Nearly 8 in 10 US high school students reported insufficient sleep in 2023, up from about 7 in 10 in 2007, according to a research letter published in JAMA.
Researchers analyzed cross-sectional data from the national Youth Risk Behavior Survey, a biennial school-based survey conducted by the Centers for Disease Control and Prevention that provides nationally representative estimates of US high school students. The analytic sample included 120,950 students who reported their average sleep duration on school nights between 2007 and 2023.
Insufficient sleep—defined as 7 hours or less per night based on American Academy of Sleep Medicine guidance—increased from 68.9% of students in 2007 to 76.8% in 2023. The rise was driven largely by growth in very short sleep, defined as 5 hours or less per night, which increased from 15.8% to 23.0% over the same period. Reports of 6 to 7 hours of sleep remained largely unchanged.
Insufficient sleep increased across demographic groups defined by sex, grade, and race and ethnicity. The increase was larger among Black students than among White students.
The researchers also examined sleep trends among adolescents reporting behavioral risk factors, including mental health symptoms, substance use, sedentary activity, weight-related behaviors, and victimization. Adolescents with these risks consistently reported higher levels of insufficient sleep, but increases over time occurred across nearly all behavioral groups.
“Insufficient sleep increased across nearly all behavioral subgroups, occurring as much or more among adolescents without behavioral risk factors as among those with them,” wrote lead author Tanner J. Bommersbach, MD, of the University of Wisconsin School of Medicine and Public Health, and colleagues.
Increases in insufficient sleep were greater among students reporting depressive symptoms or suicidal thoughts. By contrast, increases were smaller over time among adolescents who reported daily television viewing, heavy social media or video game use, or alcohol or cigarette use.
The findings suggest that widespread sleep loss among adolescents may reflect environmental or structural influences affecting most students rather than individual behaviors alone. Population-level approaches may therefore be needed. For example, later school start times have been associated with longer sleep duration, improved academic engagement, and better mental health among adolescents.
The study had several limitations. Multiple hypotheses were tested without statistical adjustment, and the cross-sectional design prevents conclusions about causality. Behavioral risks and sleep duration were assessed using single-item self-reported questions rather than objective sleep monitoring. Because adolescents often overestimate sleep duration, the true prevalence of insufficient sleep may be higher than reported.
The authors reported no conflicts of interest.
Source: JAMA
