Abstract Introduction Insufficient sleep is the most common reason for excessive daytime sleepiness in youth. To explore factors underlying this issue, we examined the relationship between time in bed (TIB) and sleepiness, along with the potential role of behaviors that may compensate for insufficient TIB, using self-reported sleep diaries and questionnaires in typically developing (TD) youth. Methods We recruited TD youth aged 8–19 with Pediatric Sleep Questionnaire scores ≤.33 to ensure healthy sleep status. Participants completed the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) and a 7-day sleep diary from which we compute average TIB, caffeine use, exercise, napping, and electronics use. Fifty-eight participants aged 8-18 completed all measures (mean age=12.7 ± 3.1 years, 35 females). Sufficient TIB was defined as recommended age-based sleep duration per American Academy of Sleep Medicine guidelines plus one hour (≥600 minutes for ages 6–12; ≥540 minutes for ages 13–18). ESS-CHAD scores ≥10 indicated abnormal sleepiness. We examine correlations between sleepiness and TIB using Pearson’s correlations, controlling for age and BMI with partial correlations. We further explore compensatory behaviors by independent sample t-tests. Significance was p.05. Results TIB and ESS-CHAD scores were negatively correlated (r= –.29, p=.04), although when accounting for age and BMI, this correlation was no longer significant (r= -.20, p=.17). 24.1% of participants (n=14) showed abnormal sleepiness. Among those with normal sleepiness (n=44), two subgroups were identified: sufficient TIB (n=24) and insufficient TIB (n=20). Independent t-tests showed no age or BMI differences between subgroups. The insufficient TIB group showed significantly higher caffeine intake than the sufficient TIB group (p=.03), while exercise (p=.90) and electronics use (p=.16) did not differ. Napping trended toward significance (p=.07). Conclusion TD youth showed high prevalence of abnormal sleepiness (24.1%). Insufficient sleepers with normal sleepiness napped more frequently and had higher caffeine intake than sufficient sleepers. These findings highlight that excessive daytime sleepiness is common in TD youth, and insufficient sleepers may rely on compensatory strategies like naps and caffeine to contribute to total daily rest and reduce sleepiness. Support (if any) This project is supported partly by the Worthington Industries Pediatric Research Fund 2025 to PM.
Patel et al. (2026) studied this question.