Study: Drinking problems later for teens who skip sleep now

A study shows that teens who skip sleep now have more drinking problems later in life.

Sleep-deprived teenagers find it difficult to focus in class, and they're more likely get sick. They are also more likely to develop problems with alcohol later on, according to a study published Friday in the journal Alcoholism: Clinical & Experimental Research.

The study included teens who suffered from conditions like insomnia as well as those who simply weren't getting enough sleep. Teenagers ages 14 through 16 who had trouble falling or staying asleep were 47 percent more likely to binge drink than their well-rested peers.

Sleep problems were linked to even more issues with alcohol later on.

Teens who had trouble sleeping when the researchers first checked in with them were 14 percent more likely to drive drunk and 11 percent more likely to have interpersonal issues related to alcohol a year later. And five years after that — when everyone was college-aged or older — those who had sleep issues in high school were 10 percent more likely to drive drunk.

About 45 percent of adolescents don't get the recommended eight to 10 hours a night, polls show.

The findings are based on data collected from 6,500 adolescents who were part of the larger National Longitudinal Study of Adolescent Health, which began tracking a group of adolescents in the mid-90s.

Researchers have known for a while that lack of sleep and alcohol use are related, says Maria Wong, a psychologist at Idaho State University who led the study. "This study shows that sleep issues can actually precede and even predict alcohol use later on."

And the influence of sleep on drinking behaviors can be dramatic, Wong tells Shots. In the study, each extra hour of sleep the teens got corresponded with a 10 percent decrease in binge drinking.

"We're not saying that sleep is the only risk factor for alcohol use," Wong says. In fact, another study published in the same journal issue found that a combination of genetics and peer influence affect teens' decisions to drink.

But a child's genetic makeup isn't something anyone can change, Wong says, "and beyond a certain extent, we cannot control whom kids spend time with outside the home."

Sleep, however, may be something that teenagers and their parents can control. "If we can make sure they have enough sleep, we can help them make good choices," Wong says.

Of course, that's much easier said than done. Teens don't usually take well to having bedtimes imposed on them. And even if they did, forcing kids to get in bed early won't necessarily help, says Dr. Maida Chen, the director of the Pediatric Sleep Disorders Center at Seattle Children's Hospital. "Because of their biology, simply saying to teens, 'Go to sleep earlier' is not a plausible solution," says Chen, who wasn't involved in the recent research.

The body's natural circadian rhythms tend to shift during adolescence, Chen explains, so teens may find it difficult fall asleep until 11 p.m. or midnight.

That's why many parents and pediatricians have been pushing to delay school start times for middle and high school students. "Teens have to get up at 5 or 6 in the morning in order to get to school by 7 or 8," Chen says, which means that most of them aren't getting nearly enough rest.

Last year the American Academy of Pediatrics issued a policy statement calling on middle and high school to start at 8:30 a.m. or later.

"This new research shows what we have long suspected — there seems to be a link between lack of sleep and risky behaviors in teenagers," Chen says.

The people involved in the recent study were teenagers in the 1990s, Chen points out. "I wouldn't be surprised if the situation was in some ways worse these days," she says, "because nowadays, everyone has some electronic distraction that they carry into bed with them."

Many of the patients Chen sees at Seattle's Children come in because their grades have started to fall or because they're having behavior issues at school, she says.

"This is not just about teens not sleeping enough and then feeling a bit grumpy the next day," Chen says. "Sleep really affects their ability to function and make good decisions."

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Kids with ADHD may be more likely to drink and smoke

A study shows that kids who have ADHD may be more likely to drink and smoke as teenagers.

Teens are more likely to start smoking or drinking with each additional symptom they have of attention-deficit hyperactivity disorder (ADHD) or conduct disorder, new research suggests.

"Our findings underscore the need to counsel families about the risk of substance use as [these] children approach adolescence," said study author Dr. William Brinkman, research director at Cincinnati Pediatric Research Group, which is part of Cincinnati Children's Hospital. "This need is heightened among children with ADHD and/or conduct disorder diagnoses or symptoms."

Brinkman's team analyzed data on more than 2,500 teens, aged 12 to 15, in a national survey conducted with their parents between 2000 and 2004.

First, the researchers identified the teens with an ADHD and/or conduct disorder diagnosis, as well as those with the symptoms of either disorder, regardless of whether there was a diagnosis. Conduct disorder is characterized by aggressive, destructive or deceitful behavior. Children with ADHD tend to be hyperactive, impulsive and/or inattentive.

Then Brinkman's team compared use of tobacco and alcohol among the teens, to look for a link between symptoms of ADHD or conduct disorder and substance use.

Brinkman said that 45 percent of the children in the study had at least one ADHD symptom, and nearly 15 percent had at least one conduct disorder symptom.

For each additional ADHD symptom related to inattention -- but not hyperactivity or impulsivity -- the risk that a teen would use tobacco or alcohol increased by 8 percent to 10 percent. Similarly, each additional conduct disorder symptom was linked to a 31 percent increase in the likelihood of using tobacco, according to the study.

A very small percentage of teens in the study -- about 1.5 percent -- were diagnosed with both ADHD and conduct disorder. These teens were more than three times more likely to use tobacco or alcohol, even after accounting for differences in age, race/ethnicity, sex, household income and having a household member who smoked.

The findings were published recently in the journal Drug and Alcohol Dependence.

Brinkman said more research may provide clues as to why the link exists between these disorders and substance use.

"Because nicotine can improve attention and arousal, some have speculated that the association between inattention symptoms and higher rates of tobacco use suggests a form of self-medication for ADHD," Brinkman said. "Certainly higher rates of risk taking and novelty seeking has been documented among children with a diagnosis of ADHD, as well as those with ADHD symptoms [but too few for a diagnosis]."

