Examining Racial/Ethnic Disparities in the Association between Adolescent Sleep and Alcohol or Marijuana Use

The current study examines the association between self-reported measures of trouble sleeping, total sleep time (TST), and bedtimes and odds of past month alcohol and marijuana (AM) use in a racially/ethnically diverse sample of adolescents.

Web-based cross-sectional survey in Los Angeles (LA) County, California.

The sample is comprised of 2539 youth representing four distinct racial/ethnic categories (Non-Hispanic White, Hispanic, Asian, and “Other”; mean age= 15.54; 54.23% female) from Los Angeles.

The survey assessed TST and bedtimes (weekdays and weekends), trouble sleeping, and past month AM use, as well as relevant covariates (sociodemographics and mental health symptoms).

Although there were significant racial/ethnic differences in the prevalence of sleep problems and AM use, the associations between sleep problems and AM use were consistent across racial/ethnic groups. Specifically, shorter TST, later bedtimes, and trouble sleeping, were each associated with significantly higher odds of past month alcohol use, whereas later bedtimes and shorter TST were also associated with increased odds of past month marijuana use, even after adjusting for other known risk factors.

Sleep problems are associated with increased AM use in teens, even after controlling for sociodemographics and mental health symptoms. Further longitudinal research on sleep and AM use is critical to identify novel prevention and intervention efforts to reduce disparities in the relationship between sleep and AM use.

Results of Logistic Regression Predicting Marijuana Use in the Past Month both overall and stratified by Race/Ethnicity.

	Overall Sample (n=2539)a		Non-Hispanic White (n=533)b		Hispanic (n=1115)b		Asian (n=532)b		Other (n=359)b
	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI
Weekday Bedtime
10 minutes	1.04	1.02 – 1.06***	1.05	1.02 – 1.09**	1.04	1.01 – 1.06*	0.99	0.93 – 1.04	1.05	1.01 – 1.09*
Weekend Bedtime
10 minutes	1.06	1.05 – 1.08***	1.07	1.03 – 1.10***	1.07	1.05 – 1.09***	1.01	0.97 – 1.06	1.08	1.05 – 1.12***
Total Sleep Time Hours
Weekend	0.87	0.80 – 0.94***	0.91	0.78 – 1.06	0.89	0.79 – 1.00	0.98	0.79 – 1.21	0.71	0.59 – 0.85***
Weekday	0.89	0.81 – 0.99*	0.85	0.71 – 1.03	0.97	0.82 – 1.15	1.01	0.72 – 1.41	0.78	0.62 – 0.99*
Bothered by Trouble Sleeping
Bothered a Little	1.17	0.87 – 1.57	0.89	0.52 – 1.51	1.26	0.80 – 1.98	1.53	0.62 – 3.77	1.32	0.62 – 2.81
Bothered a Lot	1.40	0.98 – 2.01	1.37	0.70 – 2.70	1.39	0.81 – 2.38	1.01	0.25 – 4.11	1.60	0.67 – 3.82
Not Bothered (reference)

*p<.05,

**p<.01,

***p<.001

aThe overall model controls for age, gender, race/ethnicity (White, Hispanic, Asian, Other), mother's highest education (<HS, HS, >HS), family structure (two-parent versus single-parent household), mental health symptoms (MHI-5 score), and an indicator for whether or not the respondent attended an intervention school; n's for each model differ slightly due to item missingness.

bAll stratified models control for the same covariates as in total sample, with the exception of race/ethnicity; n's for each model differ slightly due to item missingness.

Note: In the models including the sleep by race/ethnicity interactions, the omnibus interaction term was non-significant in all models.

Full article at: http://goo.gl/BXCSA9

By: Wendy M. Troxel, Brett Ewing, and Elizabeth J. D’Amico

RAND Corporation, 1776 Main St, Santa Monica, CA 90407, USA

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