Sommeil et substances à l'adolescence : les effets de la caféine, de l'alcool, du tabac et du cannabis

Sleep in adolescents is likely to be disturbed due to biological vulnerability and specific environmental factors. These factors, which relate to the psychological and cultural processes of adolescence, include the use of addictive substance. This article provides a review of international literature about the effects on adolescent sleep of the four substances which are the most used at this age : caffeine, tobacco, alcohol and cannabis. The available data indicate that all these substances modify sleep subjectively and/or objectively - in a manner, which depends on the substance and on the way it is used - to a point that can reach significant disturbance of sleep and wakefulness. This could be particularly the case for alcohol - which is associated with insomnia - and for cannabis - which seems to be associated with daytime sleepiness, hypersomnia and sleep/wake rhythm disturbance. However, most studies did not methodologically control for some major confounding factors, particularly psychopathological ones, and thus neither allow demonstrating rigorously a direct causal link between substance use and sleep disturbance, nor estimating the relative part of these problems which is related to substance use relatively to other implicated factors. However, these results argue for informing adolescents about the possible consequences of substance use on sleep, and for taking into account substance use and its associated psychological difficulties in adolescents who seek medical help for sleep problems. Finally, well-conceived studies in epidemiology and physiology would still be useful to specifically evaluate the immediate and long-term effects of addictive substance use on sleep in adolescents.