Sleep Regularity and Caregiver-Reported Fasting and Meal Skipping Behavior Among U.S. Adolescents: Findings from a National Sample

The purpose of this study was to examine associations of bedtime consistency and sleep duration with caregiver-reported fasting and meal skipping among U.S. adolescents. Data were drawn from the 2024 National Survey of Children’s Health (N = 20,774 adolescents aged 12-17 years). Complex-samples logistic regression adjusted for age, demographic characteristics, family context, and sugary-drink intake. Predicted probabilities, interaction tests, and expanded covariate models were examined. Inconsistent bedtime was associated with higher odds of caregiver-reported fasting and meal skipping (aOR = 2.45, 95% CI: 2.00-3.00, P < .001). Short sleep was not independently associated after age adjustment (aOR = 1.16, 95% CI: 0.97-1.39, P = .111). Adjusted predicted probabilities ranged from 10.9% for consistent bedtimes and adequate sleep to 25.2% for inconsistent bedtimes and short sleep. The bedtime consistency × sleep-duration interaction was not significant. The association with inconsistent bedtime persisted in expanded models. Inconsistent bedtime was associated with caregiver-reported fasting and meal skipping, whereas short sleep was not independently associated after age adjustment. The outcome does not indicate eating-disorder diagnosis or severity. The cross-sectional design cannot establish directionality or demonstrate that changing bedtime consistency would alter eating behavior.