia
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Universitas Muhammadiyah Purwokerto, Purwokerto, Central Java, Indonesia
| | - Muhammad Muslih
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- School of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, Indonesia
| | | | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
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Hasler BP, Graves JL, Wallace ML, Claudatos S, Franzen PL, Nooner KB, Brown SA, Tapert SF, Baker FC, Clark DB. Self-reported sleep and circadian characteristics predict alcohol and cannabis use: A longitudinal analysis of the National Consortium on Alcohol and Neurodevelopment in Adolescence Study. Alcohol Clin Exp Res 2022; 46:848-860. [PMID: 35579668 DOI: 10.1111/acer.14808] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Growing evidence indicates that sleep characteristics predict future substance use and related problems. However, most prior studies assessed a limited range of sleep characteristics, studied a narrow age span, and included few follow-up assessments. Here, we used six annual assessments from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study, which spans adolescence and young adulthood with an accelerated longitudinal design, to examine whether multiple sleep characteristics in any year predict alcohol and cannabis use the following year. METHODS The sample included 831 NCANDA participants (423 females; baseline age 12-21 years). Sleep variables included circadian preference, sleep quality, daytime sleepiness, the timing of midsleep (weekday/weekend), and sleep duration (weekday/weekend). Using generalized linear mixed models (logistic for cannabis; ordinal for binge severity), we tested whether each repeatedly measured sleep characteristic (years 0-4) predicted substance use (alcohol binge severity or cannabis use) the following year (years 1-5), covarying for age, sex, race, visit, parental education, and previous year's substance use. RESULTS Greater eveningness, more daytime sleepiness, later weekend sleep timing, and shorter sleep duration (weekday/weekend) all predicted more severe alcohol binge drinking the following year. Only greater eveningness predicted a greater likelihood of any cannabis use the following year. Post-hoc stratified exploratory analyses indicated that some associations (e.g., greater eveningness and shorter weekend sleep duration) predicted binge severity only in female participants, and that middle/high school versus post-high school adolescents were more vulnerable to sleep-related risk for cannabis use. CONCLUSIONS Our findings support the relevance of multiple sleep/circadian characteristics in the risk for future alcohol binge severity and cannabis use. Preliminary findings suggest that these risk factors vary based on developmental stage and sex. Results underscore a need for greater attention to sleep/circadian characteristics as potential risk factors for substance use in youth and may inform new avenues to prevention and intervention.
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Affiliation(s)
- Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jessica L Graves
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kate B Nooner
- University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Sandra A Brown
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Sattler S, Seddig D, Zerbini G. Assessing sleep problems and daytime functioning: a translation, adaption, and validation of the Athens Insomnia Scale for non-clinical application (AIS-NCA). Psychol Health 2021:1-26. [PMID: 34766856 DOI: 10.1080/08870446.2021.1998498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE & DESIGN Sleep problems are common and have been linked to health problems, diminished well-being, and impaired performance. Many scales to diagnose clinically relevant sleep problems are time-consuming, complex, and difficult to administer in non-clinical and multi-thematic studies. Through a multi-stage translation (from English to German) and scale testing process, we developed a parsimonious measure of sleep problems and daytime functioning for non-clinical applications based on the Athens Insomnia Scale. Results: Exploratory (NStudy 1 = 25,140) and confirmatory (NStudy 2 = 14,797) factor analyses suggest a two-dimensional structure with the subscales "sleep problems" and "daytime functioning". Internal scale consistency was acceptable. Measurement invariance was found across time, gender, age, and diagnosed sleep disorders. The scale discriminates between people with and without sleep disorders and predicts emerging sleep disorders. Short-term retest reliability was acceptable (NStudy 3 = 78). Convergent validity with other sleep measures and discriminant validity with indicators of well-being were observed (NStudy 4 = 341). After a multi-stage translation to English, we confirmed the factor structure and found measurement invariance across languages (NStudy 5 = 623). Conclusion: Our short 7-item scale has good psychometric properties and is suitable for self-administration, making it useful in measuring sleep problems and daytime functioning efficiently and reliably, especially for large population studies.
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Affiliation(s)
- Sebastian Sattler
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany.,Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Canada.,Faculty of Sociology, Bielefeld University, Bielefeld, Germany
| | - Daniel Seddig
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
| | - Giulia Zerbini
- Department of Medical Psychology and Sociology, Medical Faculty, Augsburg University, Augsburg, Germany
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Malhotra CK, Gunge D, Advani I, Boddu S, Nilaad S, Crotty Alexander LE. Assessing the potential impact of age and inhalant use on sleep in adolescents. J Clin Sleep Med 2021; 17:2233-2239. [PMID: 34027889 PMCID: PMC8636377 DOI: 10.5664/jcsm.9414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Targeted marketing has caused a recent surge in teen electronic cigarette usage. In all-age surveys, we isolated adolescent data (13-20 years) to assess age alongside electronic cigarettes, traditional tobacco, and dual usage of both with sleep quality and cough. Based on existing adult literature, we hypothesized an association between dual usage and increased sleep latency. METHODS Participants were recruited to complete surveys via social media sites. We performed 3 surveys: Survey 1 (n = 347) in 2018, Survey 2 (n = 1198) in 2019, Survey 3 (n = 554) in 2020. Surveys 1 and 2 had 3 sections: UCSD Inhalant Use Survey, Pittsburgh Sleep Quality Index, and Leicester Cough Questionnaire. Survey 3 did not include the Leicester Cough Questionnaire, instead the Hospital Anxiety and Depression Scale and Patient Health Questionnaire were used. The adolescent data were isolated (n = 609). RESULTS Adolescents reported longer sleep duration with increasing age by one-way analysis of variance. By Tukey's multiple comparisons test, females slept more at ages 19 and 20 years than at age 14 years (P < .01). Female dual users slept more than nonsmokers, (P = .01; mean difference 43.8 minutes; confidence interval = 0.11 to 1.36). We observed an association between dual use and sleep latency vs nonsmokers (P = .0008; mean difference 6.27 minutes; confidence interval = 1.40 to 11.13). We saw no correlation between inhalant use and cough. CONCLUSIONS In females, we observed a peak in sleep hours at age 19 years. College-aged females may wake later than younger adolescent females. The data also raised concern for sleep disruption and nicotine-induced wakefulness. Further data are required to guide public health strategies. CITATION Malhotra CK, Gunge D, Advani I, Boddu S, Nilaad S, Crotty Alexander LE. Assessing the potential impact of age and inhalant use on sleep in adolescents. J Clin Sleep Med. 2021;17(11):2233-2239.
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Affiliation(s)
- Clare Kamini Malhotra
- Pulmonary Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, California
| | - Deepti Gunge
- Pulmonary Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, California
| | - Ira Advani
- Pulmonary Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, California
| | - Shreyes Boddu
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, California
| | - Sedtavut Nilaad
- Pulmonary Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, California
| | - Laura E. Crotty Alexander
- Pulmonary Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, California,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, California,Address correspondence to: Laura E. Crotty Alexander, MD, UCSD 9500 Gilman Dr, MC 9111J, San Diego, CA 92093;
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