The Sweet Spot of Weekend Catch-up Sleep: U-shaped Associations with Internalizing Symptoms in Adolescents from the Adolescent Brain Cognitive Development study

STUDY OBJECTIVES: Adolescents often extend sleep on weekends to compensate for short weekday sleep, a behavior known as weekend catch-up sleep (WCS). Although adult and self-report studies suggest both protective and adverse effects, evidence in adolescents -especially for anxiety and depression-remains limited. We examined associations between WCS and internalizing symptoms using objectively measured sleep. METHODS: Participants were 1,867 adolescents (mean age = 14.1 years) from the Adolescent Brain Cognitive Development Study. WCS was calculated as the difference between average weekend and weekday sleep duration from Fitbit recordings (mean = 13.1 nights). Anxiety and depressive symptoms were assessed with the Child Behavior Checklist. Logistic and quadratic regression models tested associations between WCS and symptoms, accounting for age, sex, and race. RESULTS: Adolescents with moderate WCS (≤2 hours) had lower odds of clinical level anxiety than those with consistent sleep (OR = 0.49, CI [0.30, 0.78], p = .003). Quadratic models revealed U-shaped associations: both weekend sleep loss and excessive WCS were linked to elevated anxiety (p = .005) and depressive symptoms (p = .043), with the lowest symptoms at moderate WCS. This non-linear pattern remained significant for anxiety, but not for depression, after accounting for weekday sleep duration and sleep timing. CONCLUSIONS: In this large U.S. adolescent sample, moderate WCS was associated with lower anxiety, whereas large weekday-weekend sleep discrepancies were linked to higher symptoms. Associations with depressive symptoms were weaker and model-dependent. Findings suggest a potential "sweet spot" for weekend sleep extension and underscore risk of large sleep variability.