Sleep and school problems among children and adolescents in state custody.

Population-level research into the association between sleep problems and school problems among high-risk youth is limited. This study uses cross-sectional administrative and standardized assessment information for youth entering Tennessee state custody in fiscal year 2009 (n = 4280) to examine whether sleep problems are independently associated with school problems. Sleep problems were identified in 9.8% of the sample. There was no association between sleep and school problems for youth adjudicated delinquent. Among youth adjudicated dependent-neglect/unruly, multivariate logistic regression analysis indicates that youth at risk for sleep problems are 1.78 (95% confidence interval = 1.24-2.55) and youth with actionable sleep problems are 3.30 (95% confidence interval = 1.78-6.14) times more likely than youth without sleep problems to have school problems. Results suggest that the school performance of youth entering state custody adjudicated dependent-neglect/unruly may benefit from systematic screening and intervention for sleep problems.