Self‐reported sleep and circadian characteristics predict alcohol and cannabis use: A longitudinal analysis of the National Consortium on Alcohol and Neurodevelopment in Adolescence Study

Abstract

Background Growing evidence indicates that sleep characteristics predict future substance use and related problems. However, most prior studies assessed a limited range of sleep characteristics, studied a narrow age span, and included few follow‐up assessments. Here, we used six annual assessments from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study, which spans adolescence and young adulthood with an accelerated longitudinal design, to examine whether multiple sleep characteristics in any year predict alcohol and cannabis use the following year. Methods The sample included 831 NCANDA participants (423 females; baseline age 12–21 years). Sleep variables included circadian preference, sleep quality, daytime sleepiness, the timing of midsleep (weekday/weekend), and sleep duration (weekday/weekend). Using generalized linear mixed models (logistic for cannabis; ordinal for binge severity), we tested whether each repeatedly measured sleep characteristic (years 0–4) predicted substance use (alcohol binge severity or cannabis use) the following year (years 1–5), covarying for age, sex, race, visit, parental education, and previous year's substance use. Results Greater eveningness, more daytime sleepiness, later weekend sleep timing, and shorter sleep duration (weekday/weekend) all predicted more severe alcohol binge drinking the following year. Only greater eveningness predicted a greater likelihood of any cannabis use the following year. Post‐hoc stratified exploratory analyses indicated that some associations (e.g., greater eveningness and shorter weekend sleep duration) predicted binge severity only in female participants, and that middle/high school versus post‐high school adolescents were more vulnerable to sleep‐related risk for cannabis use. Conclusions Our findings support the relevance of multiple sleep/circadian characteristics in the risk for future alcohol binge severity and cannabis use. Preliminary findings suggest that these risk factors vary based on developmental stage and sex. Results underscore a need for greater attention to sleep/circadian characteristics as potential risk factors for substance use in youth and may inform new avenues to prevention and intervention.

Do sleep and circadian characteristics predict alcohol use in adult drinkers?

“…As in the cross‐sectional literature, “circadian” measures in longitudinal studies have mostly been confined to self‐report measures of circadian preference or chronotype. These studies consistently link later timing to greater alcohol involvement (Hasler et al., 2017; Hasler, Graves, Wallace, et al., 2022; Tavernier & Willoughby, 2014; Troxel et al., 2021), with recent evidence that such associations may be even stronger in adulthood than adolescence (Hasler, Graves, Wallace, et al., 2022). To our knowledge, only one longitudinal study examining alcohol outcomes has assessed circadian timing via DLMO.…”

“…A growing evidence base indicates that sleep and circadian rhythms contribute to risk for alcohol use and related problems (e.g., Hasler et al., 2024; Hasler, Graves, Wallace, et al., 2022; Haynie et al., 2018; Troxel et al., 2021), but longitudinal studies employing objective sleep/circadian measures have been scant. Furthermore, the majority of published studies examining prospective sleep/circadian‐alcohol associations have been conducted in adolescent and/or emerging adult samples, although recent evidence suggests that such associations may vary by age (Hasler, Graves, Wallace, et al., 2022). Studies incorporating objective measures of sleep and circadian rhythms in adult samples are needed for a complete understanding of how sleep/circadian‐related risk for alcohol use manifests across the lifespan.…”

“…A growing number of longitudinal studies prospectively link multiple dimensions of sleep to alcohol use and related problems, particularly in adolescents and emerging adults (Hasler et al., 2024). For example, shorter sleep duration has been linked with greater alcohol use in longitudinal studies (e.g., Hasler, Graves, Wallace, et al., 2022; Ho et al., 2020; Wong et al., 2015). As in the cross‐sectional literature, “circadian” measures in longitudinal studies have mostly been confined to self‐report measures of circadian preference or chronotype.…”

A test of competing mediators linking trouble sleeping to cannabis use in adolescents and emerging adults.

“…Collectively, results suggest that sleep problems, such as more erratic sleep/wake behaviors, difficulties falling or staying asleep, greater daytime sleepiness, shorter sleep durations, and poorer subjective sleep quality, prospectively increase risk for an earlier initiation of cannabis use (Mike et al, 2016), a greater likelihood of any cannabis use (Hasler et al, 2017(Hasler et al, , 2022Pasch et al, 2012), and more frequent lifetime cannabis use (Mike et al, 2016;Nguyen-Louie et al, 2018). Moreover, sleep problems may be a stronger indicator of future cannabis use for younger than older youth (Hasler et al, 2022). Yet, while relations between sleep problems and various cannabis-use indices among youth are well-documented, underlying mechanisms linking the two-an essential step toward informing prevention and intervention efforts-remain poorly understood (Pasch et al, 2012;Wong et al, 2010).…”

Effect of daily discrimination on naturalistic sleep health features in young adults.

“…Poor sleep health (e.g., short sleep duration, poor sleep continuity, and irregular sleep timing) is associated with many negative physical and mental health outcomes including cardiometabolic disease (Cappuccio et al, 2010a; St-Onge et al, 2016), mood disorders (Rumble et al, 2015), susceptibility to infectious illness (Prather et al, 2015), inflammation (Irwin et al, 2016), substance use (Boness et al, 2022; Graupensperger et al, 2022; Hasler et al, 2015, 2022; Logan et al, 2018), and premature mortality (Cappuccio et al, 2010b; Wallace et al, 2022; Wallace, Buysse, et al, 2019; Wallace, Lee, et al, 2019). Moreover, inequities in sleep health exist for a variety of communities and individuals.…”