Research Article| Volume 5, ISSUE 4, P382-394, August 2019

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Adolescent substance use and its association to sleep disturbances: A systematic review



      To identify adolescents' substance use and its association to sleep disturbances.


      Databases were searched using terms: “smoking”, “tobacco use”, “electronic cigarette”, “alcohol drinking”, “marijuana use” and “substance use” combined with “sleep” and “adolescents”. Articles were selected based on: adolescents residing in North America, aged between 10 and 21 years old, examining substance use and sleep disturbances as a dependent variable, and published within 10 years. The Buysse's sleep health RuSATED framework was used for analysis.


      Thirteen articles were reviewed establishing the relationship between tobacco, alcohol and marijuana use and sleep disturbances. Positive associations were reported between all substances used and sleep disturbances in sleep health domains of Regularity, Timing, Efficiency, and Duration. Alertness problems were also positively associated with tobacco and alcohol use. The most common disturbance reported was the insufficient sleep Duration. The least reported deficiencies were Satisfaction and Alertness.


      Evidence for associations between substance use and sleep disturbances in Regularity, Timing, Efficiency, and Duration domains may result in sleep deprivation, which poses a serious health risk among growing adolescents. Future research should prospectively examine disturbances in all sleep health domains including Satisfaction and Alertness with the addition of more objective sleep measures to assess long term effects of sleep deprivation in this population.

      Implications and contributions

      Understanding the adolescents' substance use in relation to their sleep disturbance with sleep as a dependent variable, provides future direction for sleep health promotion in adolescents with substance use to prevent further health consequences.


      AHRQ (Agency for Healthcare Research and Quality), ANCOVA (analysis of co-variance), ANOVA (analysis of variance), ASSIST (alcohol, smoking, and substance involvement screening test), AUDIT-C (alcohol use disorders identification test-consumption), BMI (body mass index), B-YAAXQ (brief-young adult alcohol consequences questionnaire), CINAHL (Cumulative Index of Nursing and Allied Health Literature), DAST (drug abuse screening test), DDQ (daily drinking questionnaire), DIS (difficulty initiating sleep), DMS (difficulty maintaining sleep), e-cigarette (/EC) (electronic cigarettes), EMA (early morning awakening), ISQ (insomnia symptom questionnaire), No. (number), PSQI (Pittsburgh Sleep Quality Index), PRISMA (preferred reporting items for systematic review and meta-analysis), RuSATED (Regularity, Satisfaction, Alertness during waking hours, Timing, Efficiency, Duration), SE (sleep efficiency), SHQ (smoking history questionnaire), SPQ (sleep problem questionnaire), SPS (sleep problem scale), SOL (sleep onset latency), TST (total sleep time), US (United States), WASO (wake after sleep onset)


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