Devine Emma K, Green ReJoyce, Visontay Rachel, Byrne Hollie, Riches Julia, Elliott Elizabeth J, Newton Nicola C, Squeglia Lindsay M, Mewton Louise, Stapinski Lexine A
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney. Sydney, Australia.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.
medRxiv. 2025 May 14:2025.05.14.25327575. doi: 10.1101/2025.05.14.25327575.
This study investigated the associations between prenatal alcohol exposure (PAE), including low and moderate levels of exposure, and sleep outcomes in adolescence. This is an area that remains understudied despite evidence linking PAE to poor sleep in younger children and the growing recognition of harms associated with low levels of PAE.
Participants were 10,336 adolescents (aged 12-13) from the fourth assessment wave of the Adolescent Brain Cognitive Development Study. Cross-sectional generalised linear mixed models and generalised additive mixed models were used to assess the impact of prenatal alcohol exposure, conceptualised as the presence and absence of PAE, total drinks consumed during pregnancy (i.e. dose), and patterns of PAE (i.e., abstainers, light reducing, light stable, heavy reducing), on adolescent sleep outcomes.
Adolescents with any PAE experienced worse sleep outcomes compared to those without, with the sleep-wake transitions and excessive somnolence being the domains most impacted. A non-linear dose effect was observed, whereby worse sleep-wake transitions occurred predominantly with low levels of exposure. In addition, those in the group with a light reducing pattern of PAE, compared to abstainers, experienced greater problems with sleep-wake transitions.
These findings contribute to the growing evidence that there are no safe levels of alcohol consumption during pregnancy, as even low to moderate PAE negatively impacts adolescent sleep. Identifying sleep-wake transitions and excessive somnolence as the most affected domains provides targets for both screening and intervention.
本研究调查了产前酒精暴露（PAE），包括低水平和中等水平暴露，与青少年睡眠结果之间的关联。尽管有证据表明PAE与年幼儿童睡眠质量差有关，且人们越来越认识到低水平PAE的危害，但该领域仍研究不足。
参与者为来自青少年大脑认知发展研究第四次评估浪潮的10336名青少年（12 - 13岁）。横断面广义线性混合模型和广义相加混合模型用于评估产前酒精暴露的影响，产前酒精暴露被概念化为PAE的存在与否、孕期饮酒总量（即剂量）以及PAE模式（即戒酒者、轻度减少饮酒者、轻度稳定饮酒者、重度减少饮酒者）对青少年睡眠结果的影响。
与未暴露于PAE的青少年相比，任何PAE暴露的青少年睡眠结果更差，其中睡眠 - 觉醒转换和过度嗜睡是受影响最大的领域。观察到一种非线性剂量效应，即睡眠 - 觉醒转换较差主要发生在低暴露水平时。此外，与戒酒者相比，PAE模式为轻度减少饮酒的组在睡眠 - 觉醒转换方面存在更大问题。
这些发现进一步证明，孕期饮酒不存在安全水平，因为即使是低至中等水平的PAE也会对青少年睡眠产生负面影响。确定睡眠 - 觉醒转换和过度嗜睡是受影响最大的领域为筛查和干预提供了目标。
