Too little sleep is tied to teenagers’ injury-related risk behaviors

High school students who report sleeping 7 hours or less on an average school night are significantly more likely than their peers who sleep up to 9 hours a night to engage in several injury-related risk behaviors: infrequent bicycle helmet use; infrequent seatbelt use; riding with a driver who has been drinking; drinking and driving; and texting while driving.

An analysis of data from 50,370 high school students who participated in the national Youth Risk Behavior Surveys in 2007, 2009, 2011, or 2013 found that 3 of these behaviors—infrequent seatbelt use, riding with a driver who has been drinking, and drinking and driving—also were more likely for students who reported sleeping 10 or more hours compared with 9 hours on an average school night.

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A full 68.8% of respondents reported getting too little sleep—that is, sleeping 7 hours or less on an average school night: 4 hours or less, 6.3%; 5 hours, 10.5%; 6 hours, 21.9%; or 7 hours, 30.1%. Another 23.5% reported 8 hours sleep, 5.8% reported 9 hours, and 1.8% said they got 10 or more hours. Female students were more likely than male students to report insufficient sleep. The overall percentage of those reporting insufficient sleep ranged from 59.7% of students in the 9th grade to 76.6% of those in the 12th grade. Among racial/ethnic groups, the prevalence of insufficient sleep was lowest for American Indian/Alaska Native students (60.3%) and highest for Asian students (75.7%).

Overall, 86.1% of students reported infrequent bicycle helmet use and 8.7% reported infrequent seatbelt use. Whereas 26% reported riding with a driver who had been drinking at least once during the past 30 days, 8.9% reported drinking and driving, and 30.3% reported texting while driving (Wheaton AG, et al. MMWR Morb Mortal Wkly Rep. 2016;65[13]:337-341).

Commentary: Although cause and effect aren’t clearly established here, this study suggests that teenagers are not just more likely to be injured because of fatigue and drowsiness leading to falling asleep at the wheel, but that they also may be too sleepy to be smart. Tired teenagers may be making high-risk choices that their well-rested peers avoid. —Michael G Burke, MD

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.