A Meta-Analysis of Bi-Directional Associations between Sleep Health and Substance Use among U.S. Youth: Racial/Ethnic Differences

We found evidence for a bi-directional relationship between total sleep duration and substance use. Sleep satisfaction predicted substance use, but findings were inconclusive whether substance use predicted sleep satisfaction. Sleep alertness predicted alcohol (but not cannabis) use, whereas sleep timing predicted cannabis (but not alcohol) use. Nuanced racial/ethnic differences were also found in these sleep-substance use relationships, which differed across sleep domains and types of substance.