Associations between prenatal alcohol exposure and parent‐reported sleep disturbances in 10,336 adolescents: an Adolescent Brain Cognitive Development study

BACKGROUND: This study investigated the associations between prenatal alcohol exposure (PAE), including low and moderate levels of exposure, and parent-reported sleep disturbances during adolescence. This is an area that remains understudied despite evidence linking PAE, particularly heavy PAE, to poor sleep in younger children and the growing recognition of harms associated with low levels of PAE. METHODS: Participants were 10,336 adolescents (aged 12-13) from the fourth assessment wave of the Adolescent Brain Cognitive Development Study. Cross-sectional generalised linear mixed models and generalised additive mixed models were used to assess the impact of prenatal alcohol exposure, conceptualised as the presence or absence of PAE, total drinks consumed during pregnancy (i.e. dose) and patterns of PAE (i.e. abstainers, light reducing, light stable, heavy reducing), on parent-reported adolescent sleep disturbances, while controlling for important birth related, environmental and medical factors. RESULTS: Adolescents with any PAE experienced worse overall parent-reported sleep disturbances compared to those without, with sleep-wake transitions, excessive somnolence and sleep breathing being the domains most impacted. There was limited support for a dose-response relationship between low-level PAE and sleep problems in adolescence. However, those with a pattern of PAE before knowledge of pregnancy, compared to abstainers, experienced greater problems with sleep-wake transitions and sleep breathing. CONCLUSIONS: These findings contribute to the growing evidence that there are no safe levels of alcohol consumption during pregnancy, as even low to moderate PAE negatively impacts adolescent sleep. Identifying sleep-wake transitions, excessive somnolence and sleep breathing as the most affected domains provides targets for both screening and intervention.