Relationships between insufficient sleep, depressive symptomatology, and selected depression related health-risk behaviors in U.S. adolescent students

Background: Many adolescents are chronically sleep deprived and experience excessive daytime sleepiness due to biological, psychological, and social factors. Objective: To examine the associations between self-reported insufficient sleep (<8 hours on average school nights) and the following in a nationally representative sample of adolescent students: depressive symptomatology (in the past 12 months, feeling so sad or hopeless almost every day for two weeks or more in a row that some usual activities were stopped) and selected depression related health-risk behaviors (made suicide plan in past 12 months, suicide attempt(s) in the past 12 months). Methods: Data from the 2007 cross-sectional national Youth Risk Behavior Survey of 12154 students in the United States from 157 public and private high schools in grades 9-12 (response rates: 81% of schools, 84% of students) were used to determine weighted prevalence estimates and adjusted odds ratios (age, sex, race/ethnicity) examining the relationship between insufficient sleep and depressive symptoms/risk behaviors. Results: Insufficient sleep on an average school night was reported by 68.9% of US adolescents. In multivariate logistic regression analyses, insufficient sleep was associated significantly with feelings of sadness or hopelessness (AOR, 1.62; 95% CI, 1.43-1.84), suicide plan (AOR, 1.89; 95% CI, 1.60-2.22), and suicide attempt (AOR, 1.90; 95% CI, 1.47-2.45) in adolescent students. Conclusions: The impact of insufficient sleep on adolescents' health is a problem of great magnitude that has not been adequately recognized. Later school start times hold promise as a possible effective intervention for addressing this issue in adolescent students.