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A Meta-Analysis of Bi-Directional Associations between Sleep Health and Substance Use among U.S. Youth: Racial/Ethnic
Fatima Dobani1, Emma S Schillinger1, Alison Vrabec1
1Syracuse University Department of Psychology, 352 Marley Educational Building, Syracuse, NY 13244.
Current Addiction Reports
|September 8, 2025
Summary
This study found bidirectional links between sleep duration and substance use in youth. Sleep quality and timing also influenced substance use, with racial/ethnic differences observed.
Area of Science:
- Adolescent Health
- Substance Use Research
- Sleep Science
Background:
- Sleep health is crucial for adolescent well-being.
- Substance use is a significant public health concern among youth.
- Understanding the interplay between sleep and substance use is vital for targeted interventions.
Purpose of the Study:
- To estimate pooled bidirectional associations between multidimensional sleep health and substance use in U.S. youth (ages 10-25).
- To investigate racial/ethnic variations in these sleep-substance use relationships.
Main Methods:
- Systematic literature search of empirical observational studies.
- Inclusion of studies with quantitative data on sleep (duration, satisfaction, alertness, timing) and substance use (alcohol, cannabis).
- Random effects meta-analyses of 95 effect sizes from 38 studies, including racial/ethnic demographic data.
Main Results:
- A bidirectional relationship was confirmed between total sleep duration and substance use.
- Sleep satisfaction predicted substance use; the reverse association was inconclusive.
- Sleep alertness predicted alcohol use, while sleep timing predicted cannabis use. Significant racial/ethnic differences were noted across sleep domains and substance types.
Conclusions:
- Sleep health dimensions are intricately linked with substance use patterns in youth.
- The relationships are bidirectional for sleep duration and vary across different aspects of sleep and substances.
- Racial/ethnic disparities in these associations highlight the need for tailored public health strategies.
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