Hasler Brant P, Franzen Peter L, de Zambotti Massimiliano, Prouty Devin, Brown Sandra A, Tapert Susan F, Pfefferbaum Adolf, Pohl Kilian M, Sullivan Edith V, De Bellis Michael D, Nagel Bonnie J, Baker Fiona C, Colrain Ian M, Clark Duncan B
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Center for Health Sciences, SRI International, Menlo Park, California.
Alcohol Clin Exp Res. 2017 Jun;41(6):1154-1165. doi: 10.1111/acer.13401. Epub 2017 May 29.
Abundant cross-sectional evidence links eveningness (a preference for later sleep-wake timing) and increased alcohol and drug use among adolescents and young adults. However, longitudinal studies are needed to examine whether eveningness is a risk factor for subsequent alcohol and drug use, particularly during adolescence, which is marked by parallel peaks in eveningness and risk for the onset of alcohol use disorders. This study examined whether eveningness and other sleep characteristics were associated with concurrent or subsequent substance involvement in a longitudinal study of adolescents.
Participants were 729 adolescents (368 females; age 12 to 21 years) in the National Consortium on Alcohol and Neurodevelopment in Adolescence study. Associations between the sleep variables (circadian preference, sleep quality, daytime sleepiness, sleep timing, and sleep duration) and 3 categorical substance variables (at-risk alcohol use, alcohol bingeing, and past-year marijuana use [y/n]) were examined using ordinal and logistic regression with baseline age, sex, race, ethnicity, socioeconomic status, and psychiatric problems as covariates.
At baseline, greater eveningness was associated with greater at-risk alcohol use, greater bingeing, and past-year use of marijuana. Later weekday and weekend bedtimes, but not weekday or weekend sleep duration, showed similar associations across the 3 substance outcomes at baseline. Greater baseline eveningness was also prospectively associated with greater bingeing and past-year use of marijuana at the 1-year follow-up, after covarying for baseline bingeing and marijuana use. Later baseline weekday and weekend bedtimes, and shorter baseline weekday sleep duration, were similarly associated with greater bingeing and past-year use of marijuana at the 1-year follow-up after covarying for baseline values.
Findings suggest that eveningness and sleep timing may be under recognized risk factors and future areas of intervention for adolescent involvement in alcohol and marijuana that should be considered along with other previously identified sleep factors such as insomnia and insufficient sleep.
大量横断面证据表明,晚睡倾向(偏好较晚的睡眠-觉醒时间)与青少年和青年饮酒及药物使用增加有关。然而,需要纵向研究来检验晚睡倾向是否是随后饮酒和药物使用的风险因素,尤其是在青少年时期,这一时期晚睡倾向和酒精使用障碍发病风险同时达到峰值。本研究在一项青少年纵向研究中检验了晚睡倾向和其他睡眠特征是否与同时期或随后的物质使用有关。
参与者为青少年酒精与神经发育全国联盟研究中的729名青少年(368名女性;年龄12至21岁)。使用有序回归和逻辑回归,以基线年龄、性别、种族、民族、社会经济地位和精神问题作为协变量,检验睡眠变量(昼夜偏好、睡眠质量、白天嗜睡、睡眠时间和睡眠时长)与3个分类物质变量(危险饮酒、酗酒和过去一年使用大麻[是/否])之间的关联。
在基线时,更高的晚睡倾向与更高的危险饮酒、更多的酗酒以及过去一年使用大麻有关。工作日和周末较晚的就寝时间,但不是工作日或周末的睡眠时间,在基线时的3种物质使用结果中显示出类似的关联。在对基线时的酗酒和大麻使用进行协变量调整后,更高的基线晚睡倾向在1年随访时也与更多的酗酒和过去一年使用大麻有关。在对基线值进行协变量调整后,基线时工作日和周末较晚的就寝时间以及较短的工作日睡眠时间,在1年随访时同样与更多的酗酒和过去一年使用大麻有关。
研究结果表明,晚睡倾向和睡眠时间可能是未被充分认识的风险因素,是青少年饮酒和使用大麻未来的干预领域,应与其他先前确定的睡眠因素(如失眠和睡眠不足)一起考虑。