Sleep Variability and Negative Alcohol-Related Consequences in College Students: Dynamic Associations With ADHD

College students often engage in heavy alcohol use and experience poor sleep. These risks are exacerbated among students with ADHD, who are especially vulnerable to both poor sleep and alcohol-related negative consequences. Although prior research has often focused on average sleep patterns, the impact of variability in sleep (i.e., bedtime, duration, and waketime) remains understudied. This variability may be particularly important for individuals with ADHD, given the self-regulation challenges that underline both sleep and alcohol use. Therefore, we examined ADHD-related differences in sleep variability and tested whether sleep variability predicts alcohol-related negative consequences.

Utilizing 2-week daily diaries in a sample engaging in heavy drinking (N = 101; ADHD = 51, without ADHD = 50), Dynamic Structural Equation Models (DSEM) were applied to examine ADHD group differences in sleep variability and sleep averages (bedtime, waketime, and duration) and alcohol-related negative consequences, and test if sleep variability predicted negative consequences.

ADHD group status was significantly associated with later average waketimes, but not in average bedtimes or average sleep duration. However, students with ADHD did report significantly greater variability in their bedtimes, waketimes and sleep duration, as well as greater alcohol-related negative consequences, compared to controls. Notably, ADHD was not a significant covariate in any adjusted models; instead, greater sleep duration variability significantly predicted increased negative consequences independent of ADHD status.

These findings highlight the importance of considering sleep variability for those with ADHD and more generally as a risk mechanism associated with alcohol-related negative consequences in college students who report heavy drinking.