Social pressures may be involved as well, suggested Dr. Glen Elliott, chief psychiatrist and medical director of Children's Health Council in Palo Alto, Calif.

"It is important to emphasize that not all teens with ADHD follow this path, just a higher percentage than those without ADHD," Elliott said. "We believe it is a combination of impulsive decision-making and perhaps the social strain that ADHD can place on the individual, who may feel unable to connect with peers in socially acceptable ways and therefore more vulnerable to trying other methods such as doing things peers dare them to do or that they view as 'cool' or 'adult.' "

Elliott said the study provides new insights into the interplay between ADHD and conduct disorder. But it sheds little light on whether treating ADHD, either earlier in childhood or during adolescence, might change the risk of starting to smoke or drink, he said.

"We believe medication can make a difference, but the evidence is not nearly as compelling as we wish it were -- partly because teens often go through a phase of refusing to take medications just when it might do them the most good," Elliott said. "Just as with parents of any teenager, there is no guaranteed way to prevent a son or daughter from experimenting if they are determined to do so."

The best tools parents have, Elliott said, are setting consistent and clear expectations for their children, closely monitoring them, praising them for good choices and administering appropriate, meaningful consequences for poor choices -- while also showing children early on what behavior is acceptable.

"Adolescence is hard," Elliott said. "And having ADHD can make it harder. So parents need to be vigilant, caring, consistent and involved."

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Drinking before pregnancy may indicate behavior problems in children

A study found that women who drink before pregnancy are more likely to have children with behavioral problems.

Risk drinking before pregnancy can increase the risk of the development behavioral problems in toddlers. This comes from a new study using data from the Norwegian Mother and Child Cohort Study (MoBa). Early intervention to help and support mothers and their children could help to prevent these problems from developing into long term behavioral problems.

In the study, several screening questions were used to measure maternal drinking behavior; how many drinks were needed to feel high, had others irritated or hurt them by criticizing their alcohol consumption, had they felt they ought to drink less alcohol, and had they ever drunk alcohol in the morning to relieve a hangover.

The study shows that risk drinking before pregnancy increases the risk of early behavior problems among children. According to the researchers, risk drinking may be due to other associated risk factors in maternal behavior such as anxiety, depression or attention deficit hyperactivity disorder (ADHD), which also are known to have an impact on child behavioral problems.

Prenatal exposure to alcohol is known to affect the developing fetus, with adverse cognitive and behavioral effects. Most risk drinking women therefore limit or stop drinking alcohol while pregnant. Paternal risk drinking is also known to have a negative impact on toddler behavior. This is the first study to study the impact of risk drinking before pregnancy. The results could not be explained by alcohol consumption during pregnancy and after birth.

"This increased risk for behavioral problems in the child is probably not due to the risk drinking per se, but rather to the general mental health and lifestyle of some of the mothers. Risk drinking behavior before pregnancy may indicate that these families could need closer follow-up and support during the early years of the child's life" says Ann Kristin Knudsen, primary author of the article published in the European Child and Adolescent Psychiatry journal.

The study considered both internalizing and externalizing behavioral problems among the toddlers. Internalizing behavioral problems include anxiety, inhibition, withdrawal or depression. Restlessness, defiance, fighting and lack of remorse are examples of externalizing behavior. These are known risk factors for behavior problems in childhood and adolescence, which sometimes continue into adulthood.

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Binge drinking, marijuana use, and poor academic performance predicted by sleeping problems

A study shows that binge drinking, marijuana use, and poor academic performance are predicted by problems sleeping.

While the temptations to stay up late are many, a small new study suggests a very good reason for college students to hit the hay. Those who are poor sleepers are more likely to get worse grades and to withdraw from a course, according to a new study. In fact, the effects of poor sleep were about as strong as binge drinking and marijuana use on a student's academic performance.

The researchers analyzed data from over 43,000 students included in the spring 2009 American College Health Association's National College Health Assessment (NCHA). After controlling for potentially confounding factors that might predict how a college student fares academically, like clinical depression, feelings of isolation or chronic health problems, the researchers found that getting poor sleep was a strong predictor of problems at school.

While few students are likely to have a clinical sleep disorder, Roxanne Prichard, Ph.D., associate professor of psychology at the University of St. Thomas in St. Paul, Minnesota tells The Huffington Post, about 60 percent say they have some kind of problem sleeping. But for all the effort colleges put into anti-drinking and de-stressing campaigns, little time or money is spent to promote better sleep -- and doing so could help both students and the colleges themselves, she says.

"Sleep really isn't systematically approached in a way that could have major economic benefits to both the students and the universities in terms of increased retention," she says. Indeed, reducing the number of courses a student withdraws from by just one ups his or her probability of graduating by 14 percent, she says -- and it goes without saying that student retention is good for a university's bottom line.

Prichard hopes more schools decide to include a screening for sleep problems among students, which could ultimately limit costs of care of university health centers, she says. "I don't think sleep problems are showing up on the questionnaire intake forms for health services, and that could be explaining a lot of the other problems that you see showing up," she says. "Recurrent illness could be sleep problems."

Prichard and co-investigator Monica Hartmann, Ph.D., professor of economics at the University of St. Thomas, found that poor sleep was even more detrimental among freshmen, according to the study. "I think that's partially because freshmen have the worst sleep of any age group," she says. Not only are they hungry for independence from their parents, but they also are more likely to be "delayed phase" -- essentially, they are more biologically inclined to be night owls because of their age, she says. Focusing especially on first-year students is a smart idea for universities, she says, because freshmen-year success (or lack thereof) is a strong predictor of whether or not a student drops out his or her sophomore year.

The research, published in an online supplement of the journal SLEEP, will be presented Tuesday, June 3, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies.

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