Eveningness and Later Sleep Timing Are Associated with Greater Risk for Alcohol and Marijuana Use in Adolescence: Initial Findings from the National Consortium on Alcohol and Neurodevelopment in Adolescence Study

Abstract

BACKGROUND Abundant cross-sectional evidence links eveningness (a preference for later sleep-wake timing) and increased alcohol and drug use among adolescents and young adults. However, longitudinal studies are needed to examine whether eveningness is a risk factor for subsequent alcohol and drug use, particularly during adolescence, which is marked by parallel peaks in eveningness and risk for the onset of alcohol use disorders. The present study examined whether eveningness and other sleep characteristics were associated with concurrent or subsequent substance involvement in a longitudinal study of adolescents. METHODS Participants were 729 adolescents (368 females; age 12–21 years) in the National Consortium on Adolescent Neurodevelopment and Alcohol [NCANDA] study. Associations between the sleep variables (circadian preference, sleep quality, daytime sleepiness, sleep timing, and sleep duration) and three categorical substance variables (at-risk alcohol use, alcohol bingeing, and past year marijuana use (y/n)) were examined using ordinal and logistic regression with baseline age, sex, race, ethnicity, socioeconomic status, and psychiatric problems as covariates. RESULTS At baseline, greater eveningness was associated with greater at-risk alcohol use, greater bingeing, and past-year use of marijuana. Later weekday and weekend bedtimes, but not weekday or weekend sleep duration, showed similar associations across the three substance outcomes at baseline. Greater baseline eveningness was also prospectively associated with greater bingeing and past-year use of marijuana at the 1-year follow-up, after covarying for baseline bingeing and marijuana use. Later baseline weekday and weekend bedtimes, and shorter baseline weekday sleep duration, were similarly associated with greater bingeing and past-year use of marijuana at the 1-year follow-up after covarying for baseline values. CONCLUSIONS Findings suggest that eveningness and sleep timing may be under-recognized risk factors and future areas of intervention for adolescent involvement in alcohol and marijuana that should be considered along with other previously-identified sleep factors such as insomnia and insufficient sleep.

Sleep Deficits and Cannabis Use Behaviors: An Analysis of Shared Genetics Using Linkage Disequilibrium Score Regression and Polygenic Risk Prediction

“…This effect appears strong in early development, such that early childhood sleep deficits predict cannabis use in later adolescence 22,42-44 and sleep factors during adolescence predict adult cannabis use 21, 45 . Lastly, endorsements of an adolescent eveningness chronotype is associated with follow-up reports of increased cannabis use controlling for baseline adolescent substance use 40 . With evidence of both crosssectional associations and a bidirectional relationship between cannabis and sleep deficits/eveningness chronotype, there could be an underlying common liability such as shared or common genetics responsible for this association.…”

“…Evidence exists for the reverse relationship as well, with premorbid insomnia 21 and generalized sleep problems [39][40][41] predicting later cannabis use. This effect appears strong in early development, such that early childhood sleep deficits predict cannabis use in later adolescence 22,42-44 and sleep factors during adolescence predict adult cannabis use 21, 45 .…”

Preliminary Evidence That Real World Sleep Timing and Duration are Associated With Laboratory‐Assessed Alcohol Response

“…In parallel, some studies link self‐reports of actual sleep timing (which may or may not correspond to preferred timing) to alcohol use (Pasch et al., ; Pieters et al., ). Longitudinal evidence suggests that both evening chronotype and later actual sleep timing predict more extreme binge alcohol use a year later (Hasler et al., ). Notably, eveningness is often accompanied by more variable sleep timing (Soehner et al., ; Wittmann et al., ), which is also associated with alcohol involvement and thus is a hypothesized factor linking eveningness and alcohol problems (Wittmann et al., ).…”

Adolescent Executive Dysfunction in Daily Life: Relationships to Risks, Brain Structure and Substance Use

“…In 236 healthy adolescents (age 13–16 years: Anderson et al, 2009 ), increased sleepiness was significantly associated with more problems on dimensions including Working Memory, Task Planning, Orderliness, and Task Completion (i.e., BRIEF Metacognition) and not associated with Inhibitory Control, Flexibility, Emotional Control and Monitoring (i.e., BRIEF Behavioral Regulation). Sleep problems and circadian misalignment have been found to predict adolescent alcohol and other substance use (Hasler and Clark, 2013 ; Hasler et al, 2014 , 2016 , 2017 ). A study with a larger sample is needed to determine whether the relationships observed between executive dysfunction and poor sleep (Anderson et al, 2009 ) can be confirmed.…”