# Sleep disparities' role in adolescent fatigue and functioning: A mixed-methods study

> **NIH NIH R01** · CASE WESTERN RESERVE UNIVERSITY · 2021 · $727,957

## Abstract

Abstract: Fatigue is a frequently reported complaint of adolescents and is linked to a wide range of adverse
health, behavioral, and functional outcomes. Disparities in fatigue prevalence exist, with greater frequency
seen in minority, economically disadvantaged populations. Disparities in sleep quantity and quality also fall
along ethnic and economic lines, with poorer sleep observed among the economically disadvantaged and
persons of color. Because of fatigue’s strong link with inadequate sleep, our understanding of fatigue will
benefit from greater awareness of its relationship with sleep disparities, especially among early adolescents,
when notable racial differences in sleep duration and timing emerge. Numerous social-environmental factors in
individual, household, and neighborhood levels may serve as risk and resilience factors shaping disparities in
sleep and fatigue. Yet, the relative contributions of these factors are yet unclear. Moreover, the association
between inadequate sleep and fatigue is obscured by another common teen complaint: daytime sleepiness.
The relationship between fatigue and sleepiness, and their differential effects on adolescent health and
functioning are yet unclear. Our study purpose is to identify key mechanisms underlying racial and
economic disparities in sleep and their association with fatigue, daytime sleepiness, and functioning in
early adolescents. We posit that differences in household organization, socioeconomic disadvantage, and
experiences of discrimination are key drivers of sleep disparity between African American and White
adolescents. Guided by a community advisory board, and using a novel smart phone/sensor technology
developed in our pilot research on adolescent sleep, we propose a home-based study among African
American and White adolescents in Cleveland, OH to (a) identify factors responsible for adolescent sleep
disparities; (b) determine the effects of sleep disparities on fatigue, daytime sleepiness, and functioning; and
(b) disentangle effects of sleepiness from fatigue. Using a mixed-methods design and sample of 350
adolescents and caregivers balanced by race and socio-economic status, we will conduct linear mixed
modeling to assess associations between baseline (time-invariant) and nightly (time-varying) measures of key
mechanisms with that of sleep quality and quantity, fatigue, sleepiness, and functioning over a 2-week period.
A qualitative study component will focus on how household/neighborhood factors and discrimination shape
sleep, the teen experience of sleepiness vs. fatigue, and self-management strategies to address problematic
sleep and fatigue. The study is innovative: it simultaneously investigates multiple potential mechanisms
driving adolescent sleep disparities and uses novel technology to better measure the context of teen sleep.
Expected results will be significant: identifying drivers of sleep disparities is vital to improve sleep, reduce
fatigue and sleepiness, and impro...

## Key facts

- **NIH application ID:** 10175191
- **Project number:** 1R01HD104601-01
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** James Spilsbury
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $727,957
- **Award type:** 1
- **Project period:** 2021-05-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10175191

## Citation

> US National Institutes of Health, RePORTER application 10175191, Sleep disparities' role in adolescent fatigue and functioning: A mixed-methods study (1R01HD104601-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10175191. Licensed CC0.

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