Associations between sleep and academic performance in US adolescents: a systematic review and meta-analysis

This systematic review and meta-analysis aim to investigate the relationship between sleep and academic performance in students enrolled in secondary education programs in the United States. The study team conducted a literature search of 4 databases-PubMed, Embase, CINAHL, and ERIC-on September 19 and repeated December 17, 2020. Studies were included if they were observational, published in a peer-reviewed, non-predatory journal, available in full-text, written in English, included adolescents enrolled in an organized academic program, took place in the US, and evaluated the effect of sleep duration and/or sleep quality on academic performance. After excluding reviews, editorials, interventions, and those targeting diagnostic groups, 14 studies met inclusion criteria. Risk of bias was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies; 12 studies were found to be good or high quality, 2 were adequate/fair or poor quality. A meta-analysis of 11 of the included studies revealed that sleep duration (r = 0.03; 95%CI -0.027, 0.087; p = 0.087) and sleep quality (r = 0.089; 95%CI 0.027, 0.151; p = 0.005) had negligible correlations with academic performance (non-significant and significant, respectively). Inconsistencies in definitions, methods, and measures utilized to assess sleep duration, sleep quality, and academic performance constructs may offer insight into seemingly conflicting findings. Given the pivotal role sleep plays in development, future investigations utilizing validated and objective sleep and academic performance measures are needed in adolescents.