1
|
Giannotta F, Nilsson KW, Åslund C, Olofdotter S, Vadlin S, Larm P. Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents. J Youth Adolesc 2024; 53:1355-1369. [PMID: 38580891 PMCID: PMC11045630 DOI: 10.1007/s10964-024-01980-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.
Collapse
Affiliation(s)
- F Giannotta
- Division of Public Health, School of Health, Care and Social Welfare, Malardalen University, Box 883, Västerås, Sweden.
- Department of Public Health, Stockholm University, SE-106 91, Stockholm, Sweden.
- Department of Psychology, University of Turin, via Verdi 10, 10124, Turin, Italy.
| | - K W Nilsson
- Division of Public Health, School of Health, Care and Social Welfare, Malardalen University, Box 883, Västerås, Sweden
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - C Åslund
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - S Olofdotter
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
| | - S Vadlin
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
| | - P Larm
- Department of Public Health, Stockholm University, SE-106 91, Stockholm, Sweden
| |
Collapse
|
2
|
Bauducco S, Gardner LA, Smout S, Champion KE, Chapman C, Gamble A, Teesson M, Gradisar M, Newton NC. Adolescents' trajectories of depression and anxiety symptoms prior to and during the COVID-19 pandemic and their association with healthy sleep patterns. Sci Rep 2024; 14:10764. [PMID: 38730014 PMCID: PMC11087504 DOI: 10.1038/s41598-024-60974-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
The COVID-19 pandemic has seen a rise in anxiety and depression among adolescents. This study aimed to investigate the longitudinal associations between sleep and mental health among a large sample of Australian adolescents and examine whether healthy sleep patterns were protective of mental health in the context of the COVID-19 pandemic. We used three waves of longitudinal control group data from the Health4Life cluster-randomized trial (N = 2781, baseline Mage = 12.6, SD = 0.51; 47% boys and 1.4% 'prefer not to say'). Latent class growth analyses across the 2 years period identified four trajectories of depressive symptoms: low-stable (64.3%), average-increasing (19.2%), high-decreasing (7.1%), moderate-increasing (9.4%), and three anxiety symptom trajectories: low-stable (74.8%), average-increasing (11.6%), high-decreasing (13.6%). We compared the trajectories on sociodemographic and sleep characteristics. Adolescents in low-risk trajectories were more likely to be boys and to report shorter sleep latency and wake after sleep onset, longer sleep duration, less sleepiness, and earlier chronotype. Where mental health improved or worsened, sleep patterns changed in the same direction. The subgroups analyses uncovered two important findings: (1) the majority of adolescents in the sample maintained good mental health and sleep habits (low-stable trajectories), (2) adolescents with worsening mental health also reported worsening sleep patterns and vice versa in the improving mental health trajectories. These distinct patterns of sleep and mental health would not be seen using mean-centred statistical approaches.
Collapse
Affiliation(s)
- Serena Bauducco
- Flinders University, Adelaide, Australia.
- Center for Health and Medical Psychology, Örebro University, Fakultetsgatan 1, 701 82, Örebro, Sweden.
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Amanda Gamble
- The Woolcock Institute, Macquarie University, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Michael Gradisar
- WINK Sleep Pty Ltd, Adelaide, Australia
- Sleep Cycle AB, Gothenburg, Sweden
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| |
Collapse
|
3
|
Lü W, Ma Y, Wei X, Zhang L. Social interaction anxiety and sleep quality in youth: Individual difference in childhood adversity and cardiac vagal control. J Affect Disord 2024; 350:681-688. [PMID: 38272358 DOI: 10.1016/j.jad.2024.01.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Social interaction anxiety and sleep problems are prevalent during adolescence. Social interaction anxiety undermines sleep quality, however, little is known whether the association between social interaction anxiety and sleep quality is moderated by environmental factors such as childhood adversity and individual factors such as cardiac vagal control. This study sought to investigate the moderating effects of childhood adversity and cardiac vagal control on the link between social interaction anxiety and sleep quality. METHOD The Social Interaction Anxiety Scale, the Pittsburgh Sleep Quality Index and the Childhood Trauma Questionnaire were administered to 274 adolescents, who received 3-min resting ECG recording to assess respiratory sinus arrhythmia (RSA) as an index of cardiac vagal control. RESULTS Social interaction anxiety was negatively associated with sleep quality, and this association was moderated by childhood adversity and cardiac vagal control. In specific, social interaction anxiety was negatively associated with sleep quality among adolescents with low childhood adversity regardless of cardiac vagal control. Sleep quality was generally disrupted when adolescents exposed to high childhood adversity, but the negative association between social interaction anxiety and sleep quality among adolescents with high childhood adversity could be amortized by high cardiac vagal control. LIMITATIONS Cross-sectional design precluded establishing causality among variables. CONCLUSION These findings suggest that high cardiac vagal control reflecting better self-regulation might buffer the negative effect of social interaction anxiety on sleep quality particularly among adolescents exposed to early life stress.
