The sweet spot of weekend catch-up sleep: U-shaped associations with internalizing symptoms in adolescents from the Adolescent Brain Cognitive Development Study.

STUDY OBJECTIVES: Adolescents often extend sleep on weekends to compensate for short weekday sleep, a behavior known as weekend catch-up sleep (WCS). Although adult and self-report studies suggest both protective and adverse effects, evidence in adolescents-especially for anxiety and depression-remains limited. We examined associations between WCS and internalizing symptoms using objectively measured sleep.

METHODS: Participants were 1867 adolescents (mean age = 14.1 years) from the Adolescent Brain Cognitive Development Study. WCS was calculated as the difference between average weekend and weekday sleep duration from Fitbit recordings (mean = 13.1 nights). Anxiety and depressive symptoms were assessed with the Child Behavior Checklist. Logistic and quadratic regression models tested associations between WCS and symptoms, accounting for age, sex, and race.

RESULTS: Adolescents with moderate WCS (≤2 h) had lower odds of clinical level anxiety than those with consistent sleep (odds ratio = 0.49, confidence interval = 0.30 to 0.78, p = .003). Quadratic models revealed U-shaped associations: both weekend sleep loss and excessive WCS were linked to elevated anxiety (p = .005) and depressive symptoms (p = .043), with the lowest symptoms at moderate WCS. This non-linear pattern remained significant for anxiety, but not for depression, after accounting for weekday sleep duration and sleep timing.

CONCLUSIONS: In this large US adolescent sample, moderate WCS was associated with lower anxiety, whereas large weekday-weekend sleep discrepancies were linked to higher symptoms. Associations with depressive symptoms were weaker and model-dependent. Findings suggest a potential "sweet spot" for weekend sleep extension and underscore risk of large sleep variability. Statement of Significance Adolescents commonly extend sleep on weekends to compensate for short sleep on weekdays, yet its implications for mental health remain debated. This study addresses three gaps in the literature: (1) limited evidence in adolescents, especially for anxiety, (2) reliance on self-reported rather than objectively measured sleep, and (3) limited examination of different operationalizations of weekend catch-up sleep (WCS). Using wearable-derived sleep data and testing WCS both categorically and continuously-including non-linear relationships-we found that moderate WCS was associated with lower anxiety, whereas both weekend sleep loss and excessive WCS were associated with elevated symptoms. These findings suggest a potential "sweet spot" of weekend sleep extension and underscore the importance of avoiding large discrepancies between weekday and weekend sleep, offering insights for adolescent sleep health, clinical practice, and public health policy.