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The link between sleep deprivation and teens’ bad decisions, from risky sex to crime

How sleep impacts teens’ decisions, from risky sex to crime.

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SALT LAKE CITY — When listing woes that might accrue to sleep-deprived teens, you can add risky decisions about sex.

A new study published by the American Psychological Association on Monday suggests teens who regularly fall short of the recommended 8 to 10 hours of sleep each night may be more likely than well-rested peers to have sex while under the influence of alcohol or drugs, for example.

The study, by researchers from the nonpartisan, nonprofit Rand Corporation, is featured in the journal Health Psychology.

Very few teens regularly get enough sleep, a fact so well-documented that the Centers for Disease Control and Prevention calls it a “national epidemic,” said Wendy M. Troxel, Rand senior behavioral and social scientist, who led the study.

The new study adds another layer to a stack of concerns parents have about teen schedules as risks associated with inadequate sleep have been piling up in research findings. Many of those risks, including greater likelihood of alcohol and drug abuse, suggest sleep loss impacts “the parts of the brain that control our impulses and risk-taking behavior,” Troxel told the Deseret News. “The parts of the brain like the prefrontal area that’s supposed to kind of rein in those impulses tends to be down-regulated under sleep-deprived conditions.”

Knowing that teens are more impulsive when they're tired and that sleep-deprived teens are prone to greater risk for alcohol and substance use, the Rand team wondered whether risks also increased related to sexual behavior, which they defined as having sex without using condoms or having sex while under the influence of alcohol or drugs.

“That’s what we found,” she said, noting the study indicated only an association between inadequate sleep and risky sexual behaviors, rather than making a direct causal link.

Measuring Zzzzzs

The researchers measured sleep by following 1,850 teens recruited through a Los Angeles school district for a period of four years, from 2013 to 2017. The teens were each around age 16 when the study began. Researchers looked at sleep outcomes, sleep duration and sleep quality, Troxel said, paying attention to both weekday and weekend sleep patterns.

Even teens who want to get adequate sleep have a hard time for many reasons, the researchers said. School start times are usually too early to allow even teens who go to bed at a reasonable time to get enough sleep. As Psychology Today explains, "teen brains are wired to fall asleep later and wake later." Early rising imperatives run counter to typical teen biological rhythms, which has led some school districts to delay school start times. But the majority of schools follow a traditional schedule that contributes to the teen sleep-deficit problem, according to Troxel.

There's really no way to make up lost sleep; it's a matter of doing better in the future. Sleep researchers no longer believe that sleeping longer on weekends can be “banked” to make up for deficits during the week. But they do believe that teens benefit from sleeping longer on weekends because any day a teen gets enough sleep is good, Troxel said.

If they are sacrificing sleep during this time, it can have a big impact on their future. – Wendy M. Troxel, Rand senior behavioral and social scientist

Most teens in the study were “chronically sleep deprived” across the four years. The link was between increased risky sexual activity and inadequate sleep; they did not find a link between poor sleep quality or insomnia and risky sexual behaviors. Troxel said others have demonstrated sleep quality as a factor for risky behaviors, but the Rand study focused on quantity, not quality of sleep.

“We all have to wake up to the importance of sleep, particularly for our teenagers, who are very vulnerable,” Troxel said. She described the teen years as an “inflection point that sets the stage for their future health and well-being and productivity. Things can go awry during this critical developmental stage when their brain is still rapidly developing and they’re developing the social and behavioral skills to learn how to manage the world and make good or risky decisions.

"If they are sacrificing sleep during this time, it can have a big impact on their future,” she said.

In the study, the “almost-sufficient sleepers” averaged almost 8.5 hours a night, still on the low end of the recommended range. The intermediate group averaged about 7.5 hours a night. “Short sleepers” averaged about 6.3 hours of sleep during the week. Only 1 in 5 teens were getting adequate sleep throughout high school, Troxel said.

Four more reasons to care

Here are four other research findings about inadequate sleep and risky teen activities:

• Inadequate sleep by teens appears linked to various adverse behaviors, including aggression, substance abuse and self-harm, according to a research letter in JAMA Pediatrics published in December. "These behaviors are common precursors to accidents and suicides, which are the leading causes of death among teens," the authors wrote.

• Research in the Journal of Youth and Adolescence found inadequate sleep was associated with significant increases in delinquency. Teens who had a little sleep deprivation were more prone to property crimes than were teens who were well-rested. Those who were more sleep-deprived had increased levels of violent delinquency. "The findings suggest that sleep is an important, and overlooked, dimension of delinquent behavior and studies that focus on adolescent health should further investigate the effects of insufficient sleep," the study said.

• A 2015 study from the University of California Berkeley and Columbia University found an association between too little sleep and risky weight gain that can set teens on a course that could dog them for life. Teens who sleep too little have higher body mass index over time than well-rested peers. The study, published in Sleep, said one consequence of not getting at least nine hours sleep a night is that teens are tired and even sleepy at school. "The human circadian rhythm, which regulates physiological and metabolic functions, typically shifts to a later sleep cycle at the onset of puberty," the report said, making it harder for teens to get adequate sleep if they must rise early to get to school, but also increasing inactivity and weight gain.

• Teens who are sleep-deprived are not just more prone to abusing alcohol and drugs, but also to risky driving behavior and random injuries, both vehicle crash-related and not, according to The Child Mind Institute, which tackles issues related to child and adolescent mental health and overall well-being. Sleep deprivation puts teenagers into a kind of perpetual cloud or haze, Mary Carskadon, professor of psychiatry at Brown University and director of sleep research at Bradley Hospital in Rhode Island, told the institute. “One of the metaphors I use is that it’s like having an astigmatism. You don’t realize how bad your vision is until you get glasses, or in this case, good sleep.”