1
|
Maity A, Wang AW, Dreier MJ, Wallace V, Orchard F, Schleider JL, Loades ME, Hamilton JL. How do adolescents experience a newly developed Online Single Session Sleep Intervention? A Think-Aloud Study. Clin Child Psychol Psychiatry 2024; 29:1137-1158. [PMID: 37978949 PMCID: PMC11188559 DOI: 10.1177/13591045231205475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
BACKGROUND Sleep problems are common in adolescents and have detrimental impacts on physical and mental health and daily functioning. Evidence-based treatment like cognitive behaviour therapy for insomnia (CBT-I) is often hard to access, and adolescents may not engage in and adhere to longer, clinician-delivered interventions. Brief, self-guided, and accessible sleep interventions are needed. OBJECTIVE To explore the user experience of a prototype online self-help single session sleep intervention developed for adolescents. METHODS Eleven participants aged 17-19 years (8 females, 3 males) took part in online retrospective think-aloud interviews. Participants first completed the prototype intervention independently and were then shown the intervention page by page and asked to verbalise their thoughts and experiences. Transcripts were analyzed thematically. RESULTS Participants found the intervention helpful. Four themes were generated - 'Educative: Learning, but more fun', 'Effortless: Quicker and Easier', 'Personalization: Power of Choice', and 'Positivity: Just Good Vibes'. The theme 'Educative: Learning, but more fun' encompassed two sub-themes 'Opportunity to Learn' and 'Aesthetics and Learning'. These themes reflected participants' views that the intervention was educative, personalised, solution-oriented and easy to use, but could incorporate more graphics and visuals to aid in learning and could be made more effortless and positive through modifications to its design. CONCLUSIONS Findings convey the importance of ensuring educative well-designed content, personalization, a positive tone, and ease of use while designing interventions targeting adolescents's sleep and mental health. They also indicate areas for further developing the intervention.
Collapse
Affiliation(s)
- Ananya Maity
- Department of Psychology, University of Bath, Bath, UK
| | - Angela W Wang
- Department of Psychology, Rutgers University, New Brunswick, USA
| | - Melissa J Dreier
- Department of Psychology, Rutgers University, New Brunswick, USA
| | | | - Faith Orchard
- School of Psychology, University of Sussex, Brighton, UK
| | | | | | | |
Collapse
|
2
|
Ganai UJ, Sachdev S, Bhushan B. Predictive modelling of stress, anxiety and depression: A network analysis and machine learning study. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024. [PMID: 38925547 DOI: 10.1111/bjc.12487] [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: 06/16/2023] [Revised: 04/24/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE This study assessed predictors of stress, anxiety and depression during the COVID-19 pandemic using a large number of demographic, COVID-19 context and psychological variables. METHODS Data from 741 adults were drawn from the Boston College daily sleep and well-being survey. Baseline demographics, the long version of the daily surveys and the round one assessment of the survey were utilized for the present study. A Gaussian graphical model (GGM) was estimated as a feature selection technique on a subset of ordinal/continuous variables. An ensemble Random Forest (RF) machine learning algorithm was used for prediction. RESULTS GGM was found to be an efficient feature selection method and supported the findings derived from the RF machine learning model. Psychological variables were significant predictors of stress, anxiety and depression, while demographic and COVID-19-related factors had minimal predictive value. The outcome variables were mutually predictive of each other, and negative affect and subjective sleep quality were the common predictors of these outcomes of stress, anxiety, and depression. CONCLUSION The study identifies risk factors for adverse mental health outcomes during the pandemic and informs interventions to mitigate the impact on mental health.
Collapse
Affiliation(s)
- Umer Jon Ganai
- Department of Humanities and Social Sciences, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, India
| | - Shivani Sachdev
- Department of Humanities and Social Sciences, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, India
| | - Braj Bhushan
- Department of Humanities and Social Sciences, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, India
| |
Collapse
|
3
|
Richardson R, Connell T, Foster M, Blamires J, Keshoor S, Moir C, Zeng IS. Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis. J Youth Adolesc 2024; 53:1301-1322. [PMID: 38564099 PMCID: PMC11045640 DOI: 10.1007/s10964-024-01969-w] [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: 08/28/2023] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
Suicide remains the second most common cause of death in young people aged 10-24 years and is a growing concern globally. The literature reports a vast number of factors that can predispose an adolescent to suicidality at an individual, relational, community, or societal level. There is limited high-level research identifying and understanding these risk and protective factors of adolescent suicidality. The present study used an umbrella review and meta-analysis to synthesize evidence from the review literature in the past 20 years on risk and protective factors of self-harm and suicidality (behavior and ideation) in adolescents. The umbrella review included 33 quantitative reviews with 1149 individual studies on suicidality and self-harm. Based on the data synthesis, it compared the public health impact of exposure on the population of the identified exposure. Bullying victimization was the most attributed environmental exposure for suicidality. The other identified significant school and individual factors were sleeping disturbance, school absenteeism, and exposure to antidepressants. Several significant vulnerable young populations were identified with significantly higher prevalence of suicidality, including lesbian, gay, bisexual, transgender, queer (or questioning) youth and those with mental health disorders, problem behaviors, previous suicidality, self-harm, and gender (female). A person-centered approach emphasizing connectedness and bully-free school environments should be a priority focus for schools, health professionals, and public health policymakers.
Collapse
Affiliation(s)
- Rebecca Richardson
- Faculty of Health and Environmental Science, Research Office, Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand
- Faculty of Culture and Society, School of Social Sciences and Public Policy, Auckland University of Technology, Auckland, New Zealand
| | - Tanya Connell
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Mandie Foster
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
- School of Midwifery and Nursing, Edith Cowan University, Perth, WA, Australia
| | - Julie Blamires
- Faculty of Health and Environmental Science, School of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Smita Keshoor
- Faculty of Health and Environmental Science, School of Oral Health, Auckland University of Technology, Auckland, New Zealand
| | - Chris Moir
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Irene Suilan Zeng
- Faculty of Health and Environmental Science, Research Office, Department of Biostatistics and Epidemiology, Auckland University of Technology, Auckland, New Zealand.
| |
Collapse
|
4
|
Jakobsson M, Josefsson K, Högberg K. Adolescents' Suggestions on how to Support Their Sleep: A Focus Group Study. J Sch Nurs 2024; 40:275-284. [PMID: 35253523 PMCID: PMC11095053 DOI: 10.1177/10598405221084317] [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] [Indexed: 11/15/2022] Open
Abstract
Sleeping difficulties among adolescents constitute a pressing public health issue, and it is of the utmost importance that these are approached from a health-promotion perspective. This study explores adolescents' suggestions on how their sleep could be supported. Data were collected via eight focus group interviews with 43 adolescents aged 15-16, in Sweden, and analyzed using qualitative content analysis. The results describe the adolescents' suggestions on how their sleep could be supported in three themes: being supported by involved parents- routines, engagement, and warmth are vital; being supported to achieve knowledge on the "whys" and "hows" of sleep-increased knowledge gives the ability to make well-grounded sleep choices; and being guided into finding balance-balance in life is difficult to achieve and adolescents desire support. Parents, school nurses, health professionals, and anyone who has the opportunity to improve and promote sleep should consider adolescents' suggestions.
Collapse
Affiliation(s)
- Malin Jakobsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden
| | - Karin Josefsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden
- Department of Health Science, Karlstad University, Sweden
| | - Karin Högberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden
| |
Collapse
|
5
|
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
|
6
|
Rollinson R, Cole A, Gee B, Tofan I, Graham A, Hatton J, Lyons J, Reeve S, Wilson J, Beardsworth K, Clarke T. Delivering a sleep intervention across a youth mental health service using non-expert practitioners: A service evaluation. Early Interv Psychiatry 2024. [PMID: 38703076 DOI: 10.1111/eip.13534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 05/06/2024]
Abstract
AIMS Poor sleep is highly prevalent in young people and increases risk of mental health difficulties, yet access to sleep interventions remains limited. This paper evaluates the use of a sleep intervention delivered by non-expert practitioners in a secondary care youth mental health service. METHOD Assistant psychologists were trained to deliver a six-session 1:1 cognitive-behavioural sleep intervention adapted for use with young people with mental health difficulties. A within-subject design assessed clinical outcomes relating to sleep (Insomnia Severity Index), psychological distress and personal goals (Goal Based Outcome Measures) at four time points. RESULTS High referral, intervention take-up (82.82%) and completion (70%) rates were reported, together with high baseline levels of insomnia (Insomnia Severity Index mean 20.47, SD 3.68) and poor sleep efficiency (56.36%, SD 17.23). Fifty-six young people (average age 19.2 years, SD 3.25) were included in the outcome analysis. Statistically and clinically significant improvements were seen across all outcome measures, with 68% no longer meeting clinical threshold (ISI ≥15) for insomnia at endpoint. CONCLUSIONS This study demonstrates exceptionally high levels of clinical need and engagement with a sleep intervention adapted specifically for young people with mental health difficulties. Whilst limited by the uncontrolled design, large improvements in insomnia and psychological distress support its effectiveness and utility in clinical settings. More robust implementation and evaluation is warranted in broader youth mental health services to promote earlier access.
Collapse
Affiliation(s)
- Rebecca Rollinson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
| | - Amber Cole
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Brioney Gee
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
| | - Ioana Tofan
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Adam Graham
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Jude Hatton
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Jonathan Lyons
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Sarah Reeve
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
- Cambridgeshire and Peterborough NHS FoundationTrust, Cambridge, Cambridgeshire, UK
| | - Jonathan Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
| | | | - Tim Clarke
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| |
Collapse
|
7
|
Faniyan OO, Marcotulli D, Simayi R, Del Gallo F, De Carlo S, Ficiarà E, Caramaschi D, Richmond R, Franchini D, Bellesi M, Ciccocioppo R, de Vivo L. Adolescent chronic sleep restriction promotes alcohol drinking in adulthood: evidence from epidemiological and preclinical data. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.11.561858. [PMID: 38659740 PMCID: PMC11042206 DOI: 10.1101/2023.10.11.561858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Epidemiological investigations have indicated that insufficient sleep is prevalent among adolescents, posing a globally underestimated health risk. Sleep fragmentation and sleep loss during adolescence have been linked to concurrent emotional dysregulation and an increase in impulsive, risk-taking behaviors, including a higher likelihood of substance abuse. Among the most widely used substances, alcohol stands as the primary risk factor for deaths and disability among individuals aged 15-49 worldwide. While the association between sleep loss and alcohol consumption during adolescence is well documented, the extent to which prior exposure to sleep loss in adolescence contributes to heightened alcohol use later in adulthood remains less clearly delineated. Here, we analyzed longitudinal epidemiological data spanning 9 years, from adolescence to adulthood, including 5497 participants of the Avon Longitudinal Study of Parents And Children cohort. Sleep and alcohol measures collected from interviews and questionnaires at 15 and 24 years of age were analyzed with multivariable linear regression and a cross-lagged autoregressive path model. Additionally, we employed a controlled preclinical experimental setting to investigate the causal relationship underlying the associations found in the human study and to assess comorbid behavioral alterations. Preclinical data were collected by sleep restricting Marchigian Sardinian alcohol preferring rats (msP, n=40) during adolescence and measuring voluntary alcohol drinking concurrently and in adulthood. Polysomnography was used to validate the efficacy of the sleep restriction procedure. Behavioral tests were used to assess anxiety, risky behavior, and despair. In humans, after adjusting for covariates, we found a cross-sectional association between all sleep parameters and alcohol consumption at 15 years of age but not at 24 years. Notably, alcohol consumption (Alcohol Use Disorder Identification Test for Consumption) at 24 years was predicted by insufficient sleep at 15 years whilst alcohol drinking at 15 years could not predict sleep problems at 24. In msP rats, adolescent chronic sleep restriction escalated alcohol consumption and led to increased propensity for risk-taking behavior in adolescence and adulthood. Our findings demonstrate that adolescent insufficient sleep causally contributes to higher adult alcohol consumption, potentially by promoting risky behavior.
