This prospective, longitudinal study was designed to elucidate mechanisms underlying the relationship between sleep problems and propensity to drug/alcohol use in adolescents, from age 10 through 20. Our integrative, temporal model theorized that sleep problems would be significant predictors of drug/alcohol initiation and escalation of use in adolescents.
We proposed further that this relationship could be explained at least in part by emotion dysregulation, as measured by tasks that recruit affective limbic structures and perturbations in neuroendocrine (cortisol) functioning. Level of cognitive functioning would moderate the relationship between sleep problems and drug use. Exposure to prolonged stress was expected to amplify the mediational relationship.
Finally, the model predicted that eventual drug use would exacerbate sleep problems and lead to further decrements in sleep, emotion regulation, and cognition, promoting an escalating pattern of use.