Integrative Model of the Relationship Between Sleep Problems and Risk for Youth Substance Use

Abstract

A burgeoning literature implicates sleep problems in risk for adolescent substance misuse as well as a negative prognostic indicator of substance abuse treatment response. Mechanisms underlying the relationship between sleep problems and propensity to abuse substances during this phase of development have yet to be elucidated. Many questions also remain about this relationship given the paucity of integrative models and data from prospective studies with a pre-drug exposure baseline. Our integrative, temporal model theorizes that sleep problems may increase propensity to substance misuse through interactions with emotion dysregulation and cognitive deficits. Stress exposure may exacerbate this confluence of factors, and ongoing hormonal and brain changes during puberty may also contribute to the relationship between stress and risk for substance misuse. Finally, substance use itself worsens sleep problems and further dysregulates emotion and cognition, promoting an escalating pattern of use. If sleep problems increase risk for substance misuse and treatment intractability, greater attention to causes of sleep problems in young people would have significant preventive and/or ameliorative implications given the malleability of these functions.