Collapse
Affiliation(s)
- Oluwatomisin O. Faniyan
- International School of Advanced Studies, University of Camerino, 62032 Camerino (MC), Italy
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino (MC), Italy
- Center for Neuroscience, University of Camerino, 62032 Camerino (MC), Italy
| | - Daniele Marcotulli
- Department of Sciences of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy
| | - Reyila Simayi
- International School of Advanced Studies, University of Camerino, 62032 Camerino (MC), Italy
- School of Pharmacy, University of Camerino, 62032 Camerino (MC), Italy
- Center for Neuroscience, University of Camerino, 62032 Camerino (MC), Italy
| | - Federico Del Gallo
- School of Pharmacy, University of Camerino, 62032 Camerino (MC), Italy
- Center for Neuroscience, University of Camerino, 62032 Camerino (MC), Italy
| | - Sara De Carlo
- International School of Advanced Studies, University of Camerino, 62032 Camerino (MC), Italy
- School of Pharmacy, University of Camerino, 62032 Camerino (MC), Italy
- Center for Neuroscience, University of Camerino, 62032 Camerino (MC), Italy
| | - Eleonora Ficiarà
- School of Pharmacy, University of Camerino, 62032 Camerino (MC), Italy
- Center for Neuroscience, University of Camerino, 62032 Camerino (MC), Italy
| | - Doretta Caramaschi
- Faculty of Health and Life Sciences, Department of Psychology, University of Exeter, Washington Singer Laboratories, Perry Road, Exeter EX4 4QG, UK
| | - Rebecca Richmond
- Bristol Medical School, Bristol Population Health Science Institute, University of Bristol, BS8 2BN Bristol, UK
| | - Daniela Franchini
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, BS8 1TD Bristol, UK
| | - Michele Bellesi
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, BS8 1TD Bristol, UK
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino (MC), Italy
- Center for Neuroscience, University of Camerino, 62032 Camerino (MC), Italy
| | - Roberto Ciccocioppo
- School of Pharmacy, University of Camerino, 62032 Camerino (MC), Italy
- Center for Neuroscience, University of Camerino, 62032 Camerino (MC), Italy
| | - Luisa de Vivo
- School of Pharmacy, University of Camerino, 62032 Camerino (MC), Italy
- Center for Neuroscience, University of Camerino, 62032 Camerino (MC), Italy
| |
Collapse
|
8
|
Toenders YJ, van der Cruijsen R, Runze J, van de Groep S, Wierenga L, Crone EA. Mood variability during adolescent development and its relation to sleep and brain development. Sci Rep 2024; 14:8537. [PMID: 38609481 PMCID: PMC11014928 DOI: 10.1038/s41598-024-59227-9] [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: 11/04/2022] [Accepted: 04/08/2024] [Indexed: 04/14/2024] Open
Abstract
Mood swings, or mood variability, are associated with negative mental health outcomes. Since adolescence is a time when mood disorder onset peaks, mood variability during this time is of significant interest. Understanding biological factors that might be associated with mood variability, such as sleep and structural brain development, could elucidate the mechanisms underlying mood and anxiety disorders. Data from the longitudinal Leiden self-concept study (N = 191) over 5 yearly timepoints was used to study the association between sleep, brain structure, and mood variability in healthy adolescents aged 11-21 at baseline in this pre-registered study. Sleep was measured both objectively, using actigraphy, as well as subjectively, using a daily diary self-report. Negative mood variability was defined as day-to-day negative mood swings over a period of 5 days after an MRI scan. It was found that negative mood variability peaked in mid-adolescence in females while it linearly increased in males, and average negative mood showed a similar pattern. Sleep duration (subjective and objective) generally decreased throughout adolescence, with a larger decrease in males. Mood variability was not associated with sleep, but average negative mood was associated with lower self-reported energy. In addition, higher thickness in the dorsolateral prefrontal cortex (dlPFC) compared to same-age peers, suggesting a delayed thinning process, was associated with higher negative mood variability in early and mid-adolescence. Together, this study provides an insight into the development of mood variability and its association with brain structure.
Collapse
Affiliation(s)
- Yara J Toenders
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Renske van der Cruijsen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jana Runze
- Clinical Child and Family Studies, VU University Amsterdam, Amsterdam, The Netherlands
| | - Suzanne van de Groep
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Lara Wierenga
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Eveline A Crone
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
9
|
Sukiennik O, Waite P, Percy R, Orchard F. Changes to sleep patterns and insomnia symptoms following cognitive behavioural therapy for anxiety disorders in adolescents. Behav Cogn Psychother 2024:1-13. [PMID: 38586945 DOI: 10.1017/s1352465824000195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
BACKGROUND It is unclear whether treatment for an anxiety disorder improves sleep. This study examined baseline sleep characteristics of adolescents with an anxiety disorder, comparing weekdays and weekends, and whether there were significant improvements in sleep following cognitive behaviour therapy (CBT). AIMS To improve our understanding of sleep problems in adolescents with an anxiety disorder and examine whether CBT for the treatment of the anxiety disorder improves sleep. METHOD Data was gathered from 179 participants with an anxiety disorder (11-17 years old) who had previously engaged with the out-patient child and adolescent mental health service. Baseline self-report measures of anxiety and depression symptoms, sleep patterns and experiences of insomnia were examined. Of this group, 135 participants had baseline data. A subset (n=73) had outcome data, which was used to examine changes in sleep following CBT. RESULTS At baseline, adolescents reported significantly less total sleep and more night-time waking on weekdays than weekends. Following treatment for their anxiety disorder, adolescents' weekday sleep patterns significantly improved for sleep onset latency and total sleep time, whereas weekend sleep patterns only showed improvements for sleep onset latency. No significant improvements were reported for symptoms of insomnia. CONCLUSIONS The study relied upon subjective measurement of sleep and there was no control group; however, the findings provide promising results that CBT for adolescent anxiety disorders can improve some sleep problems. Further research is needed to understand discrepancies between subjective and objective sleep, and to explore avenues for the delivery of support for sleep problems.
Collapse
Affiliation(s)
- Olivia Sukiennik
- Surrey and Borders Partnership NHS Foundation Trust, Mind Matters Surrey, UK
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ray Percy
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | |
Collapse
|
10
|
Tseliou F, Riglin L, Thapar AK, Heron J, Dennison CA, Armitage JM, Thapar A, Rice F, Collishaw S. Childhood correlates and young adult outcomes of trajectories of emotional problems from childhood to adolescence. Psychol Med 2024:1-11. [PMID: 38494928 DOI: 10.1017/s0033291724000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND Emotional problems, especially anxiety, have become increasingly common in recent generations. Few population-based studies have examined trajectories of emotional problems from early childhood to late adolescence or investigated differences in psychiatric and functional outcomes. METHODS Using the Avon Longitudinal Study of Parents and Children (ALSPAC, n = 8286, 50.4% male), we modeled latent class growth trajectories of emotional problems, using the parent-reported Strength and Difficulties Questionnaire emotional scale (SDQ-E) on seven occasions (4-17 years). Psychiatric outcomes in young adulthood (21-25 years) were major depressive disorder (MDD), generalized anxiety disorder (GAD), and self-harm. Functional outcomes were exam attainment, educational/occupational status, and social relationship quality. RESULTS We identified four classes of emotional problems: low (67.0%), decreasing (18.4%), increasing (8.9%), and persistent (5.7%) problems. Compared to those in the low class, individuals with decreasing emotional problems were not at elevated risk of any poor adult outcome. Individuals in the increasing and persistent classes had a greater risk of adult MDD (RR: 1.59 95% CI 1.13-2.26 and RR: 2.25 95% CI 1.49-3.41) and self-harm (RR: 2.37 95% CI 1.91-2.94 and RR: 1.87 95% CI 1.41-2.48), and of impairment in functional domains. Childhood sleep difficulties, irritability, conduct and neurodevelopmental problems, and family adversity were associated with a persistent course of emotional problems. CONCLUSIONS Childhood emotional problems were common, but those whose symptoms improved over time were not at increased risk for adverse adult outcomes. In contrast, individuals with persistent or adolescent-increasing emotional problems had a higher risk of mental ill-health and social impairment in young adulthood which was especially pronounced for those with persistent emotional problems.
Collapse
Affiliation(s)
- F Tseliou
- Wolfson Centre for Young People's Mental Health, Cardiff University, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| | - L Riglin
- Wolfson Centre for Young People's Mental Health, Cardiff University, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| | - A K Thapar
- Wolfson Centre for Young People's Mental Health, Cardiff University, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| | - J Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - C A Dennison
- Wolfson Centre for Young People's Mental Health, Cardiff University, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| | - J M Armitage
- Wolfson Centre for Young People's Mental Health, Cardiff University, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| | - A Thapar
- Wolfson Centre for Young People's Mental Health, Cardiff University, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| | - F Rice
- Wolfson Centre for Young People's Mental Health, Cardiff University, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| | - S Collishaw
- Wolfson Centre for Young People's Mental Health, Cardiff University, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| |
Collapse
|
11
|
Fellman V, Heppell PJ, Rao S. Afraid and Awake: The Interaction Between Trauma and Sleep in Children and Adolescents. Psychiatr Clin North Am 2024; 47:229-253. [PMID: 38302209 DOI: 10.1016/j.psc.2023.06.015] [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] [Indexed: 02/03/2024]
Abstract
Traumatic experiences and sleep disturbances are both common in children and adolescents. Because of the reciprocal relationship between sleep complaints and trauma, a mental health evaluation should include not only an assessment of posttraumatic stress disorder and other trauma symptoms but also a specific evaluation of sleep-related complaints. Similarly, if a history of both trauma and sleep complaints is identified, an effective trauma-informed intervention, whether psychological, psychopharmacologic, or a combination of the two, should directly address sleep issues.
Collapse
Affiliation(s)
- Veronica Fellman
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, Child Study Center, One Park Avenue, 7th Floor, New York City, NY 10016, USA.
| | - Patrick J Heppell
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, Child Study Center, One Park Avenue, 7th Floor, New York City, NY 10016, USA
| | - Suchet Rao
- Psychiatry and Behavioral Health, NYC Administration for Children's Services, 150 William Street, 11th Floor, New York City, NY 10038, USA
| |
Collapse
|
12
|
Zhong L, Han X, Li M, Gao S. Modifiable dietary factors in adolescent sleep: A systematic review and meta-analysis. Sleep Med 2024; 115:100-108. [PMID: 38350307 DOI: 10.1016/j.sleep.2024.02.009] [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: 11/14/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE Sleep problems are prevalent during adolescence, and modifying dietary factors may contribute to better sleep outcomes in adolescents. This systematic review and meta-analysis aimed to evaluate the impact of modifiable dietary factors on sleep health among adolescents. METHODS A systematic search of records from six databases including MEDLINE, PubMed, Embase, Scopus, CINAHL, and the CENTRAL from inception up to November 2023, identified 33 peer-reviewed publications that assessed the relationship between modifiable dietary factors and sleep outcomes in adolescents aged 12-18 years. The NIH Quality Assessment Tools were used to assess the quality of the included studies. Meta-analysis was performed on a sub-group of studies (n = 6) to ascertain the effect of dietary factors on sleep health. RESULTS Although the included studies were predominantly cross-sectional and exhibited heterogeneity, relying mainly on self-reported measures, it was observed that consumption of healthy foods was consistently linked with improved sleep outcomes among adolescents, whereas higher intake of fat-rich or sugar-rich foods and red meats or processed food was associated with poorer sleep features. The meta-analysis further substantiated that adolescents with higher caffeine intake faced increased odds of sleep problems (OR = 1.67, 95% CI: 1.28-2.17), while alcohol consumption was significantly associated with insomnia (OR = 1.17, 95% CI: 1.07-1.27). CONCLUSION Overall, despite high heterogeneity among studies, this systematic review underscores the promising role of healthy dietary factors in enhancing both the quality and quantity of sleep in adolescents. The meta-analysis results also highlight that reducing caffeine and alcohol intake holds potential for supporting better sleep in this population. However, further validation through intervention studies is warranted.
