Sleep improvement as a contributing factor to reducing alcohol use among adolescents.

Sleep quality improvement remains an underexplored protective factor for alcohol use among adolescents, a group at heightened risk for both drinking and sleep problems. This study examines the prospective association between sleep quality and alcohol use and the impact of sleep improvement on drinking behaviors. A six-month, two-wave longitudinal study was conducted with 193 Spanish adolescents (aged 15-17; 59.6 % female) who self-reported their sleep quality and alcohol use. Mixed-effects models were applied. Results showed that poor sleep predicted increased alcohol consumption (RR = 1.2; 95 %CI = 1.1-1.3). Likewise, improvements in global sleep quality scores were associated with reduced binge drinking (OR = 1.1; 95 %CI = 1.0-1.3), lower drinking frequency (OR = 1.2; 95 %CI = 1.0-1.3), and decreased AUDIT scores (OR = 1.2; 95 %CI = 1.0-1.4). Specifically, reporting more sleep hours and higher sleep efficiency was linked to lower alcohol use frequency (OR = 1.3 and OR = 1.0, respectively); also, reporting fewer night awakenings prospectively correlated with a reduction in AUDIT scores (OR = 2.0; 95 %CI = 1.4-2.9). Improving sleep quality may contribute to reduce adolescent alcohol use, underscoring the need to integrate sleep-focused strategies into drug use prevention programs.