Impact of Cumulative Unhealthy Sleep Practices in Adolescence on Substance Use in Young Adulthood Estimated Using Marginal Structural Modeling

Chia-Yi Ho, Sheng-Hsuan Lin, Meng-Che Tsai, Tsung Yu, Carol Strong*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives The purpose of this study was to identify the impact of chronic, unhealthy sleep practices in adolescence on substance use in young adulthood. Unhealthy sleep practices in adolescent samples exhibit a bidirectional relationship with substance use. The relationship is further complicated if we consider that confounders such as depression vary over time and are often in response to adolescents' prior poor sleep practice, which can be addressed by a counterfactual approach using a marginal structural model. Methods Data in this study are from the Taiwan Youth Project, a longitudinal study that started in 2000 and surveyed 2,690 7th grade students at age 13. Outcomes include frequency of cigarette smoking and alcohol drinking at age 21. Three unhealthy sleep practices were included in this study: short sleep, social jetlag, and sleep disturbance. We used a marginal structural model with stabilized inverse probability-of-treatment weights to address time-varying confounders in each wave and a total sample of 1,678 adolescents with complete information for this study. Results Accumulated waves of sleep disturbance and social jetlag in adolescence were significantly associated with cigarette use in young adulthood. Accumulated social jetlag but not sleep disturbance was also associated with alcohol use in adulthood. Accumulated waves of short sleep were not associated with later alcohol use, but were negatively correlated with cigarette use. Conclusion Interventions that aim to reduce the likelihood of substance use in young adulthood should consider confronting unhealthy sleep practices, in particular the discrepancy between bedtimes on school days and weekends and sleep disturbance.

Original languageEnglish
Article number339
Number of pages10
JournalFrontiers in Neuroscience
Volume14
DOIs
StatePublished - 9 Apr 2020

Keywords

  • insufficient sleep
  • cigarette use
  • alcohol use
  • adolescent
  • marginal structural model
  • SELF-RATED HEALTH
  • DEPRESSIVE SYMPTOMS
  • RISK BEHAVIORS
  • SOCIAL JETLAG
  • TOBACCO USE
  • DRUG-USE
  • ASSOCIATION
  • PATTERNS
  • ALCOHOL
  • EXPOSURE

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