Collapse
Affiliation(s)
- Ling Zhong
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Xuan Han
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Ming Li
- Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| | - Shan Gao
- Department of Endocrinology, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China
| |
Collapse
|
13
|
Kiss O, Qu Z, Müller-Oehring EM, Baker FC, Mirzasoleiman B. Sleep, brain systems, and persistent stress in early adolescents during COVID-19: Insights from the ABCD study. J Affect Disord 2024; 346:234-241. [PMID: 37944709 PMCID: PMC10842722 DOI: 10.1016/j.jad.2023.10.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE The first year of the COVID-19 pandemic constituted a major life stress event for many adolescents, associated with disrupted school, behaviors, social networks, and health concerns. However, pandemic-related stress was not equivalent for everyone and could have been influenced by pre-pandemic factors including brain structure and sleep, which both undergo substantial development during adolescence. Here, we analyzed clusters of perceived stress levels across the pandemic and determined developmentally relevant pre-pandemic risk factors in brain structure and sleep of persistently high stress during the first year of the COVID-19 pandemic. METHODS We investigated longitudinal changes in perceived stress at six timepoints across the first year of the pandemic (May 2020-March 2021) in 5559 adolescents (50 % female; age range: 11-14 years) in the United States (U.S.) participating in the Adolescent Brain Cognitive Development (ABCD) study. In 3141 of these adolescents, we fitted machine learning models to identify the most important pre-pandemic predictors from structural MRI brain measures and self-reported sleep data that were associated with persistently high stress across the first year of the pandemic. RESULTS Patterns of perceived stress levels varied across the pandemic, with 5 % reporting persistently high stress. Our classifiers accurately detected persistently high stress (AUC > 0.7). Pre-pandemic brain structure, specifically cortical volume in temporal regions, and cortical thickness in multiple parietal and occipital regions, predicted persistent stress. Pre-pandemic sleep difficulties and short sleep duration were also strong predictors of persistent stress, along with more advanced pubertal stage. CONCLUSIONS Adolescents showed variable stress responses during the first year of the COVID-19 pandemic, and some reported persistently high stress across the whole first year. Vulnerability to persistent stress was evident in several brain structural and self-reported sleep measures, collected before the pandemic, suggesting the relevance of other pre-existing individual factors beyond pandemic-related factors, for persistently high stress responses.
Collapse
Affiliation(s)
- Orsolya Kiss
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA.
| | - Zihan Qu
- Electrical and Computer Engineering Department, University of California Los Angeles, 420 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Eva M Müller-Oehring
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Baharan Mirzasoleiman
- Computer Science Department, University of California Los Angeles, 404 Westwood Plaza, Los Angeles, CA 90095, USA
| |
Collapse
|
14
|
Olaithe M, Richardson C, Ree M, Hartung K, Wylde T, Bucks R. Sleep in young people: What works now and where to? A meta-review of behavioural and cognitive interventions and lifestyle factors. Behav Sleep Med 2024; 22:58-75. [PMID: 36854653 DOI: 10.1080/15402002.2023.2182305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVES 1) Systematically review meta-analyses and systematic reviews that (a) explored health/lifestyle factors affecting sleep, and/or (b) investigated behavioral/psychological sleep interventions in young people (10-25-years); 2) Evaluate the quality of published literature, and, if an intervention; 3) Examine method and effectiveness of mode of delivery, to inform current clinical practice and research direction. METHOD A systematic search of Embase (n = 45), MEDLINE (n = 67), Web of Science (n = 375), Google Scholar (n = 138), and hand-searching was conducted. After full review, 12 papers were selected, 2 systematic reviews without, and 10 with, meta-analyses. Six examined associations between sleep and lifestyle/health, and six examined cognitive-behavioral (n = 4), or school education (n = 2), programs. RESULTS Electronic media use, type of day (week/end), sex, age, culture/geographical location, substance use, family environment, and evening light exposure were negatively associated with sleep, in young people. Only cognitive and/or behavioral interventions of at least 2 × 1-hr sessions improved sleep. CONCLUSION This paper informs sleep recommendations for young people and advises that ≥ 2 × 1-hr sessions of cognitive behavioral or behavioral therapy is the minimum to improve sleep in young people. School-based sleep interventions do not produce long-term change.
Collapse
Affiliation(s)
- Michelle Olaithe
- School of Psychological Science, University of Western Australia, Perth Australia
| | - Cele Richardson
- School of Psychological Science, University of Western Australia, Perth Australia
| | - Melissa Ree
- School of Psychological Science, University of Western Australia, Perth Australia
| | - Kasey Hartung
- Health Promotion Unit, University of Western Australia, Perth Australia
| | - Tricia Wylde
- Health Promotion Unit, University of Western Australia, Perth Australia
| | - Romola Bucks
- School of Psychological Science, University of Western Australia, Perth Australia
- School of Population and Global Health, University of Western Australia, PerthAustralia
| |
Collapse
|
15
|
Lawrence-Sidebottom D, Huffman LG, Beam A, Parikh A, Guerra R, Roots M, Huberty J. Improvements in sleep problems and their associations with mental health symptoms: A study of children and adolescents participating in a digital mental health intervention. Digit Health 2024; 10:20552076241249928. [PMID: 38736734 PMCID: PMC11084994 DOI: 10.1177/20552076241249928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
Objective A growing number of youth are utilizing digital mental health interventions (DMHIs) for treatment of mental health problems such as anxiety, depression, and ADHD. Although these mental health symptoms are closely related to sleep problems, it is unknown whether nonsleep DMHIs indirectly confer improvements in sleep. Using retrospective data, the current study assesses (1) whether youth sleep problems improve over participation in a nonsleep DMHI, and (2) whether mental health symptom severity and improvement are correlated with sleep problem severity over time. Methods Sleep problems and mental health symptoms were assessed every 30 days among children (ages 5-12) and adolescents (ages 13-17) participating in a pediatric digital mental health intervention (DMHI; N = 1219). Results Children and adolescents with elevated sleep problems (39.3%; n = 479) were older (P < .001), more predominantly female (P < .001), and more likely to have elevated anxiety (P < .001), depressive (P < .001) and inattention symptoms (P = .001), as compared to those with nonelevated sleep problems (60.7%; n = 740). From the baseline to last assessment, 77.3% (n = 269) of members with elevated sleep problems exhibited improvements, with sleep problems decreasing significantly over each month in care (P < .001). Members with improvements in anxiety, depressive, and/or ADHD symptoms had larger improvements in sleep over time compared to their peers with no improvement in their mental health symptoms (Months in care*Change type: P < .001 for all). Conclusions Our results provide preliminary evidence that participation in a pediatric DMHI is associated with improvements in sleep problems, even when youth are not being treated directly for sleep problems. These findings highlight a valuable secondary benefit of participating in mental health care within pediatric DMHIs and warrant further experimental research.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Jennifer Huberty
- Bend Health Inc., Madison, WI, USA
- FitMinded Inc., Phoenix, AZ, USA
| |
Collapse
|
16
|
Lien L, Bonsaksen T, Holte Stea T, Kleppang AL, Steigen AM, Leonhardt M. Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents. PLoS One 2023; 18:e0295384. [PMID: 38150420 PMCID: PMC10752533 DOI: 10.1371/journal.pone.0295384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 11/20/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Research has shown increased mental health problems and use of prescription drugs among adolescents in recent years and social media use has been linked to poorer mental health. However, trend studies concerning these topics are scarce. The purpose of this study was to analyze gender-specific trends in a) symptoms of depression and loneliness, and b) prescription of antidepressants, hypnotics and sedatives, in relation to the emergence of social media among adolescents in Norway. METHODS This is an ecological study using data from the 'Young in Oslo' surveys from 1996 to 2021. The surveys included approximately 110 000 students, 14-17 years of age, and yielded a response rate varying from 95% in 1996 to 64% in 2021. A self-report questionnaire was used to collect information on symptoms of depression and loneliness. Information on antidepressant and sleep medication prescription was retrieved from the Norwegian Prescription Database for the age group 15 to 19 years. A graphical approach and logistic regression models were used to examine gender-specific time-trends between 1996 to 2021. RESULTS We found a doubling in self-reported symptoms of depression and loneliness among girls between 1996 and 2021, with the steepest increase in the period from 2006 to 2012, when Facebook and other social media were introduced. A similar trend was observed in the prescription of antidepressants among girls, with the steepest increase between 2011 and 2013. Among both boys and girls, 'worried too much about things' and 'had sleep problems' were the two symptoms with the greatest changes. CONCLUSION A significant upward trend in self-reported depressive symptoms and medication use was observed over the past 25 years, with variations in the rate of increase, including a steeper trajectory during certain periods immediately after the introduction of social media platforms in Norway.
Collapse
Affiliation(s)
- Lars Lien
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Tore Bonsaksen
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | - Tonje Holte Stea
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Annette Løvheim Kleppang
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Anne Mari Steigen
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| |
Collapse
|
17
|
Jiang T, Yin X, Zhu L, Jia W, Tan Z, Li B, Guo J. Abnormal alterations of regional spontaneous neuronal activity and functional connectivity in insomnia patients with difficulty falling asleep: a resting-state fMRI study. BMC Neurol 2023; 23:430. [PMID: 38049760 PMCID: PMC10694975 DOI: 10.1186/s12883-023-03481-3] [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: 09/07/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Insomnia disorder (ID) seriously affects people's daily life. Difficulty falling asleep is the most commonly reported complaint in patients with ID. However, the mechanism of prolonged sleep latency (SL) is still obscure. The aim of our present study was to investigate the relationship between prolonged SL and alterations in spontaneous neural activity and brain functional connectivity (FC) in ID patients using functional magnetic resonance imaging (fMRI). METHODS A total of 52 insomniacs with difficulty falling asleep and 30 matched healthy controls (HCs) underwent resting-state fMRI. The amplitude of low-frequency fluctuation (ALFF) was measured and group differences were compared. The peak areas with significantly different ALFF values were identified as the seed regions to calculate FC to the whole brain. SL was assessed by a wrist actigraphy device in ID patients. The Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Rating Scale (HAMA), and Hyperarousal Scale (HAS) were evaluated in both ID patients and HCs. Finally, correlation analyses were performed between the clinical features and FC/ALFF values. RESULTS ID patients showed higher PSQI, HAMA, HAS scores than HCs. The functional MRI results indicated increased ALFF value in the left insula and right amygdala and decreased ALFF value in the right superior parietal lobe (SPL) in ID patients. The seed-based FC analysis demonstrated increased FC between the left insula and the bilateral precentral gyrus and FC between the right amygdala and the left posterior cingulate cortex (PCC) in patients with ID. Correlation analysis indicated that the increased FC value of the right amygdala-left PCC was positively correlated with SL measured by actigraphy. CONCLUSION This study revealed abnormal regional spontaneous fluctuations in the right amygdala, left insula, and right SPL, as well as increased FC in the left insula-precentral and right amygdala-left PCC. Moreover, the prolonged SL was positively correlated with the abnormal FC in the right amygdala-left PCC in ID patients. The current study showed the correlation between prolonged SL and the abnormal function of emotion-related brain regions in ID patients, which may contribute to a better understanding of the neural mechanisms underlying difficulty falling asleep in patients with ID. CLINICAL TRIAL REGISTRATION http://www.chictr.org.cn ., ChiCTR1800015282. Registered on 20th March 2018.
Collapse
Affiliation(s)
- Tongfei Jiang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Xuejiao Yin
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Liying Zhu
- Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Weilin Jia
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Zhongjian Tan
- Department of Radiology, Dong Zhimen Hospital Beijing University of Chinese Medicine, Beijing, 100010, China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Jing Guo
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China.
| |
Collapse
|
18
|
Cheung FTW, Li X, Hui TK, Chan NY, Chan JW, Wing YK, Li SX. Circadian preference and mental health outcomes in youth: A systematic review and meta-analysis. Sleep Med Rev 2023; 72:101851. [PMID: 37793219 DOI: 10.1016/j.smrv.2023.101851] [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: 01/25/2023] [Revised: 07/10/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023]
Abstract
Youth is a vulnerable developmental period associated with an increased preference for eveningness and risk for developing psychopathology. Growing evidence suggests a link between eveningness and poorer mental health outcomes, but the findings in the current literature are inconsistent, and a comprehensive synthesis of evidence in this area remains lacking. This meta-analysis aimed to 1) synthesise the existing evidence on the association between circadian preference and mental health outcomes in youths and 2) explore potential sleep-related factors that may moderate the relationship between circadian preference and mental health outcomes. A systematic search of five electronic databases resulted in 81 observational studies included in the review. Eveningness was found to be significantly associated with general mental health (r = 0.20), mood-related disturbances (r = 0.17), and anxiety problems (r = 0.13). The qualitative review also identified that eveningness was associated with greater risks for psychotic symptoms and maladaptive eating behaviours. These findings highlighted the need to consider circadian preference in the clinical management of youth mental health problems. Further research is needed to examine the efficacy of a circadian-focused intervention in the context of youth mental health.
