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This research examines how objective sleep characteristics relate to mental health indicators in adolescents.

July 18, 2026Open Access

Associations between objective sleep duration, sleep duration variability, and sleep onset with emotion regulation and internalizing symptoms in adolescents: findings from the ABCD® study

SISarah IzabelStanford Medicine OKOrsolya KisSRI International AKAdam KrauseStanford University

Key Points

This research examines how objective sleep characteristics relate to mental health indicators in adolescents.
Cross-sectional study design with 1,371 U.S. adolescents from the ABCD study.
Objective sleep metrics (duration, variability, onset) were analyzed in relation to emotional regulation and internalizing symptoms.
Analysis controlled for age, sex, race/ethnicity, and parental education.
Sleep duration ≤7.05 hours associated with greater internalizing symptoms (β=0.06, p=0.036).
Greater sleep variability linked to higher internalizing symptoms and greater emotion suppression (β=0.09, p=0.001).
Later sleep onset times correlated to greater internalizing symptoms (β=0.06, p=0.030).

Abstract

Poor sleep and mental health are closely linked in adolescents, but most studies have relied on self-reported sleep measures. We investigated cross-sectional associations between objective sleep features (sleep duration, variability, and onset time) and mental health outcomes (internalizing symptoms and emotion regulation) in 1,371 U.S. adolescents from the Adolescent Brain Cognitive Development℠ Study (ABCD®) year 4 follow-up; mean age 14.09±0.69, 51.84% female controlling for age, sex, race/ethnicity, and parental education.Sleeping ≤7.05 hours (β=0.06 95% CI: 0.00–0.11, p=0.036), greater sleep duration variability (β=0.09 0.03–0.14, p=0.001), with stronger effects in females (interaction: β=-0.12 -0.22–-0.02, p=0.020), and later sleep onset times (β=0.06 0.01–0.11, p=0.030) were all associated with greater internalizing symptoms. Sleep was not linked to reappraisal (all p0.05). Higher variability was associated with greater suppression (β=0.09 0.03–0.14, p=0.001).Objective sleep features were differentially associated with mental health outcomes, highlighting that thoughtful sleep interventions can support adolescent well-being.

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