Decline in adolescent sleep duration over past 20 years

1. A nationally representative cohort of adolescents reported decreased sleep duration over 20 years, from 1991 through 2012.

2. Sleep duration declined across all ages, racial/ethnic groups, and socioeconomic subgroups, while the extent of this decline differed among genders and between several sociodemographic subgroups.

Evidence Rating Level: 1 (Excellent)

Study Rundown:  Adequate sleep duration is a significant component of adolescent wellbeing and has both physical and behavioral health benefits. Past research has highlighted a decline in sleep duration among adolescents over time, indicating a potential decline in adolescent health. This study is the most extensive investigation of trends in adolescent sleep behavior in recent years. An analysis of data from the national Monitoring the Future database showed a general decline in adolescent sleep duration from 1991 to 2012. The decline occurred across all age groups and socioeconomic subgroups. Girls, racial and ethnic minorities, those living in urban areas, and those of low socioeconomic status were less likely to report a healthy amount of nightly sleep. Conversely, racial and ethnic minorities, as well as subjects of low socioeconomic status, reported that they received adequate sleep. These results expose a potential disparity in sleep literacy and thus highlight an opportunity for improving policy to better educate this population at-risk. Although this study provides a thorough trend analysis, it is limited by self-report bias and a lack of causality.

Click to read the study, published today in Pediatrics

Relevant Reading: Sleepless in America: inadequate sleep and relationships to health and well-being of our nation’s children

In-Depth [retrospective cohort study]: Using data from the annual Monitoring the Future national survey, sleep trends were analyzed of 270 077 8^th, 10^th, and 12^th graders from over 130 public and private U.S. schools over 20 years (1991 to 2012). Half (49%) of subjects were male, 63% were white, 13% black, and 12% Hispanic. Subjects were stratified based on age, gender, race, and socioeconomic status as measured by highest education level of subjects’ parents. The proportion of adolescents reporting >7 hours of sleep slowly declined over time, across all age groups, with the greatest decreases from 1991-1995 to 1996-2000. Eighteen and 19-year olds were the least likely to get >7 hours of sleep. Those in the lowest socioeconomic strata were the least likely to achieve adequate sleep duration, compared to those in medium and high strata. Girls were less likely to get enough sleep in all time periods compared to boys (OR = 0.66 in 2011-12 to 0.68 in 1991-1995 and 1996-2000), while racial minority groups were also less likely to report adequate sleep duration compared to whites in all but years 2001-2005. On the other hand, racial minorities were more likely than whites to report receiving adequate sleep (OR = 1.15 to 1.58 among black, and 1.1 to 1.48 among Hispanic).

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