Collapse
Affiliation(s)
- Wei Lü
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, China.
| | - Yunqingli Ma
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, China
| | - Xiaomin Wei
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, China
| | - Liangyi Zhang
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, China
| |
Collapse
|
4
|
Silva-Caballero A, Ball HL, Kramer KL, Bentley GR. Sleep tight! Adolescent sleep quality across three distinct sleep ecologies. Evol Med Public Health 2023; 11:448-460. [PMID: 38044930 PMCID: PMC10693291 DOI: 10.1093/emph/eoad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/05/2023] [Indexed: 12/05/2023] Open
Abstract
Background and objectives Good sleep quality, associated with few arousals, no daytime sleepiness and self-satisfaction with one's sleep, is pivotal for adolescent growth, maturation, cognition and overall health. This article aims to identify what ecological factors impact adolescent sleep quality across three distinct sleep ecologies representing a gradient of dense urbanity to small, rural environments with scarce artificial lighting and no Internet. Methodology We analyze variation of sleep efficiency, a quantitative measure of sleep quality-defined as the ratio of total time spent asleep to total time dedicated to sleep-in two agricultural indigenous populations and one post-industrial group in Mexico (Campeche = 44, Puebla = 51, Mexico City = 50, respectively). Data collection included actigraphy, sleep diaries, questionnaires, interviews and ethnographic observations. We fit linear models to examine sleep efficiency variation within and between groups. Results We found that sleep efficiency varied significantly across sites, being highest in Mexico City (88%) and lowest in Campeche (75%). We found that variation in sleep efficiency was significantly associated with nightly exposure to light and social sleep practices. Conclusions and implications Our findings point toward contextual cost-benefits of sleep disruption in adolescence. We highlight the need to prioritize research on adolescent sleep quality across distinct developmental ecologies and its impact on health to improve adolescent wellbeing through evidence-based health practices.
Collapse
Affiliation(s)
- Andrea Silva-Caballero
- Institute of Anthropological Research, National Autonomous University of Mexico, Mexico City, 04510, Mexico
- Department of Anthropology, Durham University, Durham, DH1 3LE, UK
| | - Helen L Ball
- Department of Anthropology, Durham University, Durham, DH1 3LE, UK
| | - Karen L Kramer
- Department of Anthropology, Univesity of Utah, Salt Lake City, RM 4625, USA
| | | |
Collapse
|
5
|
Sollenberger NA, Kimbler A, Cummings LR, Pettit JW, Hayes T, Patriarca GC, Vázquez AL, Shumway P, Yegüez CE, Rey Y, Mattfeld AT, McMakin DL. Sleep fails to depotentiate amygdala-reactivity to negative emotional stimuli in youth with elevated symptoms of anxiety. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:415-426. [PMID: 36788201 PMCID: PMC10770807 DOI: 10.3758/s13415-023-01066-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/16/2023]
Abstract
Sleep-related problems often precede escalating anxiety in early adolescence. Pushing beyond broad sleep-mental health associations and toward mechanistic theories of their interplay can inform etiological models of psychopathology. Recent studies suggest that sleep depotentiates neural (e.g., amygdala) reactivity during reexposure to negative emotional stimuli in adults. Persistent amygdala reactivity to negative experiences and poor sleep characterize anxiety, particularly at the transition to adolescence. We propose that sleep depotentiates amygdala reactivity in youth but fails to do so among youth with anxiety. Participants (n = 34; 18 males; age, mean [M] = 11.35, standard deviation [SD] = 2.00) recruited from the community and specialty anxiety clinics viewed valenced images (positive, negative, and neutral) across two fMRI sessions (Study, Test), separated by a 10-12-hour retention period of sleep or wake (randomized). Mixed linear models regressed basolateral amygdala (BLA) activation and BLA-medial prefrontal cortex (mPFC) functional connectivity to negative images on Time, Condition, and Anxiety Severity. There were greater reductions in BLA activations to negative target images from Study to Test in the Sleep Condition, which was blunted with higher anxiety (b = -0.065, z = -2.355, p = 0.019). No such sleep- or anxiety-related effects were observed for BLA-mPFC functional connectivity (ps > 0.05). Sleep supports depotentiation of amygdala reactivity to negative stimuli in youth, but this effect is blunted at higher levels of anxiety. Disruptions in sleep-related affective habituation may be a critical, modifiable driver of anxiety.
