A Meta-Analysis of Bi-Directional Associations between Sleep Health and Substance Use among U.S. Youth: Racial/Ethnic...

This paper aimed to estimate pooled bi-directional associations between multidimensional sleep health and substance use among youth and investigate whether these associations differed as a function of race/ethnicity.

Empirical observational studies providing quantitative data on the association of sleep health (duration [sleep obtained per 24 hours], satisfaction [subjective assessment of sleep], alertness [ability to maintain attentive wakefulness], and timing [placement of sleep]) and substance use (i.e., alcohol and cannabis), and racial/ethnic demographic information among U.S. youth (10-25) were identified through a systematic literature search. Random effects meta-analyses were conducted using 95 effect sizes extracted from 38 studies.

We found evidence for a bi-directional relationship between total sleep duration and substance use. Sleep satisfaction predicted substance use, but findings were inconclusive whether substance use predicted sleep satisfaction. Sleep alertness predicted alcohol (but not cannabis) use, whereas sleep timing predicted cannabis (but not alcohol) use. Nuanced racial/ethnic differences were also found in these sleep-substance use relationships, which differed across sleep domains and types of substance.