title: Sleep and use of alcohol and drug in adolescence. A large population-based study of Norwegian adolescents aged 16 to 19 years.
abstract: BACKGROUND
  Changes in sleep patterns and increased substance involvement are common in adolescence, but our knowledge of the nature of their association remains limited. The aim of this study was to examine the association between several sleep problems and sleep behaviours, and use and misuse of alcohol and illicit drugs using data from a large population-based sample.
  
  
  METHODS
  A large population-based study from Norway conducted in 2012, the youth@hordaland study, surveyed 9328 adolescents aged 16-19 years (54% girls). Self-reported sleep measures provided information on sleep duration, sleep deficit, weekday bedtime and bedtime difference and insomnia. The main dependent variables were frequency and amount of alcohol consumption and illicit drug use, in addition to the presence of alcohol and drug problems as measured by CRAFFT.
  
  
  RESULTS
  The results showed that all sleep parameters were associated with substance involvement in a dose-response manner. Short sleep duration, sleep deficit, large bedtime differences and insomnia were all significantly associated with higher odds of all alcohol and drug use/misuse measures. The associations were only partly attenuated by sociodemographics factors and co-existing symptoms of depression and ADHD.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first population-based study to examine the association between sleep, and alcohol and drug use, by employing detailed measures of sleep behaviour and problems, as well as validated measures on consumption of alcohol and illicit drug use. The findings call for increased awareness of the link between sleep problems and alcohol and drugs use/misuse as a major public health issue.
authors.affiliation: Norwegian Institute of Public Health, Division of Mental Health, Kalfarveien 31, 5018 Bergen, Norway; Department of Psychiatry, Helse Fonna HF, PO Box 2170, N-5504 Haugesund, Norway; Uni Research Health, Bergen, PO Box 7810, N-5020 Bergen, Norway. Electronic address: borge.sivertsen@fhi.no.
authors.forename: Børge
authors.initials: B
authors.lastname: Sivertsen
authors.affiliation: Norwegian Institute of Public Health, Division of Mental Health, Kalfarveien 31, 5018 Bergen, Norway; Alcohol and Drug Research Western Norway, Stavanger University Hospital, PO Box 8100, 4068 Stavanger, Norway.
authors.forename: Jens Christoffer
authors.initials: JC
authors.lastname: Skogen
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, PO Box 7810, N-5020 Bergen, Norway.
authors.forename: Reidar
authors.initials: R
authors.lastname: Jakobsen
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, PO Box 7810, N-5020 Bergen, Norway.
authors.forename: Mari
authors.initials: M
authors.lastname: Hysing
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000428:Alcohol Drinking / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway / Q000453:epidemiology; D057566:Self Report; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: Adolescence; Alcohol and drug use; Epidemiology; Mental health; Sleep