Overview: Slowed circadian rhythms and sleep disturbances may be a cause of teenage depression, rather than a symptom that develops as a result of the mental disorder.
Source: Flinders University
New evidence suggests that sleep problems, long thought to be a symptom of adolescent depression, may be coming first.
A new article, published in Nature Reviews Psychology and led by Flinders University, argues that a combination of adolescent sleep biology and psychology uniquely predisposes young people to developing depression.
dr. Cele Richardson, a Flinders University graduate and now a Psychological Sciences lecturer at the University of Western Australia, says a slowed circadian rhythm, limited sleep duration and a greater chance of negative thinking while trying to fall asleep were all contributing factors.
“Adolescents are the most chronically sleep-deprived subpopulation in human development, in both Western and Eastern societies, with data from around the world suggesting they are sleeping too late and too little,” she says.
The researchers found that a combination of developmental changes in the biological systems that control sleep and wakefulness during this time in people’s lives, rather than factors such as use of technology in the evening, provides unique pathways to depression.
“The first factor is a slower build-up of sleepiness during the day, which delays the onset of sleep in older adolescents,” says Dr. Richardson.
“Although teens fall asleep later, school hours remain early, which means it is difficult for young people to achieve optimal sleep of 9.3 hours. And this sleep restriction, in turn, increases depression symptoms.
“Second, the difficulty of falling asleep is further exacerbated by a delay in the timing of the circadian rhythm that occurs during adolescent development and having a late biological clock is consistently associated with an increased risk of depression.”
“These physiologically driven changes in sleep provide the potential for a third pathway to depression that is more psychological – the potential for repetitive negative thinking (worry and rumination), which in turn is linked to higher levels of depression in adolescents.”
Researchers say evidence-based sleep interventions — including bright light therapy, the use of melatonin, and cognitive behavioral therapy techniques — may represent a new way to relieve depressive symptoms in young people.
“Further research into the role of sleep in depression may also help us develop more effective prevention approaches so that we can halt the onset of depression, at least for some young people,” says Dr. Richardson, who is conducting a clinical trial at UWA where bright light therapy will be added to a common treatment for depression to see if it improves outcomes for adolescents.
Flinders Institute for Sleep Health researcher Dr. Gorica Micic, also a co-author of the new paper, says schools and communities could incorporate sleep education into curricula to support the wellbeing of young people at this vulnerable age.
“Since underlying biological and physiological factors contribute significantly to this manifestation, basic understanding of sleep and what happens during sleep in adolescence can help young people better understand and manage their sleep,” says Dr. micic.
Flinders University researcher Dr. Michelle Short said the responsibility also rests with the parents.
“Families could support teen sleep and mental health by instituting bedtime limits on school nights, while schools could allow students to start classes at 8:30am or later and refrain from scheduling.” of extracurricular activities before school,” says Dr. short.
About this research news on sleep and depression
Original research: Closed access.
†The role of sleep in the development and resolution of depression in adolescentsby Michael Gradisar et al. Nature Reviews Psychology
The role of sleep in the development and resolution of depression in adolescents
Two areas of adolescent mental health — sleep and depression — have largely advanced in parallel until about four years ago. While sleep problems have been thought to be a symptom of depression in adolescents, emerging evidence suggests that sleep problems are more likely to occur than depression.
In this Review, we describe how the combination of sleep biology and psychology uniquely predisposes adolescents to developing depression.
We describe multiple pathways and contributions, including a delayed circadian rhythm, limited sleep duration, and increased likelihood of repetitive negative thinking while waiting for sleep. We match each contributor with evidence-based sleep interventions, including bright light therapy, exogenous melatonin, and cognitive behavioral therapy techniques.
Such treatments improve sleep and alleviate depression symptoms, highlighting the usefulness of sleep treatment for comorbid disorders in adolescents.