Collapse
Affiliation(s)
- Forrest Tin Wai Cheung
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong.
| | - Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Tsz Kwan Hui
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Joey Wy Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
| |
Collapse
|
19
|
Grigorian K, Östberg V, Raninen J, Åhlén J, Brolin Låftman S. Prospective associations between psychosomatic complaints in adolescence and depression and anxiety symptoms in young adulthood: A Swedish national cohort study. SSM Popul Health 2023; 24:101509. [PMID: 37720821 PMCID: PMC10500464 DOI: 10.1016/j.ssmph.2023.101509] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/16/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023] Open
Abstract
Background Psychosomatic complaints are reported by high shares of adolescents in Sweden and elsewhere. Yet, little is known about to the extent to which the frequency, number, and persistence of such complaints in adolescence are associated with subsequent mental health problems. The aim of this study was to examine how the frequency, number, and persistence of psychosomatic complaints in middle and late adolescence are associated with depression and anxiety symptoms in young adulthood. Methods A Swedish national cohort study of adolescents who were surveyed in 2017 (t1; age 15-16), in 2019 (t2; age 17-18) and in 2022 (t3; age 20-21 years) was used. Psychosomatic complaints were measured by questions on stomach ache, headache and difficulties falling asleep at t1 and t2. Depression and anxiety symptoms were measured by the Patient Health Questionnaire-4 (PHQ-4) at t3. Multivariable binary logistic regression analyses stratified by gender were based on data from t1, t2 and t3 (n = 2779). Results The frequency, number, and persistence of psychosomatic complaints during adolescence were associated with symptoms of depression and anxiety in young adulthood. Both earlier (at t1 only) and more recent (at t2 only) complaints were linked to subsequent depression and anxiety symptoms, while persistent (at both t1 and t2) psychosomatic complaints showed stronger associations in girls. Conclusions Psychosomatic complaints in adolescence were associated with depression and anxiety symptoms in young adulthood. This was true for the frequency, number, and persistence of psychosomatic complaints. Among girls, those who reported persistent psychosomatic complaints from middle to late adolescence had the highest likelihood of reporting subsequent depression and anxiety symptoms. Taken together, the results indicate that psychosomatic complaints during adolescence can translate into later depression and anxiety symptoms. Furthermore, repeated measurements of psychosomatic complaints can be used to identify the most vulnerable group.
Collapse
Affiliation(s)
- Karina Grigorian
- Department of Public Health Sciences, Stockholm University, Sweden
| | - Viveca Östberg
- Department of Public Health Sciences, Stockholm University, Sweden
| | - Jonas Raninen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Johan Åhlén
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Sweden
| | | |
Collapse
|
20
|
Dong RB, Dou KY, Luo J. Construction of a model for adolescent physical and mental health promotion based on the multiple mediating effects of general self-efficacy and sleep duration. BMC Public Health 2023; 23:2293. [PMID: 37986158 PMCID: PMC10662560 DOI: 10.1186/s12889-023-17197-z] [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: 03/28/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
We developed a model for promoting adolescent physical and mental health (MH) to investigate the integrated pathways of physical activity (PA), MH, general self-efficacy (GSE), and sleep duration (SD) promotion among adolescents in China. The research hypotheses were tested using questionnaires, descriptive statistics, and validated factor analysis. The mean age of the respondents was 14.94 ± 1.76 years, the PA level was 2.49 [95% confidence interval (CI): 2.46-2.53], the GSE score was 2.60 (95% CI: 2.57-2.64), the SD was 436.52 min/day (95% CI: 432.89-440.15), and the total mean MH score was 1.72 (95% CI: 1.69-1.76) (model fitness index: χ2/df = 1.295, comparative fit index = 0.999, Tucker-Lewis index = 0.997, root mean square error of approximation = 0.014, standardized root mean square residual = 0.007). The SD accounted for 46.85% of the mediating effect. The adolescents exhibited moderately low PA levels, severe SD deficits, and high rates of overall MH abnormalities. Consequently, the constructed model for promoting adolescent physical health and MH was confirmed to be reliable; GSE and SD are significant factors mediating MH promotion.
Collapse
Affiliation(s)
- Ru-Bao Dong
- School of Physical Education, Guizhou Normal University, Guizhou, China.
| | - Kai-Yun Dou
- School of Physical Education, Guizhou Normal University, Guizhou, China
| | - Jie Luo
- School of Psychology, Guizhou Normal University, Guizhou, China
| |
Collapse
|
21
|
Lemke T, Hökby S, Wasserman D, Carli V, Hadlaczky G. Associations between sleep habits, quality, chronotype and depression in a large cross-sectional sample of Swedish adolescents. PLoS One 2023; 18:e0293580. [PMID: 37917651 PMCID: PMC10621812 DOI: 10.1371/journal.pone.0293580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To investigate behavioral sleep habits, self-perceived quality of sleep, and chronotype, and to examine their association with clinically relevant levels of depression in Swedish adolescents. METHOD Questionnaire data were obtained from a representative sample of Swedish adolescents (n = 8449; 50.8% girls; aged 12-16). Depression was defined as >13 BDI-II scores. Logistic regression modelling estimated the effects of sleep duration, sleep quality, and chronotype on depression, adjusted for socio-demographic factors. RESULTS On weekdays, approximately 46% of adolescents slept less than the recommended length of eight hours per night (depressed: 68%, non-depressed: 40%). On weekends, however, only 17% slept shorter than recommended. Short weekday sleep duration was more common among girls than boys (53% vs. 38%) and girls reported worse sleep quality. The regression model showed that depression was predicted by weekday sleep duration (OR = 0.773, p < .0001), sleep quality (OR = 0.327, p < .0001), and late chronotype (OR = 1.126, p = .0017), but not by weekend sleep duration. A 30-minute increase in weekday sleep duration was associated with about 10% lower odds of depression. CONCLUSIONS A substantial proportion of Swedish adolescents do not seem to meet the sleep recommendations of eight hours per night. Short sleep duration on weekdays, poor sleep quality, and late chronotype were associated with increased risk of depression. Interventions promoting longer weekday sleep duration (e.g., later school start times) seem relevant in this context, but further research is needed to investigate the directionality and underlying mechanisms of these associations.
Collapse
Affiliation(s)
- Theresa Lemke
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Sebastian Hökby
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| |
Collapse
|
22
|
Hamilton OS, Steptoe A, Ajnakina O. Polygenic predisposition, sleep duration, and depression: evidence from a prospective population-based cohort. Transl Psychiatry 2023; 13:323. [PMID: 37857612 PMCID: PMC10587060 DOI: 10.1038/s41398-023-02622-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
Suboptimal sleep durations and depression frequently cooccur. Short-sleep and long-sleep are commonly thought of as symptoms of depression, but a growing literature suggests that they may be prodromal. While each represents a process of mutual influence, the directionality between them remains unclear. Using polygenic scores (PGS), we investigate the prospective direction involved in suboptimal sleep durations and depression. Male and female participants, aged ≥50, were recruited from the English Longitudinal Study of Ageing (ELSA). PGS for sleep duration, short-sleep, and long-sleep were calculated using summary statistics data from the UK Biobank cohort. Sleep duration, categorised into short-sleep ("≤5 h"), optimal-sleep (">5 to <9 h"), and long-sleep ("≥9 h"), was measured at baseline and across an average 8-year follow-up. Subclinical depression (Centre for Epidemiological Studies Depression Scale [≥4 of 7]) was also ascertained at baseline and across an average 8-year follow-up. One standard deviation increase in PGS for short-sleep was associated with 14% higher odds of depression onset (95% CI = 1.03-1.25, p = 0.008). However, PGS for sleep duration (OR = 0.92, 95% CI = 0.84-1.00, p = 0.053) and long-sleep (OR = 0.97, 95% CI = 0.89-1.06, p = 0.544) were not associated with depression onset during follow-up. During the same period, PGS for depression was not associated with overall sleep duration, short-sleep, or long-sleep. Polygenic predisposition to short-sleep was associated with depression onset over an average 8-year period. However, polygenic predisposition to depression was not associated with overall sleep duration, short-sleep or long-sleep, suggesting different mechanisms underlie the relationship between depression and the subsequent onset of suboptimal sleep durations in older adults.
Collapse
Affiliation(s)
- Odessa S Hamilton
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Olesya Ajnakina
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| |
Collapse
|
23
|
Qiao X, Shi X, Chen X, Zhu Y. Associations between insomnia symptom trajectories with depression and self-harm behaviors in Chinese college students before and during the COVID-19 pandemic: A five-wave longitudinal investigation. J Affect Disord 2023; 339:877-886. [PMID: 37506771 DOI: 10.1016/j.jad.2023.07.108] [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: 12/22/2022] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Sleep problems are highly prevalent during COVID-19 pandemic. However, only very limited studies have examined the changing patterns of insomnia symptom before and during the COVID-19 pandemic, and most of these studies were limited to two-wave designs and the variable-centered approach. METHODS The data was taken from a large-scale health-related cohort among Chinese college students. This cohort was a five-wave design and 3834 participants who completed at least two waves were included in the present study. Growth mixture modeling (GMM) was used to estimate trajectory classes for insomnia symptoms, followed by binary logistic regression to explore the association between trajectory classes and subsequent mental health problems. RESULTS GMM analyses extracted four distinct trajectories of insomnia symptoms: stable-low pattern (n = 2897, 75.6 %), increasing pattern (n = 405, 10.6 %), decreasing pattern (n = 182, 4.7 %), and stable-high pattern (n = 350, 9.1 %). Additionally, we found that individuals in stable-high and increasing patterns were more likely to experience mental health problems after the COVID-19 pandemic even after adjusting significant covariates and outcomes at baseline. CONCLUSIONS Appreciable heterogeneity in insomnia symptoms among college students was revealed before and during the COVID-19 pandemic. About 20 % of college students were classified as high-risk patterns of insomnia symptoms. Psychological interventions should target such vulnerable groups to reduce the rates of mental health problems.
Collapse
Affiliation(s)
- Xiaofei Qiao
- College of Education, Hebei University, Baoding, China
| | - Xuliang Shi
- College of Education, Hebei University, Baoding, China.
| | - Xiaoyan Chen
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ya Zhu
- Center for Mental Health Education and Counseling, Guangdong University of Science and Technology, Dongguan, China
| |
Collapse
|
24
|
Waters AM, Gibson L, Sluis RA, Modecki KL. Using Nightly Sleep Guidelines to Address Links Between Adolescents' Self-Reported Weekly Sleep Patterns and Anxiety and Depression Symptoms. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01610-0. [PMID: 37823958 DOI: 10.1007/s10578-023-01610-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
Short and long nightly sleep durations are associated with anxiety and depression symptoms among adolescents. However, studies have not used recommended hours of nightly sleep or focused on sleep patterns across weekdays and weekends in examining links with anxiety and depression symptoms. The present study included 709 adolescents in Grade 11 (402 females; 307 males) who self-reported hours of sleep on weeknights and weekends and anxiety and depression symptoms. Using the recommended 8-10 h to define average nightly sleep for adolescents, sleep patterns across weekdays and weekends were categorised into seven classes: short stable, short increasing, average decreasing, average stable, average increasing, long decreasing, and long stable. Relative to average stable sleepers, short stable, short increasing, and long stable sleepers had significantly higher anxiety and depression. Adolescents require 8-10 h of sleep on weeknights, regardless of weekends, for optimal emotional wellbeing.
