Sufficient Sleep, Physical Activity, and Sedentary Behaviors Kathryn E. Foti, MPH, Danice K. Eaton, PhD, Richard Lowry, MD, MS, Lela R. McKnight-Ely, PhD Background: Insuffıcient sleep among adolescents is common and has adverse health and behavior consequences. Understanding associations of physical activity and sedentary behaviors with sleep duration could shed light on ways to promote suffıcient sleep. Purpose: The purpose of this study is to determine whether physical activity and sedentary behav- iors are associated with suffıcient sleep (8 or more hours of sleep on an average school night) among U.S. high school students. Methods: Data were from the 2009 national Youth Risk Behavior Survey and are representative of 9th–12th-grade students nationally (n=14,782). Associations of physical activity and sedentary behaviors with suffıcient sleep were determined using logistic regression models controlling for confounders. Data were analyzed in October 2010. Results: Students who engaged in 60 minutes of physical activity daily during the 7 days before the survey had higher odds of suffıcient sleep than those who did not engage in 60 minutes on any day. There was no association between the number of days students were vigorously active 20 minutes and suffıcient sleep. Compared to their respective referent groups of 0 hours on an average school day, students who watched TV 4 hours/day had higher odds of suffıcient sleep and students who played video or computer games or used a computer for something that was not school work 2 hours/day had lower odds of suffıcient sleep. Conclusions: Daily physical activity for 60 minutes and limited computer use are associated with suffıcient sleep among adolescents. (Am J Prev Med 2011;41(6):596 – 602) Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine S leep is an important component of adolescent growth and development. Laboratory studies show adolescent sleep needs are on the order of 8 –9 hours per night 1,2 and adolescent self-reports also indicate this amount of sleep is needed for optimal daytime function- ing. 3,4 However, according to the National Sleep Founda- tion (NSF), 5 more than 60% of U.S. high school students report getting less than 8 hours of sleep/night on an average school night (i.e., insuffıcient sleep). Conse- quences of insuffıcient sleep include poor academic per- formance, 4,5 depressed mood, 4,5 daytime sleepiness, in- creased use of caffeine, feeling irritable during the day, and having trouble getting along with family members. 5 Shorter sleep duration or other measures of sleep prob- lems among adolescents have also been associated with drowsy driving 5 ; tobacco, alcohol, and drug use 6,7 ; un- healthy dietary behaviors 8,9 ; being overweight 8,10 ; sexual risk behaviors 7 ; and suicide attempts. 11 Among adolescents, factors such as social opportuni- ties, extracurricular activities, academic demands, and part-time jobs contribute to delayed bedtimes 12,13 and biological changes at puberty result in a preference for later sleep and wake times. 13 Early school start times, however, place a constraint on sleep time and can result in a chronic sleep defıcit. 12,13 Common recommenda- tions for increasing adolescents’ sleep time include exer- cising and limiting TV, video game, and computer use, particularly before bedtime. 14,15 Physical activity has been shown in some small or non-U.S. studies 8,16 –22 of adolescents to be associated with longer sleep duration and better quality sleep. For example, Brand et al. 20 found that high school students From the Division of Adolescent and School Health (Foti, Eaton, Lowry), the Division of Adult and Community Health (McKnight-Ely), National Center for Chronic Disease Prevention and Health Promotion, CDC, At- lanta, Georgia Address correspondence to: Kathryn E. Foti, MPH, Division of Adoles- cent and School Health, CDC, 1600 Clifton Rd NE, MS D-14, Atlanta GA 30341. E-mail: htk7@cdc.gov. 0749-3797/$36.00 doi: 10.1016/j.amepre.2011.08.009 596 Am J Prev Med 2011;41(6):596 – 602 Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine