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Disordered Sleep in Teens Tied to Poor Grades, Expulsion

Teenagers with greater sleep pattern variability have a higher likelihood of school-related problems including poor grades, suspension, and expulsion, new research shows.

The cross-sectional study of more than 700 teenagers showed those with greater night-to-night variability in the time they fell asleep were 42% more likely to have a history of being suspended or expelled and 26%-29% more likely to have failed a class or received a D grade.

Moreover, teens who fell asleep at a later time were 9% less likely to take an honors course and teens who woke up later were 11% more likely to have a history of being suspended or expelled.

The findings are “concerning, but also highlight an opportunity for parents to encourage regular bedtimes and consistent sleep across the week to reduce sleep variability,” study investigator Gina Marie Mathew, PhD, postdoctoral associate at Stony Brook Medicine in Stony Brook, New York, told Medscape Medical News.

“Reducing sleep variability might be a pathway through which we can improve academic performance and also reduce problematic behaviors in school,” said Mathew. “This may be accomplished, in part, through promoting earlier school start times, which may stabilize sleep schedules across the week.”

Preliminary findings from the study were presented at SLEEP 2023, the 37th annual meeting of the Associated Professional Sleep Societies.

Stabilize Sleep to Improve Function

Short sleep duration in adolescents has been linked to poor grades and greater behavioral issues at school, but less is known about the impact of other dimensions of sleep, such as sleep variability, on school-related outcomes.

To investigate, the researchers analyzed data from more than 700 students in a sub-study of the age 15 wave of the Future of Families and Child Wellbeing Study, a national sample of diverse teens.

As part of the study, the students wore a wrist actigraphy device for about 1 week to track their movement and estimate their sleep patterns, and they provided information on their grades and current or past problems at school.

After adjusting demographic and household characteristics, as well as symptoms of depression and anxiety, greater variability in sleep onset was associated with higher odds of receiving a grade of D or F in any course (odds ratio [OR] 1.29, P = .040) and of ever failing a course (OR 1.26, P = .038), the researchers found.

Later sleep offset was also associated with lower average grade point average (P = .033).

Furthermore, later sleep offset (OR 1.11, P = .034) and greater variability in sleep duration (OR 1.31, P = .012) and onset (OR 1.42, P = .004) were associated with higher odds of ever being suspended or expelled in the past 2 years. Also, greater variability in sleep duration was associated with greater behavioral problems in school (P < .001).

This study suggests that later sleep timing and greater sleep variability are risk factors for school-related problems among adolescents.

“Stabilizing sleep schedules in adolescents may be an important tool to promote functioning at school,” Mathew said in a news release.

Commenting on the findings for Medscape Medical News, Fariha Abassi-Feinberg, MD, spokesperson for the American Academy of Sleep Medicine, who wasn’t involved in the study, said the research underscores the importance of maintaining a regular schedule for adolescents.

“Teenagers require an adequate amount of sleep for their overall well-being, physical growth, cognitive functioning, and emotional stability. We know that lack of sleep makes us less empathetic and can affect our immune system,” said Abassi-Feinberg, sleep specialist with the Millennium Physician Group, Fort Myers, Florida.

“Sleep is important in learning, so getting good quality sleep can help teenagers perform better academically. Since we all have a circadian rhythm, a biological clock, maximizing teenagers’ sleep includes not only quantity but also quality, which improves with a regular schedule,” Abassi-Feinberg added.

The study was supported by funding from the National Institute of Child Health and Human Development within the National Institutes of Health. Mathew and Abassi-Feinberg report no relevant financial relationships.

SLEEP 2023: 37th Annual Meeting of the Associated Professional Sleep Societies. Abstract 0103. Presented June 6, 2023.

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