Collapse
Affiliation(s)
- Allison M Waters
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia.
| | - Lily Gibson
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
| | - Rachel A Sluis
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
| | - Kathryn L Modecki
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
| |
Collapse
|
25
|
Bowker JC, Gurbacki JN, Richard CL, Rubin KH. Anxious-Withdrawal and Sleep Problems during Adolescence: The Moderating Role of Peer Difficulties. Behav Sci (Basel) 2023; 13:740. [PMID: 37754018 PMCID: PMC10525876 DOI: 10.3390/bs13090740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/29/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023] Open
Abstract
Anxious-withdrawal is a well-established individual risk factor for psychosocial difficulties during adolescence. It is unknown, however, whether it also places youth at increased risk for physical health problems, such as sleep difficulties. This study examines the concurrent and prospective associations between anxious-withdrawal and six types of sleep difficulties (i.e., sleeping too much, sleeping too little, talking/walking in sleep, being overtired, nightmares, and general trouble sleeping). We further evaluate whether these associations differ for adolescents who are high versus low in exclusion and victimization. The participants were 395 adolescents (Mage = 13.61 years; 35% ethnic minority) who completed peer nominations of anxious-withdrawal, exclusion, and victimization at Time 1 (T1). Their mothers completed reports of sleep difficulties at T1 and at Time 2 (T2). Path analyses revealed unique associations between anxious-withdrawal and several types of sleep difficulties (e.g., sleeping too much) at T1. Analyses also revealed a significant interaction effect between T1 anxious-withdrawal and exclusion/victimization such that anxious-withdrawal was prospectively associated with trouble sleeping only for those young adolescents who are highly excluded/victimized. Our findings are the first to link anxious-withdrawal to a physical health outcome in adolescence and point to the need for future research to not only examine anxious-withdrawal and physical health but also to include assessments of peer difficulties.
Collapse
Affiliation(s)
- Julie C. Bowker
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY 14260-4110, USA; (J.N.G.); (C.L.R.)
| | - Jessica N. Gurbacki
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY 14260-4110, USA; (J.N.G.); (C.L.R.)
| | - Chloe L. Richard
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY 14260-4110, USA; (J.N.G.); (C.L.R.)
| | - Kenneth H. Rubin
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20742, USA;
| |
Collapse
|
26
|
Pan R, Zhang G, Deng F, Lin W, Pan J. Effects of red light on sleep and mood in healthy subjects and individuals with insomnia disorder. Front Psychiatry 2023; 14:1200350. [PMID: 37692298 PMCID: PMC10484593 DOI: 10.3389/fpsyt.2023.1200350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/04/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction This study aimed to determine the influence of red light on objective sleep and the relationship between mood and sleep among individuals with insomnia disorder (ID). Method 57 individuals with insomnia symptoms and 57 healthy participants were randomly divided into three groups (red- and white-light groups, and the black control group), which received different light treatments for 1 h before bedtime. The emotions and subjective alertness of participants were evaluated using Positive and Negative Affect Schedule scales (PANAS) and Karolinska Sleepiness Scale (KSS), their sleeping data were recorded using polysomnography (PSG). Result The negative emotion scores were higher in the healthy subject-red light (HS-RL) group than in the HS-white light (WL) and HS-black control (BC) groups (p < 0.001). The anxiety and negative emotion scores were higher in the ID-RL group than in the ID-WL and ID-BC groups (p = 0.007 and p < 0.001, respectively). The KSS scores were lower in the RL group than in the WL and BC groups for both HS and ID group (both p < 0.001). The SOL was shorter in the HS-RL group than in HS-WL group (p = 0.019). Compared with the HS-BC group, the HS-RL group had an increase in microarousal index (MAI) and N1% (p = 0.034 and p = 0.021, respectively), while the total sleep time (TST) and sleep efficiency (SE) decreased (p = 0.001 and p < 0.001, respectively). Compared with the ID-WL group, the SOL was shorter in the ID-RL group (p = 0.043), while TST, SE, number of microarousals (NMA), and numbers of cycles of REM period were increased (p = 0.016, p = 0.046, p = 0.001, and p = 0.041, respectively). Compared with the ID-BC group, the ID-RL group had increases in the SOL, WASO, and the numbers of cycles and NMA in REM period (p = 0.038, p = 0.005, p = 0.045, and p = 0.033, respectively), and a decrease in SE (p = 0.014). The effects of ID-WL (vs. ID-RL group) and ID-BC (vs. ID-RL group) on SOL were mediated by negative emotions (mediating effects were - 37.626 and - 33.768, respectively). Conclusion Red light can increase subjective alertness, anxiety, and negative emotions in both healthy subjects and people with ID, which can affect sleep directly or indirectly via the mediating effect of negative emotions.
Collapse
Affiliation(s)
- Rong Pan
- Department of Psychology, The Third People’s Hospital of Zhaoqing, Zhaoqing, Guangdong Province, China
| | - Guimei Zhang
- Department of Psychiatry, Sleep Medicine Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Fangyi Deng
- Department of Psychiatry, Sleep Medicine Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Weifeng Lin
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan People’s Hospital, Southern Medical University), Guangzhou, Guangdong Province, China
| | - Jiyang Pan
- Department of Psychiatry, Sleep Medicine Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| |
Collapse
|
27
|
Anan YH, Kahn NF, Garrison MM, McCarty CA, Richardson LP. Associations Between Sleep Duration and Positive Mental Health Screens During Adolescent Preventive Visits in Primary Care. Acad Pediatr 2023; 23:1242-1246. [PMID: 36905952 DOI: 10.1016/j.acap.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE The purpose of this paper was to understand associations between low sleep duration (<8.ßhours) and positive mental health screens among adolescents (ages 13...18) seen for preventive visits in primary care. METHODS Data were from two randomized controlled trials testing the efficacy of an electronic health risk behavior screening and feedback tool for adolescent preventive visits. Participants (n.ß=.ß601) completed screeners at baseline, 3 months, and 6 months which included sleep duration in hours and the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 screeners for depression and anxiety, respectively. Main analyses included adjusted logistic regressions testing associations between low sleep duration and positive mental health screens. RESULTS Adjusted models showed that low sleep duration was associated with significantly greater odds of a positive depression screen (OR.ß=.ß1.58, 95% CI: 1.06...2.37) but not with a positive anxiety screen or co-occurring positive depression and anxiety screens. However, follow-up analyses indicated an interaction between sleep duration and anxiety in the association with a positive depression screen, such that the association between low sleep and a positive depression screen was driven by those who did not screen positive for anxiety. CONCLUSIONS As pediatric primary care guidelines for sleep continue to evolve, further research, training, and support for sleep screening are warranted to ensure effective early intervention for sleep and mental health problems during adolescence.
Collapse
Affiliation(s)
- Yomna H Anan
- Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash.
| | - Nicole F Kahn
- Division of Adolescent Medicine (NF Kahn, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Hospital, Wash
| | - Michelle M Garrison
- Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash; Department of Health Systems and Population Health (MM Garrison), University of Washington School of Public Health, Seattle; Division of Child & Adolescent Psychiatry (MM Garrison), Seattle Children...s Hospital, Wash
| | - Carolyn A McCarty
- Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash; Division of Adolescent Medicine (NF Kahn, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Hospital, Wash
| | - Laura P Richardson
- Center for Child Health, Behavior & Development (YH Anan, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Research Institute, Wash; Division of Adolescent Medicine (NF Kahn, MM Garrison, CA McCarty, and LP Richardson), Seattle Children...s Hospital, Wash
| |
Collapse
|
28
|
Ramar S, Lloyd RM. Perspective: Teenagers and the sleep paradox. J Clin Sleep Med 2023; 19:1569-1571. [PMID: 37185050 PMCID: PMC10394353 DOI: 10.5664/jcsm.10636] [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: 02/13/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023]
Abstract
STUDY OBJECTIVES Teenagers experience sleep deficits as they try to manage expectations with school, their social media presence, and increasingly competitive extracurriculars. Late-night screen time is a barrier to sleep hygiene. It is important to acknowledge and understand lifestyle challenges that can prevent teenagers from receiving adequate sleep every night. A teenager perspective on these issues and recommendations can incite better ways to outreach, educate, and support teenagers in maintaining good sleep. METHODS We describe what is known and not known about sleep health among teenagers and challenges to maintaining adequate sleep from the perspective of a third-year high school student. We also provide recommendations for outreach to promote early recognition of issues and tools that can support sleep hygiene to reinforce future mental and physical health. RESULTS While teenagers enjoy good sleep, this is limited by heavy loads of homework along with increasingly competitive extracurriculars, keeping up with social and cultural demands, and early school starts. Also, teenagers may not understand what adequate sleep entails and the full impact of sleep on well-being. CONCLUSIONS Social media provides a channel to extend outreach to teenagers to communicate the importance of consistent quality and quantity of sleep, increase awareness of sleep tracking tools, and highlight the impact of sleep on mental health. Additionally, better engagement is needed with schools and community to manage academic and extracurricular schedules that allow teenagers to schedule consistent bedtimes and wake times. CITATION Ramar S, Lloyd RM Perspective: teenagers and the sleep paradox. J Clin Sleep Med. 2023;19(8):1569-1571.
Collapse
Affiliation(s)
- Sreya Ramar
- High School Student, Century High School, Rochester, Minnesota
| | | |
Collapse
|
29
|
Wood G, Goodyear V, Adab P, Al-Janabi H, Fenton S, Jones K, Michail M, Morrison B, Patterson P, Sitch AJ, Wade M, Pallan M. Smartphones, social Media and Adolescent mental well-being: the impact of school policies Restricting dayTime use-protocol for a natural experimental observational study using mixed methods at secondary schools in England (SMART Schools Study). BMJ Open 2023; 13:e075832. [PMID: 37407051 DOI: 10.1136/bmjopen-2023-075832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
INTRODUCTION Smartphone and social media use is prevalent during adolescence, with high levels of use associated with lower levels of mental well-being. Secondary schools in the UK have introduced policies that restrict daytime use of smartphones and social media, but there is no evaluation on the impact of these policies on adolescent mental well-being. The SMART Schools Study aims to determine the impact of daytime restrictions of smartphone and social media use on indicators of adolescent mental well-being, anxiety, depression, physical activity, sleep, classroom behaviour, attainment and addictive social media use. METHODS AND ANALYSIS This is a natural experimental observational study using mixed methods. Secondary schools within a 100 mile radius of the recruiting centre in the West Midlands (UK) have been categorised into two groups: Schools that restrict (intervention) and permit (comparator) daytime use of smartphones. We aim to recruit 30 schools (20 restrictive, 10 permissive) and 1170 pupils aged 12-13 and 14-15 years. We will collect data on mental well-being, anxiety and depressive symptoms, phone and social media use, sleep and physical activity from pupil surveys, and accelerometers. Policy implementation measures and data on individual pupil factors will be collected through school staff surveys, and website/policy analysis. Six case study schools will explore individual, school and family/home factors that influence relationships between school smartphone policies, smartphone/social media use, and mental well-being. Economic evaluation will be completed through a cost-consequence analysis from an education sector perspective. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Birmingham's Research Ethics Committee (ERN_22-0723). Parents/carers of pupil participants can complete a form to opt their child out of the study. Pupil, school staff and parent/carer participants are asked to complete online/written consent (or assent). Findings will be disseminated through policy briefings, resources for schools, social media, reports, and open access publications. TRIAL REGISTRATION NUMBER ISRCTN77948572.
Collapse
Affiliation(s)
- Grace Wood
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Victoria Goodyear
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Hareth Al-Janabi
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sally Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Kirsty Jones
- Head of School Support, Services for Education, Birmingham, UK
| | - Maria Michail
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Breanna Morrison
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Paul Patterson
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Alice J Sitch
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Institute of Translational Medicine, Birmingham, UK
| | - Matthew Wade
- ukactive Research Institute, London, UK
- Advanced Wellbeing Research Centre, Sheffield Hallam University College of Health Wellbeing and Life Sciences, Sheffield, UK
| | - Miranda Pallan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
30
|
Putilov AA, Sveshnikov DS, Bakaeva ZV, Yakunina EB, Starshinov YP, Torshin VI, Trutneva EA, Lapkin MM, Lopatskaya ZN, Gandina EO, Ligun NV, Puchkova AN, Dorokhov VB. Evening chronotype, insufficient weekday sleep, and weekday-weekend gap in sleep times: What is really to blame for a reduction in self-perceived health among university students? Chronobiol Int 2023; 40:874-884. [PMID: 37314700 DOI: 10.1080/07420528.2023.2222797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/31/2023] [Accepted: 06/04/2023] [Indexed: 06/15/2023]
Abstract
The association of insufficient sleep with reduced self-perceived health was previously well established. Moreover, it was sometimes shown that the indicators of poorer health were significantly related to chronotype and weekday-weekend gaps in sleep timing and duration. It remains to be elucidated, however, whether chronotype and these gaps can contribute to the reduced health self-ratings independently from shortened sleep duration or, alternatively, their relationship with health can be simply explained by their association with insufficient sleep on weekdays. In an online survey, we tested whether the self-rated health of university students can be predicted by several individual characteristics of the sleep-wake cycles, such as chronotype, weekday and weekend sleep times, weekday-weekend gap in sleep times, sleepability and wakeability at different times of the day, etc. Responses to a question about general health and to items of several questionnaires for chronobiological assessment were collected from smartphones of 1582 university students (mean age ± standard deviation was 19.5 ± 1.7 y). The results of regression analyses suggested that lower odds of having good self-rated health were significantly associated with an earlier weekday risetime, a later weekday bedtime, and, consequently, a shorter weekday time in bed. After accounting for weekday sleep, self-rated health showed significant association with neither chronotype nor weekday-weekend differences in sleep duration and timing. Besides, the adverse health effects of reduced weekday sleep were independent from the significant adverse effects of several other individual sleep-wake characteristics including poorer nighttime sleepability and lower daytime wakeability. We concluded that university students perceive the negative health impacts of losing sleep by waking up early on weekdays irrespective of their night sleep quality and daytime level of alertness. Their chronotype and weekday-weekend difference in sleep times might not be among significant contributors to this perception. It is of practical importance to consider the reduction of weekday sleep losses among the interventions aimed at preventing sleep and health problems.
