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Cited by 233Sleep and related disordersSleep and Work-Related FatigueSleep and Wakefulness Research

Associations of executive function with sleepiness and sleep duration in adolescents

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Anderson, Basil, Storfer-Isser, Amy, Taylor, H. Gerry, Rosen, Carol L., Redline, Susan·2009·Pediatrics
DOI 10.1542/peds.2008-1182PMC PMC4430079
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Abstract

BACKGROUND. Sleep deprivation and sleepiness are associated with poorer school performance, impaired neurobehavioral functioning, and behavioral problems. OBJECTIVE. To determine if adolescents with high levels of sleepiness or short sleep duration have impaired executive functioning. METHODS. Ours was a cross-sectional analysis of data from 236 healthy adolescents in a community-based cohort study. Sleepiness was measured by using a modified version of the Epworth Sleepiness Scale. Participants underwent 5- to 7-day wrist actigraphy at home before overnight polysomnography. Exposure variables were excessive sleepiness (Epworth Sleepiness Scale ≥ 11) and weekday mean sleep duration. The main outcome measures were the global executive composite scale from the Behavior Rating Inventory of Executive Function and the tower test-total achievement score from the Delis-Kaplan Executive Functioning System. RESULTS. Participants (N = 236) were 13.7 ± 0.8 years of age, and 52.1% were boys. Mean weekday sleep duration was 7.70 ± 1.03 hours; 11% slept <6.5 hours on average on weekdays, and 26% reported excessive sleepiness. In unadjusted analyses, sleepy adolescents had poorer executive functioning on the Behavior Rating Inventory of Executive Function global executive composite scale and the Delis-Kaplan Executive Functioning System tower test-total achievement. Analyses adjusted for potential confounders resulted in a modest attenuation of the association with the Behavior Rating Inventory of Executive Function and a larger attenuation for the Delis-Kaplan Executive Functioning System. Caregiver education modified the association between sleepiness and the Behavior Rating Inventory of Executive Function outcomes. Among sleepy adolescents, those with less-educated caregivers had greater impairment on the Behavior Rating Inventory of Executive Function global executive composite scale. Sleep duration was not significantly associated with executive functioning outcomes. CONCLUSIONS. Decrements in selected executive function scales are associated with subjective sleepiness, but not sleep duration, in adolescents. The association between sleepiness and executive functioning is strongest among adolescents with primary caregivers who have lower levels of education, suggesting an increased susceptibility. Pediatricians and public health officials should consider sleepiness as a potentially important contributor to adolescent functioning.

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  • Sleep restricted adolescents have been consistently found to be more sleepy.

    “Sleep restricted adolescents have been consistently found to be more sleepy.”

    From Cognitive Performance, Sleepiness, and Mood in Partially Sleep Deprived Adolescents: The Need for Sleep Study (2016) · cites this paper as [12]

    The Results (Associations with Sleepiness; page unavailable) report that short weekday sleep was more prevalent among sleepy adolescents, supporting an association between shorter sleep and sleepiness. The study is cross-sectional and does not establish that sleep restriction made adolescents sleepier or that this has been consistently found across studies. (LLM, conf=0.84)

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  • Other studies have failed to find a significant relationship between sleep duration and speed of processing, working memory, or executive function in children and adolescents.

    “Although several observational studies have found that speed of processing, sustained attention, working memory, and executive function are poorer in children and adolescents who report shorter sleep, [22][23][24] other studies have failed to find a significant relationship between sleep duration and speed of processing, 23,25 working memory, or executive function.12,23,25”

    From Cognitive Performance, Sleepiness, and Mood in Partially Sleep Deprived Adolescents: The Need for Sleep Study (2016) · cites this paper as [12]

    The Results section, “Associations between Measures of Executive Function and Sleep Duration” (page unavailable), reports no significant association between sleep duration and the primary executive-function outcomes. The Methods section, “Executive Functioning Outcomes” (page unavailable), describes working memory as one demand of an executive-function test, but the paper does not report separate findings for working memory or processing speed. It therefore supports the executive-function part of the claim, not all three outcomes attributed to it. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Sleep-deprived adolescents and adolescents who report high levels of sleepiness show detriments in higher-level executive functioning, decreased cognitive modulation of drives, impulses, and emotions, and less effortful control of attention.

    “For example, sleep-deprived adolescents and adolescents who report high levels of sleepiness show detriments in higher-level executive functioning, decreased cognitive modulation of drives, impulses, and emotions, and less effortful control of attention (Anderson et al., 2008; Beebe et al., 2008; Dahl, 1996).”

    From The effects of poor quality sleep on brain function and risk taking in adolescence (2013) · cites this paper as Anderson et al., 2008

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Authors
Anderson, B., Storfer-Isser, A., Taylor, H. G., Rosen, C. L., & Redline, S.
Affiliations
  • Case Western Reserve University (US)
  • Center for Clinical Investigation, Case Western Reserve University School of Medicine, Cleveland, Ohio
  • Rainbow Babies & Children's Hospital (US)
  • University Hospitals of Cleveland (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2009-04-01
Volume
123
Issue
4
Pages
e701-e707
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2008-1182
PMC
PMC4430079
OpenAlex
W2028062440
Cited by
233
References
30
Citations by year
2026: 5 · 2025: 19 · 2024: 10 · 2023: 12 · 2022: 20 · 2021: 16 · 2020: 15 · 2019: 19 · 2018: 16 · 2017: 15 · 2016: 17 · 2015: 15 · 2014: 15 · 2013: 14 · 2012: 11
FWCI
10.58
Type
journal article
Language
en
Open access
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (HL07567, HL60957, K23 HL04426, T32HL007567, R01HL060957, K23HL004426)
  • National Cancer Institute (U54CA116867)
  • National Institute of Nursing Research (R01 NR02707, R01NR002707)
  • National Center for Research Resources (M01RR000080, UL1RR024989, M01RR00080)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
executive function, sleepiness, sleep duration, adolescents, excessive daytime sleepiness, Behavior Rating Inventory of Executive Function, caregiver education, sleep deprivation, neurobehavioral function
MeSH terms
Adolescent, Cognition, Cognition Disorders, Cross-Sectional Studies, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Regression Analysis, Sleep, Socioeconomic Factors, Effect Modifier, Epidemiologic

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