Poor actigraphic and self-reported sleep patterns predict delinquency and daytime impairment among at-risk adolescents

Objective: To evaluate associations between actigraphic sleep patterns, subjective sleep quality, and daytime functioning (ie, sleepiness, symptoms of depression, and delinquency and other conduct problems) in at-risk adolescents.

Design: Prospective, observational cohort study.

Setting: Providence, RI, predominantly home and school and 2 visits to the Brown Center for the Study of Children at Risk.

Participants: A diverse group of low-income 13-year-olds (n = 49) with and without prenatal drug exposure.

Interventions: None.

Measurements: Actigraphy, sleep diaries, and sleep and health questionnaires.

Results: Above and beyond the effects of prenatal drug exposure and postnatal adversity, actigraphic daytime sleep was a significant predictor of daytime sleepiness and delinquency. Subjective sleep quality was a significant predictor of daytime sleepiness, delinquency, and depressive symptoms. Later bed times predicted increased delinquency.

Conclusions: There was a unique effect of actigraphic daytime sleep duration, subjective nighttime sleep quality, and bedtime on daytime functioning (ie, sleepiness, symptoms of depression, and delinquency and other conduct problems) of at-risk adolescents. In these vulnerable youth, these problematic sleep patterns may contribute to feeling and behaving poorly. Intervention studies with at-risk teens should be conducted to further explore the role of these sleep parameters on daytime functioning.