Sleep Duration, Mental Health, And Substance Use Among Rural Adolescents: Developmental Correlates

Numerous studies have demonstrated that most adolescents do not get adequate amounts of sleep. Furthermore, insuf?cient sleep is associated with increased risk for depression and suicide attempts as well as substance abuse in adolescence. However, extant studies have relied primarily on national samples or suburban adolescents, with a paucity of research examining the associations between sleep duration and mental health and substance abuse risk in rural adolescents. Additionally, these associations rarely have been examined within a developmental context. The present study attempted to address these gaps by using data from the Youth Risk Behavior Survey (YRBS) to examine the associations between sleep duration and risk factors in the lower and upper grade levels for high school students attending schools in rural areas. YRBS data were obtained from 2 rural school districts located in the Appalachian region of North Carolina (n ? 987). For the full sample, approximately 40% of students reported receiving 6 or fewer hours of sleep on a typical school night. High school students in the lower grades (9th and 10th) who reported short sleep duration were more likely to have endorsed each of the mental health, suicidal behavior, and substance use items. Signi?cant differences emerged between sleep groups on suicide attempts and alcohol, tobacco, and marijuana use for students in the upper grade levels. We conclude that short sleep duration is problematic in rural high school students, especially for those students recently transitioning from middle school to high school. These ?ndings can inform identi?cation, prevention, and intervention strategies to encourage and promote healthy sleep habits among rural adolescents.