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.