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Sleep / Wake Disorders

Prospective Association between Circadian Preference and Academic Impairment in Adolescents: The Role of Daytime Sleepiness

(PS6-B39) Prospective Association Between Circadian Preference and Academic Impairment in Adolescents: The Role of Daytime Sleepiness

Saturday, November 19, 2022

9:00 AM – 10:00 AM EST

Location: Westside Ballroom, 5th Floor

Author(s)

TC

Taryn Cook, B.S.

Clinical Research Coordinator
Cincinnati Children's Hospital Medical Center
CINCINNATI, Ohio

Co-Author(s)

JF

Joseph Fredrick, Ph.D.

Postdoctoral Fellow
Cincinnati Children’s Hospital Medical Center
Cincinnnati, Ohio
JL

Joshua Langberg, Ph.D.

Faculty
Virginia Commonwealth University
Richmond, Virginia
SB

Stephen P. Becker, Ph.D.

Associate Professor
Cincinnati Children's Hospital and Medical Center
Cincinnati, Ohio

Circadian preference refers to an individual’s preference for the timing of activities and sleep. Evening preference has been associated with a variety of adverse outcomes, including increased sleep problems, higher depressive symptoms, and worse academic performance (Dickinson et al., 2018; Russo et al., 2017; Tonetti et al., 2015). Despite growing interest in the relation between circadian preference and academic functioning, the current literature is limited in several ways, including 1) using a cross-sectional rather than longitudinal research design, 2) typically relying on a single informant, and 3) absence of studies testing mechanisms linking circadian preference to academic impairment. Furthermore, largely separate lines of research have linked evening preference to increased daytime sleepiness, and daytime sleepiness to greater academic impairment (Giannoti et al., 2002; Russo et al., 2017). However, no study has examined whether daytime sleepiness explains the relation between circadian preference and academic impairment. The current study extends the literature by using a multi-informant, prospective design to examine the longitudinal relation between circadian preference and academic impairment, and daytime sleepiness as a potential mediator. Participants were 302 adolescents (M_age = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD) recruited in the fall of their 8^th grade. Adolescents, parents, and teachers completed surveys in the fall of 8^th (T1) and 9^th grade (T2), and middle of 10^th grade (T3). At T1, adolescents completed a measure of circadian preference and adolescents and parents completed measures of adolescents’ daytime sleepiness at T2. At T3, parents and teachers completed a measure of the adolescents’ academic impairment and grade point average (GPA) was calculated based on core subject grades obtained from school report cards. Covariates included adolescent sex, ADHD status, T1 medication status, and T1 adolescent-reported nightly sleep duration. Each model controlled for baseline ratings of the T3 outcome variable. The indirect effect and their 95% confidence intervals (CI) were calculated using 10,000 bias-corrected bootstrapped sampling estimates. Above and beyond covariates and baseline academic impairment, evening preference in 8^th grade predicted greater academic impairment in 10^th grade via parent, but not adolescent, ratings of daytime sleepiness in 9^th grade. The significant indirect effect was consistent across parent-reported academic impairment (ab=-.04, SE= .02, 95% CI [-.03, -.003]), teacher-reported academic impairment (ab= -.06, SE=.03, 95% CI [-.05, -.001]), and GPA obtained from school records (ab=.04, SE= .02, 95% CI [.001, .012]). Finally, the indirect effect was not moderated by adolescent ADHD status. The findings point to the importance of both circadian preference and daytime sleepiness in the longitudinal development of academic impairment across adolescence. Future research could examine whether identifying and treating daytime sleepiness and evening preference in adolescents has downstream impacts on academic outcomes.