Adolescent Sleep in a Family Context: Family Dysfunction’s Role in Adolescent Sleep and Mental Health

• In Event: Sleep in Adolescence: The Importance of Family and School Contexts

Abstract

Approximately 90% of high-school aged adolescents get either insufficient sleep or barely meet the required amount of sleep expected for healthy functioning (National Sleep Foundation, 2006). In fact, sleep problems and insufficient sleep are so pervasive for adolescents that they could be considered an epidemic due to their adverse impact on adolescent mental and physical health (Owens, 2015; Shochat et al., 2014). Addressing adolescent sleep problems thus represents a critical point of study and intervention. Research suggests that the family environment plays an integral role in both adolescents’ sleep (Bartel et al., 2015; Peltz et al., 2019) and their mental health (Repetti et al., 2002). Despite robust links between adolescents’ sleep quality/duration and their mental health (Short et al., 2013), there remains little evidence examining the family environment’s role in links between adolescent sleep and mental health. Accordingly, the current study examines the role of family dysfunction in a sample of high school students. A total of 197 adolescents (Mage=15.6, SD=1.8; 53% female) completed the baseline survey and 7-day sleep/mood diaries. Most participants identified as Caucasian (71%), with another 14% identifying as African American, 8% identifying as multiracial, and 7% identifying as Latino/a, Asian American, or “other.” The sample of families was economically diverse (M=$81,100 annual family income; SD=$28,100), with 18.3% of families reporting incomes equal to or less than $45,000. We tested two models to investigate family dysfunction’s role in adolescent sleep and mental health: 1) a multi-level structural equation model of mediation, in which family dysfunction directly predicted adolescents’ sleep hygiene behaviors, which, in turn, influenced morning-reported sleep quality and evening-reported mental health, and 2) a moderated-mediation model utilizing the PROCESS macro for SPSS (model 59; Hayes et al., 2013) in which we examined if family dysfunction (moderator) played a role in adolescents’ sleep hygiene indirectly affecting their mental health symptoms via their sleep quality. Adolescents completed at baseline the 12-item Family Assessment Device-General scale (Epstein et al., 1983) and the 28-item Adolescent Sleep Hygiene Scale (LeBourgeois et al., 2005). In addition, adolescents provided diary-reported sleep duration and quality each morning and daily depressive/anxiety symptoms (Patient Health Questionnaire-4; Löwe et al., 2010) each evening across a typical school week. Adolescent age, gender, sleep duration, and family SES were included as covariates in both models. In our multilevel mediation model (Figure 1), higher levels of family dysfunction directly predicted lower levels of adolescent sleep hygiene, which negatively impacted anxiety/depressive symptoms via worse sleep quality. In our moderated-mediation model (Table 1), poorer sleep hygiene predicted lower average weekly sleep quality, which, in turn, predicted higher anxiety/depressive symptoms only in families with average or above-average levels of dysfunction. These results suggest that within the context of family dysfunction, adolescent mental health is negatively influenced by both poorer sleep hygiene behaviors and lower levels of sleep quality. The current results provide further evidence that the family environment plays an integral role in adolescent sleep and mental health and should be considered a point of intervention when adolescents are experiencing mental health problems.

Authors

• Jack S Peltz, SUNY Brockport
  Presenting Author

• Ronald Rogge, University of Rochester
  Non-Presenting Author