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Substance use as a risk factor for sleep problems among adolescents presenting to the Emergency Department
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  • Description:

    To determine correlates of sleep problems among adolescents. Specifically, to assess the relative strength of associations between sleep problems and: dating victimization, reasons for emergency department (ED) visit, depression, unhealthy alcohol use, and other drug use (marijuana, nonmedical use of prescription opioids, stimulants, and tranquilizers).


    1,852 adolescents aged 14-20 presenting for care to the University of Michigan Emergency Department, in Ann Arbor, Michigan, (2011-2012) self-administered a computerized health survey. Sleep problems were identified if any of the 4 items on the Sleep Problems Questionnaire were rated by a patient as greater than 3 on a 0-5 scale. Adolescents that were too sick to be screened in the ED were eligible to participate in the study during their inpatient stay. Exclusion criteria for baseline included: insufficient cognitive orientation precluding informed consent, not having parent/guardian present if <18 years-old, medical severity precluding participation, active suicidal/homicidal ideation, non-English speaking, deaf/visually impaired, or already participated in this study on a prior visit.


    23.5% of adolescents reported clinically significant sleep problems. Female gender, depression, dating victimization, tobacco use, nonmedical use of prescription medication, and an ED visit for medical reasons were each associated with sleep problems among adolescents, even while controlling for age, other types of drug use, receiving public assistance, and dropping out of school.


    These exploratory findings indicate that ED-based screening and brief intervention approaches addressing substance use and/or dating victimization may need to account for previously undiagnosed sleep problems.

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  • Funding:
    R01 AA018122/AA/NIAAA NIH HHS/United States
    R49 CE002099/CE/NCIPC CDC HHS/United States
    T32 DA007267/DA/NIDA NIH HHS/United States
    UL1 TR000433/TR/NCATS NIH HHS/United States
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