Early exposure to mature content is linked to high-risk behaviors. This study aims to prospectively investigate how sleep and sensation-seeking behaviors influence the consumption of mature video games and R-rated movies in early adolescents. A secondary analysis examines the bidirectional relationships between sleep patterns and mature screen usage. Data were obtained from a subsample of 3,687 early adolescents (49.2% female; mean age: 11.96 years) participating in the Adolescent Brain and Cognitive Development study. At Year 2 follow-up, participants wore Fitbit wearables for up to 21 nights to assess objective sleep measures and completed a scale about sensation-seeking traits. At Year 3 follow-up, they answered questions about mature screen usage. Of the sample, 41.8% of the sample reported playing mature-rated video games and 49% reported watching R-rated movies. Sensation-seeking traits were associated with R-rated movie watching one year later. Shorter sleep duration, later bedtime, more bedtime variability, and more social jetlag (discrepancy between the mid-sleep on weekdays and weekends) were associated with mature-rated video gaming and R-rated movie watching one year later. Sleep duration variability was associated with mature-rated video gaming. There was also an interaction effect: those with higher sensation-seeking scores and shorter sleep duration reported more frequent R-rated movie usage than those with longer sleep duration. Secondary analyses showed bidirectional associations between later bedtimes, more variability in bedtimes, and more social jetlag with mature screen usage. Early adolescents with sensation-seeking traits and poorer sleep health were more likely to engage in mature screen usage.