The association between perceived bedtime autonomy, sleep patterns, and daytime functioning in adolescents

Sleep duration in adolescents is determined by bedtime as weekday getting up times are fixed by school starting times. The impact of adolescents' choice of bedtime (bedtime autonomy) during the week and at the weekend on sleep duration and sleep timing has been little studied.

A cross sectional questionnaire survey of adolescents responding to an online survey recorded sleep habits on school nights and weekends, screen use and daytime repercussions. Bedtime autonomy (determining one's own bedtime) on weeknights and at weekends, sleep deprivation (< 7 h in bed/night), school night sleep restriction (≥2 h difference in time in bed on school nights vs. weekends), social jetlag (midpoint of time in bed variation >2 h between school nights and weekends), difficulty waking, level of anxiety/depression hospital anxiety and depression scale (HAD), sleepiness (FSSA-8 sleepiness scale), duration of screen use and timing of screen use (evening, after bedtime, during the night) were determined.

Two thousand eight hundred ninety-five questionnaires were returned of which 2,512 were completed by adolescents (70% female, mean age 14.46 ± 2.08). Fourteen percent were non autonomous (NA), 21% were autonomous at the weekend only weekend autonomy (WA) and 65% at the weekend and on weeknights total autonomy (TA). Autonomy increased with age (p < 0.001) and female sex (p < 0.001). Weekend autonomy is granted to younger children than weeknight autonomy (13.61 ± 2.0 vs. 16.4 ± 2.8): nearly all participants were totally autonomous by the age of 18. In a model adjusting for age, sex, mood, and sleepiness potential sleep deprivation was linked to WA and more strongly to TA while social jetlag was only associated with WA.

Bedtime autonomy is an important factor in determining bed time duration and sleep rhythms in adolescents.