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

Purpose: To identify adolescents' substance use and its association to sleep disturbances. Methods: 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. Results: 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. Conclusions: 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.