Longitudinal Bi-directional Relationships Between Sleep and Youth Substance Use

Keryn E. Pasch, Lara A. Latimer, Jessica Duncan Cance, Stacey G. Moe, Leslie A. Lytle

Research output: Contribution to journalArticlepeer-review

123 Scopus citations


Despite the known deficits in sleep that occur during adolescence and the high prevalence of substance use behaviors among this group, relatively little research has explored how sleep and substance use may be causally related. The purpose of this study was to explore the longitudinal bi-directional relationships between sleep duration, sleep patterns and youth substance use behaviors. Participants included 704 mostly white (86. 4 %) youth, 51 % female, with a baseline mean age of 14. 7 years. Self-reported substance use behaviors included past month alcohol, cigarette, and marijuana use. Sleep measures included sleep duration on weekends and weekdays, total sleep, weekend oversleep, and weekend sleep delay. Cross-lagged structural equation models, accounting for clustering at the school level, were run to determine the longitudinal association between sleep and substance use adjusting for socio-demographic characteristics, pubertal status, body mass index z-score, and depressive symptoms. Cigarette use and weekend sleep were bi-directionally related as were marijuana use and total sleep. No other bi-directional associations were identified. However, alcohol use predicted shorter weekend oversleep and marijuana use predicted increased weekend sleep and weekend oversleep. Sleep patterns and duration also predicted adolescents' cigarette, alcohol, and marijuana use. Sleep, both patterns and duration, and substance use among youth are intertwined. Future research is needed to explore these bi-directional relationships, as well as other important contextual factors that may moderate these associations.

Original languageEnglish (US)
Pages (from-to)1184-1196
Number of pages13
JournalJournal of Youth and Adolescence
Issue number9
StatePublished - Sep 2012

Bibliographical note

Funding Information:
Acknowledgments This research was funded through a grant from the National Cancer Institute as part of their Transdisciplinary Research in Energetics and Cancer (TREC) Initiative. Grant # 1U54CA116849 and through a grant supported by the Etiology of Childhood Obesity (ECHO) with funding from the National Heart, Lung and Blood Institute, Grant #R01HL085978. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, National Heart, Lung and Blood Institute, or the National Institutes of Health.


  • Adolescents
  • Cross-lagged models
  • Sleep
  • Substance use
  • Youth


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