What helps and what hurts adolescents' sleep? An intense longitudinal ecological momentary assessment of daily facilitators and barriers of sleep on school and non-school nights.

OBJECTIVE

Using an intense longitudinal design, we investigated adolescents' perceptions of everyday factors facilitating (i.e., facilitators) and hindering (i.e., barriers) sufficient and good quality sleep.

METHOD

Adolescents (N = 205, M = 16.9 ± 0.9, 54.1 % female, 64.4 % non-white) completed daily morning surveys, assessing self-reported sleep and the use of 8 facilitators and 6 barriers of sleep from the previous night, and wore actigraphs over 2 school-weeks followed by 2 vacation-weeks (5162 total observations). Linear mixed-effects models examined the contribution of facilitators/barriers to actigraphy and self-reported total sleep time (TST) and sleep onset latency (SOL), controlling for age, sex, race, and study day. School/non-school day status was included as a moderator.

RESULTS

Seven facilitators and two barriers were reported by >30 % of adolescents as frequently (≥50 % nights) helping/preventing them from achieving good sleep. Facilitators or barriers explained 1-5% (p-values <.001) of unique variance above and beyond the covariates. Facilitators that predicted better sleep were: following body cues, managing thoughts and emotions, creating good sleep environment, avoiding activities interfering with sleep, and bedtime planning (only TST on school nights). Barriers that predicted worse sleep were: pre-bed thoughts and emotions, unconducive sleep environment, activities interfering with sleep, inconsistent routines, and other household members' activities.

CONCLUSION

Adolescents use a range of sleep-facilitating behaviours, and a number of factors prevent sufficient and good quality sleep in their everyday life. These factors are predictive of their sleep duration and onset latency and require further research to understand their functions and clinical implications.