Collapse
Affiliation(s)
- Arcady A Putilov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
- Research Group for Math-Modeling of Biomedical Systems, Research Institute for Molecular Biology and Biophysics of the Federal Research Centre for Fundamental and Translational Medicine, Novosibirsk, Russia
- Laboratory of Nanobiotechnology and Biophysics, North-Caucasus Federal University, Stavropol, Russia
| | - Dmitry S Sveshnikov
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Zarina V Bakaeva
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Elena B Yakunina
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Yuri P Starshinov
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Vladimir I Torshin
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Elena A Trutneva
- Department of Physiology, Ryazan State Medical University, Ryazan, Russia
| | - Michael M Lapkin
- Department of Physiology, Ryazan State Medical University, Ryazan, Russia
| | - Zhanna N Lopatskaya
- Department of Physiology, Medical Institute of the of Surgut State University, Surgut, Russia
| | - Eugenia O Gandina
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
| | - Natalya V Ligun
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
| | - Alexandra N Puchkova
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
| | - Vladimir B Dorokhov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
| |
Collapse
|
31
|
Liu J, Cao S, Huo Y, Liu H, Wang Y, Zhang B, Xu K, Yang P, Zeng L, Dang S, Yan H, Mi B. Association of sleep behavior with depression: a cross-sectional study in northwestern China. Front Psychiatry 2023; 14:1171310. [PMID: 37426097 PMCID: PMC10327479 DOI: 10.3389/fpsyt.2023.1171310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background This study aimed to examine the association between sleep duration, sleep problems, and depression in Northwest China. Method Depression was diagnosed at the hospital and self-reported by the participants in the baseline survey. Sleep duration and problems, including difficulty initiating and maintaining sleep, early morning awakening, daytime dysfunction, use of sleeping pills or drugs, and any sleep problems, were obtained by a self-reported questionnaire. Logistic regression was used to estimate odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for exploring the association between sleep duration, sleep problems, and depression, adjusting for demographic and socioeconomic characteristics and health behaviors. The association between depression and sleep duration was also evaluated continuously with restricted cubic spline curves based on logistic models. Results 36,515 adults from Regional Ethnic Cohort Study in Northwest China were included. About 24.04% of participants reported short sleep duration (<7 h), and 15.64% reported long sleep duration (≥9 h). Compared with standard sleep duration (7-9 h), short sleep duration was associated with a higher risk of depression (OR: 1.69, 95%CI: 1.26-2.27, p = 0.001). Self-reported sleep problems were also related to four times depression risk increased (OR: 4.02, 95%CI: 3.03-5.35, p < 0.001) compared with no sleep problems. In addition, a nonlinear relationship was found between sleep duration and depression after adjusting covariates (p = 0.043). Conclusion Sleep duration and sleep problems are associated with depression. Enough sleep time and healthy sleep habits in life course might be a practical health promotion approach to reduce depression risk in Northwest Chinese adults. A further study from cohort study is needed to verify the temporal association.
Collapse
Affiliation(s)
- Jingchun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Suixia Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yating Huo
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Huimeng Liu
- Department of Occupational and Environmental Health, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yutong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Binyan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Kun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Peiying Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Shaanxi Open Sharing Platform of Critical Disease Prevention and Big Health Data Science, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| |
Collapse
|
32
|
Boniel-Nissim M, Tynjälä J, Gobiņa I, Furstova J, van den Eijnden RJJM, Marino C, Klanšček HJ, Klavina-Makrecka S, Villeruša A, Lahti H, Vieno A, Wong SL, Villberg J, Inchley J, Gariépy G. Adolescent use of social media and associations with sleep patterns across 18 European and North American countries. Sleep Health 2023; 9:314-321. [PMID: 36804326 DOI: 10.1016/j.sleh.2023.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 11/23/2022] [Accepted: 01/10/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Over the past decade, concurrent with increasing social media use (SMU), there has been a shift toward poorer sleep among adolescents in many countries. The purpose of this study was to examine the cross-national associations between adolescent SMU and sleep patterns, by comparing 4 different categories of SMU (nonactive, active, intense, and problematic use). DESIGN, SETTING, AND PARTICIPANTS Data were from 86,542 adolescents in 18 European and North American countries that participated in the 2017/18 Health Behaviour in School-aged study. MEASUREMENTS Mixed-effects linear regression models were used to examine cross-national associations between 4 SMU categories and adolescent sleep duration, bedtime and social jetlag derived from self-reported data. RESULTS For all countries combined, nonactive SMU was associated with longer sleep, earlier bedtimes, and less social jetlag, compared to active SMU, although the differences were minor. By comparison, intense and problematic SMU were associated with less sleep and later bedtimes on both school and nonschool days, and greater social jetlag, compared to active SMU. While findings were relatively consistent between countries, some differences were observed, suggesting that the national and cultural context may be important in interpreting results. CONCLUSIONS These findings suggest that both intense and problematic SMU are associated with poorer sleep patterns in adolescents across most countries. Further research is needed to identify effective policies, programs, and messaging to promote the healthy use of social media and prevent potential negative impacts on adolescent sleep.
Collapse
Affiliation(s)
- Meyran Boniel-Nissim
- Department of Educational Counselling, The Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Jana Furstova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | | | - Claudia Marino
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | | | | | - Anita Villeruša
- Department of Public Health and Epidemiology, Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Henri Lahti
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Suzy L Wong
- Public Health Agency of Canada, Ottawa, Canada
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Geneviève Gariépy
- Public Health Agency of Canada, Ottawa, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada.
| |
Collapse
|
33
|
Hitt TA, Hershey JA, Olivos-Stewart D, Forth E, Stuart F, Garren P, Mitchell J, Hawkes CP, Willi SM, Gettings JM. The impact of fear of hypoglycaemia on sleep in adolescents with type 1 diabetes. Diabet Med 2023; 40:e15066. [PMID: 36786042 PMCID: PMC10184772 DOI: 10.1111/dme.15066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
AIMS Fear of hypoglycaemia (FOH) can contribute to impaired sleep for adults with type 1 diabetes (T1D) and parents of children with T1D, although it is unknown how FOH may affect sleep for adolescents with T1D. This study examines the relationship between adolescent FOH and sleep and assessed the influences of continuous glucose monitor (CGM) and insulin pump use. METHODS Adolescents ages 14-18 years with T1D completed questionnaires evaluating FOH (Child Hypoglycemia Fear Survey) and sleep (Pittsburgh Sleep Quality Index, PSQI). Analyses included linear and logistic regression, t-tests and Fisher's exact tests. RESULTS Participants included 95 adolescents (52 female) with a median (IQR) age of 16.5 (15.3-17.7) years and a T1D duration of 5.7 (2.5-9.6) years. Analyses showed increased FOH-Worry subscale scores were associated with reduced sleep duration (β = -0.03, p = 0.042, adjusting for BMI z-score, race and ethnicity) and increased sleep disturbances (OR = 1.1, p = 0.038, adjusting for race and ethnicity). Frequent CGM users had longer sleep duration (average 7.5 h) compared with infrequent or non-CGM users (average = 6.8 h; p = 0.029), and pump users had overall improved sleep health as determined by PSQI score (p = 0.019). Technology use did not have significant interactions in the relationships between FOH and sleep duration or sleep disturbances. CONCLUSIONS Worrying about hypoglycaemia was associated with impaired sleep for adolescents with T1D. Diabetes technology users have some sleep improvements, but CGM and pump use do little to alter the relationship between FOH and sleep outcomes.
Collapse
Affiliation(s)
- Talia A. Hitt
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jennifer A. Hershey
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Diana Olivos-Stewart
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Emily Forth
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Fiona Stuart
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Patrik Garren
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jonathan Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Colin P. Hawkes
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Steven M. Willi
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Julie M. Gettings
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| |
Collapse
|
34
|
Zhang D, Qu Y, Zhai S, Li T, Xie Y, Tao S, Zou L, Tao F, Wu X. Association between healthy sleep patterns and depressive trajectories among college students: a prospective cohort study. BMC Psychiatry 2023; 23:182. [PMID: 36941547 PMCID: PMC10026494 DOI: 10.1186/s12888-023-04596-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/07/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The purpose of this study was to identify different develpment trajectories of depression symptoms during college period, and prospectively investigate the associations healthy sleep patterns with trajectories of depression symptoms among college students from freshman through junior year. METHODS A total of 999 participants from the College Student Behavior and Health Cohort Study were included between April 2019 and June 2021. Healthy sleep patterns were defined by chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Latent growth curve model was used to identify trajectories of depression symptoms. Then binary logistic regression was used to examine association of the healthy sleep patterns with these trajectories. RESULTS In baseline survey, we found that a total of 100 (10.0%) participants had healthy sleep patterns' score equal to 5. Then, we used 5 surveys' data to identify 2 distinct trajectories of depression symptoms during college (decreasing: 82.5%; increasing: 17.5%). The healthy sleep patterns were associated with these trajectories, the better healthy sleep patterns significantly decrease the risk of increasing trajectories of depression symptoms in males (OR: 0.72, 95%CI: 0.54 ~ 0.97, P = 0.031). Moreover, we found out that the healthy sleep patterns of college students can predict the future depressive symptoms in this study (all P < 0.001). CONCLUSION Our findings indicate that the better healthy sleep patterns may significantly decrease the risk of increasing trajectory of depression symptoms only in male college students. The results speak to a need for college student with depression symptoms to identify and address sleep problems when present, which could prevent or reduce depression detriments in later life.
Collapse
Affiliation(s)
- Dan Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Yang Qu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Shuang Zhai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Tingting Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Yang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Shuman Tao
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Liwei Zou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
| |
Collapse
|
35
|
Perpétuo C, El-Sheikh M, Diniz E, Veríssimo M. Attachment to Mother and Father, Sleep, and Well-Being in Late Middle Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3399. [PMID: 36834099 PMCID: PMC9965866 DOI: 10.3390/ijerph20043399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
The security of attachment has been related to several advantageous developmental outcomes, such as good sleep quality and higher well-being indicators. However, few studies concern the associations between attachment dimensions to both parents, sleep, and well-being in late middle childhood. Our study aims to expand knowledge in this area, clarifying the above-mentioned associations by considering the secure base and safe haven dimensions of attachment. We also investigate the role of sleep as a mediator of the relationship between attachment and well-being. The 258 participants (49.2% girls, mean age = 11.19, SD = 0.85) completed self-report questionnaires regarding attachment (KSS), sleep (SSR), and well-being (CHIP-CE). The results show significant associations between attachment to both parents (0.40 ** ≤ r ≤ 0.61 **) and between attachment security, sleep (-0.21 ** ≤ r ≤ -0.35 **) and child well-being (0.42 ** ≤ r ≤ 0.47 **). Besides, sleep quality partially mediated the relations between all attachment dimensions to both parents and well-being. The results are discussed in light of attachment theory, focusing on the comparison between attachment to mother and father as a valid framework to unravel differences in child well-being, with sleep as a process that can help to explain the mechanisms through which attachment security enables subjective perceptions of well-being.
