Purpose: Examining the associations between sleep duration and lifestyle risk factors and assessed whether sex modify such associations among U.S. adolescents.
Design: Cross-sectional study among high school students from the 2015-19 national Youth Risk Behavior Survey.
Setting: US, national.
Subjects: High school students grade 9-12 (n = 31 871).
Measures: Students reported hours of sleep on an average school night categorized into "less than 6 hours", "6 to 7 hours" and "8 hours and more". Lifestyle risk factors including physical inactivity, insufficient breakfast consumption, current tobacco use, and current binge drinking were self-reported and dichotomized.
Analysis: Multivariable logistic regression models were used to estimate associations between sleep duration and lifestyle risk factors, adjusting for confounders.
Results: Compared to students with 8 hours and more of sleep, students with 6 to 7 hours and less than 6 hours of sleep had 79% and 228% (P < .01) increased odds of insufficient breakfast consumption; and had 22% (P = 0.0014) and 74% (P < .01) increased odds of binge drinking, respectively. There is a significant interaction between sleep duration and sex (P < .05) for physical inactivity and current tobacco use.
Conclusion: Insufficient sleep is common among US adolescents and is associated with increased risks of multiple lifestyle risk factors, which suggests great needs for multilevel interventions to address sleep deprivation and promote good sleep hygiene among adolescents.
Keywords: adolescents; binge drinking; breakfast; lifestyle; physical activity; sleep duration; tobacco use.