Restless Sleep and Variable Sleep Timing During Late Childhood Accelerate the Onset of Alcohol and Other Drug Involvement

Objective: Limited prospective data indicate that premorbid sleep disturbances elevate the risk for subsequent alcohol and other drug problems, yet the implications for subsequent substance involvement trajectories remain unclear. In the present analyses, we examined risk associations between sleep characteristics during late childhood and the onset of substance use and substance use disorders into adulthood.

Method: A sample of 707 children was recruited at ages 9-13 years and followed over seven additional visits through age 30 years. In 304 participants, fathers had a history of substance use disorder involving illicit drugs. Self-reported baseline sleep characteristics (restless sleep and variable sleep timing) were assessed at approximately ages 9-13 years. Assessment of alcohol, cannabis, and cocaine involvement occurred at follow-up visits. Cox proportional hazard models tested sleep characteristics as predictors of two substance-related outcomes (age at first use or diagnosis of disorder), as well as the onset of major depressive disorder.

Results: Restless sleep at baseline significantly predicted an earlier onset age for trying alcohol and cannabis and showed a trend toward predicting early onset of cannabis use disorder. Restless sleep also predicted an earlier onset of depression. Irregular sleep timing at baseline significantly predicted an earlier onset age for alcohol use disorder and showed trends toward predicting early onsets of disorders of cannabis and cocaine use.

Conclusions: Disturbed sleep during late childhood appears to accelerate the onset of not only initial substance use but also the development of clinically defined substance use disorder. Sleep-focused preventative efforts during late childhood may reduce the incidence of mood and substance use disorders.