Household Basic Needs Support and Insufficient Sleep Among United States High School Students: Evidence From the 2023 National Youth Risk Behavior Survey

Background Insufficient school-night sleep is common among U.S. adolescents. The 2023 Youth Risk Behavior Survey (YRBS) includes a basic-needs support item about adult effort to ensure safety, clean clothes, and food. Methods We conducted a cross-sectional secondary analysis of the 2023 national YRBS. Insufficient sleep was defined as fewer than 8 hours on an average school night. Support was coded as present versus lacking. Survey-weighted models adjusted for demographic, behavioral, mental-health, and BMI covariates. Results Among students with nonmissing sleep data ( n = 17,441 ), 76.8% reported insufficient sleep. In the sleep/support frame ( n = 15,607 ), prevalence was 76.0% with support present and 82.0% with support lacking. In the multiply-imputed primary model ( m = 20 ), lacking support was associated with a small, statistically detectable increase in insufficient sleep (aPR = 1.052, 95% CI 1.007 to 1.098; ARD = +4.3 percentage points, 95% CI + 0.5 to +8.1). A complete-case sensitivity model gave a comparable but less precise estimate (aPR = 1.036, 95% CI 0.990 to 1.085). Conclusions Lacking perceived basic-needs support marked higher unadjusted insufficient-sleep prevalence, but adjusted estimates were modest. Sleep screening and basic-needs assessment may be clinically useful together; longitudinal work is needed to clarify directionality.