Substance abuse is linked to numerous mental and physical health problems, including disturbed sleep. The association between substance use and sleep appears to be bidirectional, in that substance use may directly cause sleep disturbances, and difficulty sleeping may be a risk factor for relapse to substance use. Growing evidence similarly links substance use to disturbances in circadian rhythms, although many gaps in knowledge persist, particularly regarding whether circadian disturbance leads to substance abuse or dependence. Given the integral role circadian rhythms play in regulating sleep, circadian mechanisms may account in part for sleep-substance abuse interactions. Furthermore, a burgeoning research base supports a role for the circadian system in regulating reward processing, indicating that circadian mechanisms may be directly linked to substance abuse independently of sleep pathways. More work in this area is needed, particularly in elucidating how sleep and circadian disturbance may contribute to initiation of, and/or relapse to, substance use. Sleep and circadian-based interventions could play a critical role in the prevention and treatment of substance use disorders.

This relationship may be important to consider in the treatment of youth affective disorders.

Objective The Child Behavior Checklist is sometimes used to assess sleep disturbance despite not having been validated for this purpose. This study examined associations between the Child Behavior Checklist sleep items and other measures of sleep. Method Participants were 122 youth (61% female, aged 7 through 17 years) with anxiety disorders (19%), major depressive disorder (9%), both anxiety and depression (26%), or a negative history of any psychiatric disorder (46%). Parents completed the Child Behavior Checklist and children completed a sleep diary, wore actigraphs for multiple nights, and spent 2 nights in the sleep laboratory. Partial correlations ([pr], controlling for age, gender and diagnostic status) were used to examine associations. Results Child Behavior Checklist sleep items were associated with several other sleep variables. For example, “trouble sleeping” correlated significantly with sleep latency assessed by both diary (pr(113) = 0.25, p = .008) and actigraphy (pr(105) = 0.21, p = .029). Other expected associations were not found (e.g., “sleeps more than most kids” was not significantly correlated with EEG-assessed total sleep time: pr(84) = 0.12, p = .258). Conclusions Assessing sleep using the Child Behavior Checklist exclusively is not ideal. Nonetheless, certain Child Behavior Checklist items (e.g., “trouble sleeping”) may be valuable. Although the Child Behavior Checklist may provide a means of examining some aspects of sleep from existing datasets that do not include other measures of sleep, hypotheses generated from such analyses need to be tested using more rigorous measures of sleep.

Background: Short sleep duration is highly prevalent in adolescence, and it prospectively predicts problems with emotional adjustment and psychiatric health. To move beyond epidemiological associations and inform models of developmental psychopathology, we experimentally restricted sleep to observe impacts on affective functioning. Based on the importance of social contexts to adolescent emotional experiences, we also examined the impact of restricted sleep on socioaffective functioning in an ecologically valid peer interaction task. Methods: In Study 1, adolescents (ages 11.5-15.0, n = 48) were randomly assigned to two nights of polysomnography-monitored sleep restriction (4 hr in bed) or extension (10 hr in bed). One week later, they completed the other sleep manipulation. Affective functioning was assessed by self-report and pupil response to standardized affective sounds. Study 2 used a similar protocol and invited adolescents (ages 12-15.0, n = 16) to the sleep laboratory along with 2-4 friends to observe affective behavior in a social context primed for peer conflict. Mixed effects models were used to evaluate the effect of sleep condition on affective outcomes. Results: Study 1 demonstrated increased negative affect following sleep restriction, relative to extension, on self-report (p = .02) and pupil measures (p = .01). Study 2 replicated these effects (both p = .04) and demonstrated greater negative affective behavior in a peer social context (p = .01). Exploratory analyses for positive affect showed reductions as assessed by self-report (p = .005), but not pupil (p = .81), in Study 1; and no significant effects in Study 2 (self-report, p = .14; pupil, p = .29; positive affective behavior, p = .43). Conclusions: Experimental sleep restriction in adolescence impacts negative affective functioning as evidenced by self-report and pupil reactivity, as well as observed behavior in a social context primed for peer conflict. Implications for the impact of short sleep on developmental trajectories of emotional adjustment and psychiatric health, and opportunities for early intervention, are briefly discussed.