Substance use impacts various sleep characteristics in young adults

1. In this systematic review, substance use impacted various sleep characteristics in young adults, but the impact was dependent on the substance. For example, both caffeine and nicotine use were associated with higher odds of sleep disturbance, while nicotine alone was associated with poor sleep satisfaction.

2. Furthermore, evening chronotype, the preference to conduct activities in the evening, was associated with alcohol, caffeine, and nicotine use.

Evidence Rating Level: 1 (Excellent)

Young adults have high reports of both sleep difficulties and substance use. Although it is known that sleep difficulties and substance use exhibit a bi-directional relationship, no systematic review to date has assessed the effects of various substances on the many dimensions of sleep health in this population. Therefore, the purpose of the present study was to evaluate the association between substance use and various sleep dimensions in young adults and assess the bi-directional relationship between these domains.

Of 20,755 identified records, 46 studies were included from 3 databases (PubMed, PsychINFO, and Scopus), including 36 cross-sectional, 4 case-control, and 6 prospective studies. Studies that included participants aged 18 to 30 years and had substance use and various sleep-wake dimensions as the outcome and exposure, or vice-versa, were included. Studies that recruited participants from a special population, such as veterans or pregnant individuals, were excluded. The review was conducted in accordance with PRISMA guidelines. The odds ratios were calculated to estimate the effect of the association between substance use and various sleep dimensions. The primary outcome was the bi-directional association between substance use and several sleep characteristics.

The results demonstrated that substance use impacted several sleep characteristics, but the impact depended on the substance in question. For example, caffeine and nicotine use were associated with higher odds of sleep disturbance, but nicotine alone was associated with poor sleep satisfaction. Meanwhile, alcohol and caffeine were associated with daytime dysfunction. It was found that sleep also impacted substance use, as evening chronotype was associated with the use of alcohol, caffeine, and nicotine. Despite these results, the review was limited by the fact that most of the included studies were conducted on college students, which limited the generalizability of the results to other young adult populations. Nonetheless, the study demonstrated that the use of various substances, including alcohol, caffeine, and nicotine, may negatively impact sleep in young adults.

Click to read the study in Sleep Medicine Reviews

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