Collapse
Affiliation(s)
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University, Auburn, AL 36849, USA
| | - Eva Diniz
- William James Center for Research, ISPA, 1100-287 Lisbon, Portugal
| | | |
Collapse
|
36
|
Yang Y, Liu X, Liu ZZ, Tein JY, Jia CX. Life stress, insomnia, and anxiety/depressive symptoms in adolescents: A three-wave longitudinal study. J Affect Disord 2023; 322:91-98. [PMID: 36372126 DOI: 10.1016/j.jad.2022.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/18/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE Life stress has negative impacts on sleep and mental health. Little empirical work has investigated the associations between life stress, insomnia, and anxiety/depressive symptoms (ADS) in multi-wave longitudinal studies. This longitudinal study examined these associations in a large sample of adolescents. METHODS A total of 6995 adolescents (mean age = 14.86 years, 51.4 % male) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. Standardized rating scales were used to assess life stress, insomnia, and ADS in 2015 (T1), 1 year later (T2), and 2 years later (T3). Three-wave longitudinal panel models were conducted to examine the prospective relationships between life stress, insomnia, and ADS. RESULTS The prevalence and persistence rates of insomnia and ADS across T1-T3 significantly increased with elevated life stress score (p < .001). Cross-lagged panel analysis showed that life stress, insomnia, and ADS at a later time point were significantly predicted by the same variable at earlier time points (all p < .01). Life stress, insomnia, and ADS significantly predicted each other bidirectionally over time (all p < .01). The relationship between life stress and ADS was partially mediated by insomnia. The relationship between life stress and insomnia was partially mediated by ADS. STUDY LIMITATION Life stress, insomnia, and ADS were all self-reports. CONCLUSIONS Life stress, insomnia, and ADS are prospectively bidirectionally related to one another. Insomnia was a mediator of life stress and subsequent ADS and vice versa. These findings underscore the importance of sleep and mental health assessment and intervention in adolescents following life stress.
Collapse
Affiliation(s)
- Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun, China; Shandong University School of Public Health, Jinan, China
| | - Jenn-Yun Tein
- Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Cun-Xian Jia
- Shandong University School of Public Health, Jinan, China
| |
Collapse
|
37
|
Sleep and Mental Health Problems in Children and Adolescents. Sleep Med Clin 2023; 18:245-254. [PMID: 37120167 DOI: 10.1016/j.jsmc.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Previous reviews have described the links between sleep and mental health extensively. In this narrative review, we focus on literature published during the last decade investigating the links between sleep and mental health difficulties in childhood and adolescence. More specifically, we focus on the mental health disorders listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders. We also discuss possible mechanisms underlying these associations. The review ends with a discussion of possible future lines of enquiry.
Collapse
|
38
|
Kleppang AL, Vettore MV, Hartz I, Haugland SH, Stea TH. Patterns of unhealthy behaviours during adolescence and subsequent anxiety and depression in adulthood: a prospective register linkage study of the HUNT survey and health registries. Int J Behav Nutr Phys Act 2023; 20:6. [PMID: 36691059 PMCID: PMC9869587 DOI: 10.1186/s12966-023-01408-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 01/06/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND There is increasing need for prospective investigations in the preventing role of health-related behaviours on mental health problems. The aim of this study is to identify patterns of health-related behaviours in adolescence, and the association between the behavioural patterns and the subsequent diagnoses and/or drug treatment for anxiety and/or depression in adulthood. METHODS This prospective study consisted of 13-19-year-old participants in the Trøndelag Health Study (Young-HUNT3) in 2006-2008 (n = 2061, 1205 females and 856 males) in Norway, who also participated in HUNT4 (2017-2019). Survey data on health-related behaviours in adolescence, including low level of physical activity, low consumption of wholegrain bread, fish, fruit, vegetables and high consumption of sugar-sweetened beverages and insomnia were linked on an individual level to prospective information on drug use and diagnosis in national health registries. The different patterns of health-related behaviours were identified through latent class analysis. Subsequent anxiety or depression was defined as at least one recording in either of three registries covering recorded diagnosis in primary and specialist healthcare, or dispensed prescription drugs during 2008-2019. Additionally, self-reported psychological distress measured in young adulthood was applied as a supplemental outcome measure. RESULTS Four patterns of health-related behaviours were identified: high risk behaviours (class 1), moderate to high risk behaviours (class 2), low to moderate risk behaviours (class 3) and low risk behaviours (class 4). Adolescents in class 3 showed higher odds of subsequent diagnoses for anxiety and/or depression in primary and specialist healthcare compared to class 4 participants. In addition, both class 1 and class 4 participants had higher odds for self-reported psychological distress than those class 4 (OR = 1.56 and OR = 1.86, respectively). CONCLUSIONS Our findings suggest that health-related behaviours are clustered among Norwegian adolescents. The patterns of unhealthy behaviours during adolescence only partly increased the risk of anxiety and depression in adulthood. Promoting healthy behaviours during adolescence may potentially reduce the burden of mental illness in adulthood, but further research is needed to clarify the nature of the relationships.
Collapse
Affiliation(s)
- Annette Løvheim Kleppang
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Mario Vianna Vettore
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Ingeborg Hartz
- grid.412929.50000 0004 0627 386XInnlandet Hospital Trust, Hedmark, Norway ,grid.477237.2Department of Health and Nursing Science, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Siri Håvås Haugland
- grid.23048.3d0000 0004 0417 6230Department of Psychosocial Health, University of Agder, Kristiansand, Norway
| | - Tonje Holte Stea
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| |
Collapse
|
39
|
Keles B, Grealish A, Leamy M. The beauty and the beast of social media: an interpretative phenomenological analysis of the impact of adolescents' social media experiences on their mental health during the Covid-19 pandemic. CURRENT PSYCHOLOGY 2023; 43:1-17. [PMID: 36713619 PMCID: PMC9860222 DOI: 10.1007/s12144-023-04271-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
Despite extensive research, the mental health implication of social media in adolescents is not yet understood due to mixed and inconsistent findings and more in-depth qualitative studies are needed to expand our understanding of the impact of social media on adolescent mental health during the Covid-19 pandemic. The purpose of this study was to explore why and how adolescents use social media, adolescents' lived experiences on social media, how they make sense of these experiences having impact on their mental health, and the influence of the Covid-19 pandemic on their use of social media and mental health. In-depth interviews were conducted with eleven adolescents aged 14-16 (five female, six male) across England. The interviews were audio-recorded, transcribed verbatim and analysed using interpretative phenomenological analysis. Two key themes were identified: the beauty of social media that captured positive experiences and emotions of adolescents and the beast of social media that captured negative experiences and emotions. From the adolescents' accounts, social media has both positive and negative impacts on their mental health, but mostly positive impacts during the Covid-19 pandemic. The results were discussed in relation to the study aims and previous study findings. Strengths and methodological limitations of the study, implications for future research that emerged from the study were discussed.
Collapse
Affiliation(s)
- Betul Keles
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, James Clerk Maxwell Building, Room 1.38a, 57 Waterloo Road, London, SE1 8WA UK
| | - Annmarie Grealish
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, James Clerk Maxwell Building, Room 1.38a, 57 Waterloo Road, London, SE1 8WA UK
- Department of Nursing and Midwifery, Faculty of Education & Health Sciences, University of Limerick, Room HS3-032, Health Sciences Building, Limerick, V94 T9PX Republic of Ireland
| | - Mary Leamy
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, James Clerk Maxwell Building, Room 1.38a, 57 Waterloo Road, London, SE1 8WA UK
| |
Collapse
|
40
|
Linkas J, Ahmed LA, Csifcsak G, Emaus N, Furberg AS, Pettersen G, Rognmo K, Christoffersen T. Two-year changes in sleep duration are associated with changes in psychological distress in adolescent girls and boys: the fit futures study. Health Psychol Behav Med 2022; 10:1159-1175. [PMID: 36437871 PMCID: PMC9683068 DOI: 10.1080/21642850.2022.2147936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Studies indicate an inverse association between sleep duration and psychological distress. We aimed to explore associations between changes in sleep duration and changes in psychological distress in girls and boys. Methods The Fit Futures Study is a broad adolescent study providing data from 373 girls and 294 boys aged 15–18 years collected in 2010/2011 (FF1) and 2012/2013 (FF2). Psychological distress was measured by the Hopkins Symptom Checklist (HSCL-10) and sleep duration was self-reported. Change score variables were calculated as the change between baseline and follow-up for sleep duration and HSCL-10, respectively. Associations between changes in sleep duration and changes in HSCL-10 were explored by linear regressions, in gender-stratified analyses. Results At FF1, girls and boys slept on average 6.93 (SD = 1.08) and 7.05 (SD = 1.20) hours per night respectively, and correspondingly, 6.83 (SD = 1.19) and 6.85 (SD = 1.21) at FF2. At FF1, 22.8% of the girls and 25.8% of the boys slept ≤ 6 h per night, and correspondingly 28.0% and 28.2% at FF2. In girls and boys, one unit increase (30 min) in sleep duration was associated with a decrease in HSCL-10 score of B [95% CI] = −0.090 [−0.131, −0.048], p < 0.001, and −0.054 [−0.091, −0.017], p < 0.001, respectively. The associations remained significant after adjusting for confounders. Conclusion Our findings show that increased sleep duration was associated with decreased psychological distress during adolescence. Future studies should examine the causality between sleep duration and psychological distress.
Collapse
Affiliation(s)
- Jonas Linkas
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Narvik, Norway
| | - Luai Awad Ahmed
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, Al Ain, UAE
| | - Gabor Csifcsak
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne-Sofie Furberg
- Faculty of Health and Care Sciences, Molde University College, Molde, Norway
| | - Gunn Pettersen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kamilla Rognmo
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tore Christoffersen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- School of Sport Sciences, UiT The Arctic University of Norway, Alta, Norway
- Department of Research and Development, Finnmark Hospital Trust, Alta, Norway
| |
Collapse
|
41
|
Ikram M, Shaikh NF, Vishwanatha JK, Sambamoorthi U. Leading Predictors of COVID-19-Related Poor Mental Health in Adult Asian Indians: An Application of Extreme Gradient Boosting and Shapley Additive Explanations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:775. [PMID: 36613095 PMCID: PMC9819341 DOI: 10.3390/ijerph20010775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
During the COVID-19 pandemic, an increase in poor mental health among Asian Indians was observed in the United States. However, the leading predictors of poor mental health during the COVID-19 pandemic in Asian Indians remained unknown. A cross-sectional online survey was administered to self-identified Asian Indians aged 18 and older (N = 289). Survey collected information on demographic and socio-economic characteristics and the COVID-19 burden. Two novel machine learning techniques-eXtreme Gradient Boosting and Shapley Additive exPlanations (SHAP) were used to identify the leading predictors and explain their associations with poor mental health. A majority of the study participants were female (65.1%), below 50 years of age (73.3%), and had income ≥ $75,000 (81.0%). The six leading predictors of poor mental health among Asian Indians were sleep disturbance, age, general health, income, wearing a mask, and self-reported discrimination. SHAP plots indicated that higher age, wearing a mask, and maintaining social distancing all the time were negatively associated with poor mental health while having sleep disturbance and imputed income levels were positively associated with poor mental health. The model performance metrics indicated high accuracy (0.77), precision (0.78), F1 score (0.77), recall (0.77), and AUROC (0.87). Nearly one in two adults reported poor mental health, and one in five reported sleep disturbance. Findings from our study suggest a paradoxical relationship between income and poor mental health; further studies are needed to confirm our study findings. Sleep disturbance and perceived discrimination can be targeted through tailored intervention to reduce the risk of poor mental health in Asian Indians.
