title: The Prospective Association Between Sleep and Initiation of Substance Use in Young Adolescents.
abstract: OBJECTIVE
  This study aimed to determine the unique utility of poor sleep health in predicting the onset of substance use in adolescents.
  
  
  METHODS
  Middle school students (N = 829, mean (M)age= 12.6 years, 52% female, 73% white) who participated in an ongoing prospective study of alcohol onset and progression completed a set of Web-based health behavior surveys over a 4-year period, with recruitment beginning in 2009. Surveys included assessments of alcohol, cigarette, and marijuana use as well as sleep duration, bedtime delay (from weekdays to weekends), and daytime sleepiness. Data were analyzed using discrete-time Cox Proportional hazard's regression.
  
  
  RESULTS
  Controlling for participant age at sleep assessment, gender, and internalizing and externalizing behaviors, shorter sleep duration and greater daytime sleepiness in year 1 were associated with increased odds of having had a full drink of alcohol, having engaged in heavy episodic drinking, and having experienced alcohol-related consequences by year 4. Shorter sleep duration was also associated with increased odds of marijuana use by year 4. No sleep parameter was uniquely associated with increased odds of cigarette use (first puff or first full cigarette). Effects were evident for both males and females. Age at sleep assessment did not moderate effects.
  
  
  CONCLUSIONS
  Sleep health is a prospective predictor of the onset of alcohol and marijuana use among adolescents. Increased efforts to prevent and intervene in sleep problems among adolescents are warranted.
authors: Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island. Electronic address: millerme04@gmail.com.
authors: Mary Beth
authors: MB
authors: Miller
authors: Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island.
authors: Tim
authors: T
authors: Janssen
authors: Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island.
authors: Kristina M
authors: KM
authors: Jackson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000523:psychology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Alcohol; Bedtime; Marijuana; Sleep health; Tobacco