Associations Between Sleep and Health-Risk Behaviors in a Rural Adolescent Population

• Students in rural North Dakota completed the Rural Adolescent Health Survey.
• We examine associations between time spent in bed and health-risk behaviors.
• Less time in bed was associated with more smoking, alcohol use, and drug use.
• Sexual risk behaviors and chewing tobacco use were not associated with time in bed.

IntroductionInsufficient sleep has been associated with engagement in a number of health-risk behaviors in adolescents, including substance use and sexual activity. Associations between sleep and health-risk behaviors in adolescents living in rural areas of the United States are not well investigated. In rural settings, adolescents' sleep patterns, lifestyle factors, and health-risk opportunities may differ from those of urban adolescents, making the independent study of sleep and health behavior associations necessary.MethodThis study examined data from the Rural Adolescent Health Survey (N = 322) administered in rural North Dakota.ResultsRural adolescents who reported engaging in smoking, alcohol use, or drug use slept significantly less than adolescents who did not report engaging in these activities.DiscussionSleep was not associated with chewing tobacco use or risky sexual activity, which may reflect an effect of rural cultural values on sleep and health-risk behavior associations.