Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
J Child Psychol Psychiatry. 2023 Jan;64(1):175-184. doi: 10.1111/jcpp.13683. Epub 2022 Aug 11.
There is growing evidence for the role of circadian factors in adolescents' sleep and academic adjustment, with greater evening preference being linked to poorer academic functioning. However, studies have yet to evaluate this association prospectively in adolescence, nor have studies examined daytime sleepiness as a putative mechanism linking evening preference to poor academic functioning. The current study used a multi-informant design to test the prospective association of evening circadian preference, daytime sleepiness, and academic functioning (e.g., global academic impairment and grades) across 2 years in adolescence. As evening circadian preference, sleepiness, and academic problems are elevated in adolescents with ADHD, we used a sample enriched for adolescents with ADHD and explored whether ADHD moderated effects.
Participants were 302 adolescents (M = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD). In the fall of eighth grade, adolescents reported on their circadian preference, and in the fall of ninth grade, adolescents and parents completed ratings of daytime sleepiness. In the middle of 10th grade, parents and teachers reported on adolescents' academic impairment and at the end of 10th grade, adolescents' grade point average (GPA) was obtained from school records.
Above and beyond covariates (e.g., adolescent sex, ADHD status, medication, sleep duration) and baseline academic impairment, greater self-reported evening preference in 8th grade predicted increased parent ratings of academic impairment in 10th grade indirectly via adolescent and parent ratings of daytime sleepiness in 9th grade. Furthermore, evening preference in 8th grade predicted greater teacher ratings of academic impairment and lower average GPA in 10th grade via parent ratings of daytime sleepiness in 9th grade, controlling for covariates and baseline GPA. ADHD status did not moderate indirect effects.
Findings underscore daytime sleepiness as a possible intervening mechanism linking evening preference to poor academic functioning across adolescence. Intervention studies are needed to evaluate whether targeting circadian preference and sleepiness improves academic functioning in adolescents.
越来越多的证据表明，昼夜节律因素在青少年的睡眠和学业适应中起作用，晚上偏好较强与较差的学业功能有关。然而，研究尚未在青少年中前瞻性地评估这种关联，也没有研究检查白天嗜睡作为将晚上偏好与较差的学业功能联系起来的潜在机制。本研究使用多信息源设计，在青少年中前瞻性地测试了晚上昼夜节律偏好、白天嗜睡和学业功能（例如，全球学业障碍和成绩）之间的关联，时间跨度为 2 年。由于 ADHD 青少年的晚上昼夜节律偏好、嗜睡和学业问题较高，我们使用了一个 ADHD 青少年丰富的样本，并探索了 ADHD 是否调节了这些影响。
参与者为 302 名青少年（M = 13.17 岁；44.7%女性；81.8%白人；52%患有 ADHD）。在八年级秋季，青少年报告了他们的昼夜节律偏好，在九年级秋季，青少年和家长完成了白天嗜睡的评定。在 10 年级中期，家长和老师报告了青少年的学业障碍，在 10 年级结束时，从学校记录中获得了青少年的平均绩点（GPA）。
除了协变量（例如，青少年性别、ADHD 状态、药物治疗、睡眠时长）和基线学业障碍外，8 年级时自我报告的晚上偏好越高，9 年级时青少年和家长的白天嗜睡评定越高，间接预测 10 年级时家长的学业障碍评定越高。此外，8 年级时的晚上偏好通过 9 年级时家长的白天嗜睡评定，预测 10 年级时教师对学业障碍的评定越高和平均 GPA 越低，控制了协变量和基线 GPA。ADHD 状态没有调节间接影响。
研究结果强调了白天嗜睡作为将晚上偏好与较差的学业功能联系起来的潜在机制。需要进行干预研究，以评估针对昼夜节律偏好和嗜睡是否能改善青少年的学业功能。