Collapse
Affiliation(s)
| | - Adam Kimbler
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Logan R Cummings
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Jeremy W Pettit
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Timothy Hayes
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | | | | | - Philip Shumway
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Carlos E Yegüez
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Yasmin Rey
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Aaron T Mattfeld
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Dana L McMakin
- Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| |
Collapse
|
6
|
Smout S, Gardner LA, Newton N, Champion KE. Dose-response associations between modifiable lifestyle behaviours and anxiety, depression and psychological distress symptoms in early adolescence. Aust N Z J Public Health 2023; 47:100010. [PMID: 36645951 DOI: 10.1016/j.anzjph.2022.100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To investigate associations between key modifiable lifestyle behaviours (sleep; physical activity; fruit, vegetable and sugar-sweetened beverage consumption; screen time; alcohol use and tobacco use) and mental health among early adolescents in Australia. METHODS Cross-sectional self-report data from 6,640 Year 7 students (Mage:12.7[0.5]; 50.6% male, 48.9% female, 0.5% non-binary) from 71 schools in New South Wales, Queensland and Western Australia were analysed using multivariate linear regression adjusting for sociodemographic factors and school-level clustering. RESULTS All examined behaviours were associated with anxiety, depression and psychological distress (p≤0.001), with the lowest mental health symptom scores observed in participants who slept 9.5-10.5 hours per night; consumed three serves of fruit daily; consumed two serves of vegetables daily; never or rarely drank sugar-sweetened beverages; engaged in six days of moderate-to-vigorous physical activity per week; kept daily recreational screen time to 31-60 minutes; had not consumed a full standard alcoholic drink (past six months); or smoked a cigarette (past six months). CONCLUSIONS Targeting modifiable risk behaviours offers promising prevention potential to improve adolescent mental health; however, further longitudinal research to determine directionality and behavioural interactions is needed. IMPLICATIONS FOR PUBLIC HEALTH While Australian Dietary, Movement and Alcohol Guidelines target physical health, findings indicate similar behaviour thresholds may offer mental health benefits.
Collapse
Affiliation(s)
- Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| |
Collapse
|
7
|
Gradisar M, Kahn M, Micic G, Short M, Reynolds C, Orchard F, Bauducco S, Bartel K, Richardson C. Sleep’s role in the development and resolution of adolescent depression. NATURE REVIEWS PSYCHOLOGY 2022; 1:512-523. [PMID: 35754789 PMCID: PMC9208261 DOI: 10.1038/s44159-022-00074-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 12/03/2022]
Abstract
Two adolescent mental health fields — sleep and depression — have advanced largely in parallel until about four years ago. Although sleep problems have been thought to be a symptom of adolescent depression, emerging evidence suggests that sleep difficulties arise before depression does. In this Review, we describe how the combination of adolescent sleep biology and psychology uniquely predispose adolescents to develop depression. We describe multiple pathways and contributors, including a delayed circadian rhythm, restricted sleep duration and greater opportunity for repetitive negative thinking while waiting for sleep. We match each contributor with evidence-based sleep interventions, including bright light therapy, exogenous melatonin and cognitive-behaviour therapy techniques. Such treatments improve sleep and alleviate depression symptoms, highlighting the utility of sleep treatment for comorbid disorders experienced by adolescents. Sleep problems are both a symptom and precursor of adolescent depression. In this Review, Gradisar et al. describe how the combination of adolescent sleep biology and psychology predisposes adolescents to develop depression, and describe interventions that improve sleep and depression symptoms in this population.
Collapse
|
8
|
Beyond the neuron: Role of non-neuronal cells in stress disorders. Neuron 2022; 110:1116-1138. [PMID: 35182484 PMCID: PMC8989648 DOI: 10.1016/j.neuron.2022.01.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/15/2021] [Accepted: 01/24/2022] [Indexed: 12/11/2022]
Abstract
Stress disorders are leading causes of disease burden in the U.S. and worldwide, yet available therapies are fully effective in less than half of all individuals with these disorders. Although to date, much of the focus has been on neuron-intrinsic mechanisms, emerging evidence suggests that chronic stress can affect a wide range of cell types in the brain and periphery, which are linked to maladaptive behavioral outcomes. Here, we synthesize emerging literature and discuss mechanisms of how non-neuronal cells in limbic regions of brain interface at synapses, the neurovascular unit, and other sites of intercellular communication to mediate the deleterious, or adaptive (i.e., pro-resilient), effects of chronic stress in rodent models and in human stress-related disorders. We believe that such an approach may one day allow us to adopt a holistic "whole body" approach to stress disorder research, which could lead to more precise diagnostic tests and personalized treatment strategies. Stress is a major risk factor for many psychiatric disorders. Cathomas et al. review new insight into how non-neuronal cells mediate the deleterious effects, as well as the adaptive, protective effects, of stress in rodent models and human stress-related disorders.
Collapse
|