đŹ Editorâs Note by JAMA Editorial Fellow Randi Bates and JAMA Deputy Editor Tracy Lieu: Adolescents face increasing rates of insufficient sleep, driven by early school start times and digital media use, undermining cognitive and mental health.
Insufficient sleep is one of the most common health risks in adolescents and is associated with worse cognitive performance and academic achievement, as well as depression, other mental health conditions, and physical concerns. The American Academy of Sleep Medicine and American Academy of Pediatrics (AAP) recommend adolescents aged 13 to 18 years sleep for 8 to 10 hours each night.1 Yet, studies have found that adequate sleep eludes most adolescents.2
In this issue of JAMA, Bommersbach and colleagues report worsening trends in insufficient sleep duration among US high school students based on an analysis of the national Youth Risk Behavior Survey.3 Insufficient sleep increased from 68.9% in 2007 to 76.8% in 2023, largely from increases in very short sleep durations of less than or equal to 5 hours per night. This trend was observed in all demographic groups and was generally consistent across subgroups characterized by behavioral risk factors.
These sweeping patterns suggest that structural and environmental factors may be driving increases in insufficient sleep at the population level. Although some studies have focused on changing individual behavior to increase sleep, such interventions may have limitations in adolescents whose self-regulatory and decision-making abilities are still maturing. Additionally, adolescents may lack sufficient agency to overcome school or social system barriers that limit sleep.





