Interactions between sleep duration and quality as predictors of adolescents' adjustment

We examined interactions between adolescents' sleep duration and quality as predictors of their internalizing symptoms and externalizing behaviors. As a secondary aim, we assessed adolescent sex, race/ethnicity, and socioeconomic status (SES) as additional moderators of risk (ie, 3-way interactions among sleep duration; quality; and sex, race, or SES).

The study used a cross-sectional design.

Participants were from small towns and semirural communities in Alabama.

The sample consisted of 235 adolescents (M_age = 15.78 years, SD = 9.60 months) and was diverse with respect to sex (54% female), race/ethnicity (32% Black/African American, 67% White), and SES.

Sleep duration (actual sleep minutes) was examined with actigraphs for 1 week. Adolescents reported on their subjective sleep quality, internalizing symptoms, and externalizing behavior with psychometrically sound measures.

Findings revealed interactions between sleep duration and sleep quality as predictors of adolescents' adjustment. Adolescents with both short sleep duration in conjunction with poor sleep quality had the highest levels of internalizing symptoms and aggressive and rule-breaking behavior. SES interacted with sleep duration and sleep quality to predict rule-breaking behavior, and the highest level of problems was observed for adolescents from lower-SES homes who had short sleep duration accompanied by poor sleep quality.

Findings identify the conjoint role of sleep duration and quality as predictors of adolescents' socioemotional adjustment and emphasize the importance of examining multiple sleep parameters simultaneously toward a better understanding of adaptation in adolescence.