Associations Between Sleep Duration and Positive Mental Health Screens During Adolescent Preventive Visits in Primary Care

Acad Pediatr. 2023 Aug;23(6):1242-1246. doi: 10.1016/j.acap.2023.02.013. Epub 2023 Mar 9.


Objective: The purpose of this paper was to understand associations between low sleep duration (<8.ßhours) and positive mental health screens among adolescents (ages 13...18) seen for preventive visits in primary care.

Methods: Data were from two randomized controlled trials testing the efficacy of an electronic health risk behavior screening and feedback tool for adolescent preventive visits. Participants (n.ß=.ß601) completed screeners at baseline, 3 months, and 6 months which included sleep duration in hours and the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 screeners for depression and anxiety, respectively. Main analyses included adjusted logistic regressions testing associations between low sleep duration and positive mental health screens.

Results: Adjusted models showed that low sleep duration was associated with significantly greater odds of a positive depression screen (OR.ß=.ß1.58, 95% CI: 1.06...2.37) but not with a positive anxiety screen or co-occurring positive depression and anxiety screens. However, follow-up analyses indicated an interaction between sleep duration and anxiety in the association with a positive depression screen, such that the association between low sleep and a positive depression screen was driven by those who did not screen positive for anxiety.

Conclusions: As pediatric primary care guidelines for sleep continue to evolve, further research, training, and support for sleep screening are warranted to ensure effective early intervention for sleep and mental health problems during adolescence.

Keywords: adolescents; anxiety; depression; preventive care visits; screening in primary care; sleep.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Anxiety
  • Anxiety Disorders / diagnosis
  • Depression
  • Humans
  • Mental Health*
  • Primary Health Care
  • Randomized Controlled Trials as Topic
  • Sleep Duration*