Collapse
Affiliation(s)
- Mohammad Ikram
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510, Morgantown, WV 26506-9510, USA
| | - Nazneen Fatima Shaikh
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510, Morgantown, WV 26506-9510, USA
| | - Jamboor K. Vishwanatha
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Usha Sambamoorthi
- Department of Pharmacotherapy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| |
Collapse
|
42
|
Orihuela CA, Mrug S, Evans RR. Associations between sleepiness, sleep duration, and academic outcomes in early adolescence. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Catheryn A. Orihuela
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| | - Sylvie Mrug
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| | - Retta R. Evans
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| |
Collapse
|
43
|
Li C, Ma C, Wu H, Zhao M, Zhu D, Xi B. Sleep duration change from childhood to adulthood and adult depressive disorders in the Chinese population. Sleep Med 2022; 100:128-132. [PMID: 36049406 DOI: 10.1016/j.sleep.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/26/2022] [Accepted: 08/12/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Sleep deprivation may cause depressive disorders in both children and adults. However, the effects of sleep duration change from childhood to adulthood on adult depressive disorders are poorly documented. Using the China Family Panel Study (CFPS) data, we aimed to examine the association between sleep duration change from childhood to adulthood and adult depressive disorders in the Chinese population. METHODS Data were from 1172 children aged 10-15 years in 2010 who were followed up through 2018 based on the nationally representative and population-based CFPS. According to sleep duration in childhood and early adulthood, the sleep duration change was categorized into four groups: persistently insufficient sleep, sleep duration loss, sleep duration gain and persistently sufficient sleep. RESULTS After adjustment for potential covariates, compared with individuals with persistently sufficient sleep duration, those with sleep duration loss (OR = 1.98, 95% CI = 1.14-3.46) and persistently insufficient sleep (OR = 2.35, 95% CI = 1.43-3.88) had higher odds of depressive disorders in adulthood. In contrast, the odds of adult depressive disorders did not significantly increase in those with sleep duration gain (OR = 1.46, 95% CI = 0.88-2.41). LIMITATIONS Information on sleep duration was obtained through a questionnaire; the sample size of this study was not large; the generalizality of our findings to other populations should be caucious. CONCLUSION Persistently insufficient sleep duration and sleep duration loss from childhood to adulthood were associated with higher odds of adult depressive disorders, while those who were able to change their sleep duration from insufficient status to sufficient status didn't have an increased odds of adult depressive disorders.
Collapse
Affiliation(s)
- Cheng Li
- Department of Epidemiology, School of Public Health, Qi Lu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chuanwei Ma
- Department of Epidemiology, School of Public Health, Qi Lu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Han Wu
- Department of Epidemiology, School of Public Health, Qi Lu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dongshan Zhu
- Department of Epidemiology, School of Public Health, Qi Lu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Qi Lu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
| |
Collapse
|
44
|
Anastasiades PG, de Vivo L, Bellesi M, Jones MW. Adolescent sleep and the foundations of prefrontal cortical development and dysfunction. Prog Neurobiol 2022; 218:102338. [PMID: 35963360 PMCID: PMC7616212 DOI: 10.1016/j.pneurobio.2022.102338] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
Modern life poses many threats to good-quality sleep, challenging brain health across the lifespan. Curtailed or fragmented sleep may be particularly damaging during adolescence, when sleep disruption by delayed chronotypes and societal pressures coincides with our brains preparing for adult life via intense refinement of neural connectivity. These vulnerabilities converge on the prefrontal cortex, one of the last brain regions to mature and a central hub of the limbic-cortical circuits underpinning decision-making, reward processing, social interactions and emotion. Even subtle disruption of prefrontal cortical development during adolescence may therefore have enduring impact. In this review, we integrate synaptic and circuit mechanisms, glial biology, sleep neurophysiology and epidemiology, to frame a hypothesis highlighting the implications of adolescent sleep disruption for the neural circuitry of the prefrontal cortex. Convergent evidence underscores the importance of acknowledging, quantifying and optimizing adolescent sleep's contributions to normative brain development and to lifelong mental health.
Collapse
Affiliation(s)
- Paul G Anastasiades
- University of Bristol, Translational Health Sciences, Dorothy Hodgkin Building, Whitson Street, Bristol BS1 3NY, UK
| | - Luisa de Vivo
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK; University of Camerino, School of Pharmacy, via Gentile III Da Varano, Camerino 62032, Italy
| | - Michele Bellesi
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK; University of Camerino, School of Bioscience and Veterinary Medicine, via Gentile III Da Varano, Camerino 62032, Italy
| | - Matt W Jones
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK
| |
Collapse
|
45
|
Williamson AA, Soehner AM, Boyd RC, Buysse DJ, Harvey AG, Jonassaint CR, Franzen PL, Goldstein TR. A protocol for applying health equity-informed implementation science models and frameworks to adapt a sleep intervention for adolescents at risk for suicidal thoughts and behaviors. Front Public Health 2022; 10:971754. [PMID: 36311565 PMCID: PMC9597692 DOI: 10.3389/fpubh.2022.971754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/16/2022] [Indexed: 01/25/2023] Open
Abstract
Background Effective and equitable strategies to prevent youth suicidal thoughts and behaviors (STB) are an urgent public health priority. Adolescent sleep disturbances are robustly linked to STB but are rarely addressed in preventive interventions or among Black and/or Hispanic/Latinx youth for whom STB risk is increasing disproportionately. This paper describes an application of health equity-informed implementation science models and frameworks to adapt and evaluate the evidence-based Transdiagnostic Sleep and Circadian (TSC) intervention for primary care implementation with adolescents of minoritized backgrounds with depression and STB risk. Methods This multiphase study protocol uses the Assessment, Decision, Adaptation, Production, Topical Experts-Integration, Training, Testing (ADAPT-ITT) model to adapt and evaluate TSC for primary care implementation with adolescents who are depressed, at risk for STB, and of primarily Black and/or Hispanic/Latinx backgrounds. We integrate the Consolidated Framework for Implementation Research (CFIR) in an initial qualitative inquiry of adolescent, caregiver, and clinician perceptions of TSC. Subsequent ADAPT-ITT phases include systematically and iteratively testing adaptations based on the qualitative inquiry, with ongoing key informant input, and then evaluating the adapted TSC for feasibility, acceptability, and efficacy in a pilot randomized trial. Anticipated results Based on youth depression and sleep health disparities research, we expect that TSC adaptations will be needed to enhance intervention content for adolescents with depression, STB risk, and primarily Black and/or Hispanic/Latinx backgrounds. We also anticipate adaptations will be needed to align TSC delivery methods with primary care implementation. Conclusions Adapting evidence-based interventions with end-users and contexts in mind can help ensure that intervention strategies and delivery methods are acceptable to, and feasible with, health disparate populations. Although TSC has shown effectiveness for adolescents with sleep disturbances, we expect that additional multiphase research is necessary to optimize TSC for primary care delivery with Black and/or Hispanic/Latinx adolescents with depression and STB risk.
Collapse
Affiliation(s)
- Ariel A. Williamson
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, United States,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States,*Correspondence: Ariel A. Williamson
| | - Adriane M. Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Rhonda C. Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, United States,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Allison G. Harvey
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Charles R. Jonassaint
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Tina R. Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| |
Collapse
|
46
|
Back to Basics: Lifestyle Interventions for Adolescent Depression. Harv Rev Psychiatry 2022; 30:283-302. [PMID: 36103683 DOI: 10.1097/hrp.0000000000000343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
LEARNING OBJECTIVES After completing this activity, practitioners will be better able to:• Discuss and better understand the recently adopted screening standards for adolescents with depression and the potential advantages of using "lifestyle medicine"• Set up a process for providing effective interventions for the increased number of patients with adolescent depression• Design or update their toolbox of treatment options for adolescents with depression based on the new literature and increased demand. ABSTRACT Recently adopted quality standards recommend that pediatricians screen adolescents for depression and that they document follow-up plans for those who screen positive. As a result of these new recommendations, pediatricians and other pediatric providers, as well as psychiatrists and other mental health professionals, may face an increasing number of referrals and a growing need for effective interventions for adolescent depression. Given the widely acknowledged scarcity of traditional mental health resources, the current study reviewed the rapidly expanding array of evidence-based, but nontraditional, interventions applicable to outpatient pediatric and mental health care settings. Many of these interventions come from a lifestyle medicine framework. Lifestyle medicine interventions are congruent with the cultures of pediatrics and outpatient psychiatry, and offer additional evidence-based tools for providers managing adolescent depression. These interventions can be implemented individually or within group or community settings, and may be used in conjunction with more common interventions such as psychotherapy or psychotropic medications.
Collapse
|
47
|
Akbar SA, Mattfeld AT, Laird AR, McMakin DL. Sleep to Internalizing Pathway in Young Adolescents (SIPYA): A proposed neurodevelopmental model. Neurosci Biobehav Rev 2022; 140:104780. [PMID: 35843345 PMCID: PMC10750488 DOI: 10.1016/j.neubiorev.2022.104780] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/28/2023]
Abstract
The prevalence of internalizing disorders, i.e., anxiety and depressive disorders, spikes in adolescence and has been increasing amongst adolescents despite the existence of evidence-based treatments, highlighting the need for advancing theories on how internalizing disorders emerge. The current review presents a theoretical model, called the Sleep to Internalizing Pathway in Young Adolescents (SIPYA) Model, to explain how risk factors, namely sleep-related problems (SRPs), are prospectively associated with internalizing disorders in adolescence. Specifically, SRPs during late childhood and early adolescence, around the initiation of pubertal development, contribute to the interruption of intrinsic brain networks dynamics, both within the default mode network and between the default mode network and other networks in the brain. This interruption leaves adolescents vulnerable to repetitive negative thought, such as worry or rumination, which then increases vulnerability to internalizing symptoms and disorders later in adolescence. Sleep-related behaviors are observable, modifiable, low-stigma, and beneficial beyond treating internalizing psychopathology, highlighting the intervention potential associated with understanding the neurodevelopmental impact of SRPs around the transition to adolescence. This review details support for the SIPYA Model, as well as gaps in the literature and future directions.
Collapse
Affiliation(s)
- Saima A Akbar
- Department of Psychology, Florida International University, Miami, FL, USA.
| | - Aaron T Mattfeld
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
| |
Collapse
|
48
|
Xu X, Zheng F, Cai Y, Lin J, Zeng Z, Wei S, Wu S. Sleep health and its related influencing factors in primary and middle school students in Fuzhou: A large multi-center cross-sectional study. Front Public Health 2022; 10:924741. [PMID: 35991023 PMCID: PMC9386349 DOI: 10.3389/fpubh.2022.924741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background This current study set out to investigate the status of sleep health in 7–20-year-old students in Fuzhou and explore the related influencing factors of sleep health. Methods A total of 38,467 children and adolescents in Fuzhou were included in the study through a random stratified cluster sampling. Data were collected from May to June 2019, in 18 primary schools and 18 middle schools from nine districts, Fuzhou. Children's parents and adolescents of sampled classes were invited to fill out a series of questionnaires about the performance of the last 6 months (sociodemographic characteristics, sleep-related lifestyle behaviors, and electronic-products usage). Multiple linear regression was carried out to analyze data. Results Of the total 40,888 questionnaires we released, 38,467 were valid and effective with the response rate was 94.08%. The age of the surveyed participants was 11.85 ± 3.1, including 20,013 boys and 18,454 girls. The multiple linear regression analysis identified factors associated with sleep health (p < 0.05): Boy (coef = 0.073, 95% CI: 0.030–0.115), age (coef = 1.797, 95% CI: 0.224–0.243), key school (coef = 2.069, 95% CI: 0.105–0.193), urban (coef = 0.096, 95% CI: 0.054–0.139), excessive daytime sleepiness (coef = 0.535, 95% CI: 0.432–0.639), unhealthy sleep habits (coef = 0.363, 95% CI: 0.307–0.419), eating before sleep (coef = 0.578, 95% CI: 0.527–0.630), using electronic products in bedroom (coef = 0.074, 95% CI: 0.028–0.121), screen time per day during school (coef = 0.260, 95% CI: 0.235–0.284), frequency of using electronics 30 min before bedtime (coef = 0.150, 95% CI: 0.134–0.166), strained relationship with parents (coef = 0.361, 95% CI: 0.270–0.452), strained relationship with peers (coef = 0.267, 95% CI: 0.171–0.363), excessive homework or learning (coef = 0.189, 95% CI: 0.141–0.237), time for doing homework (coef = 0.266, 95% CI: 0.245–0.287), and mood swings frequently (coef = 1.174, 95% CI: 1.127–1.221) negatively impact sleep health. Sleep alone (coef = −0.204, 95% CI: −0.262–0.147) were the risk factors for sleep health. Furthermore, frequent mood swings was considered the most influential factor on overall variables. Conclusions Sleep health is associated with factors covered sociodemographic characteristics, family sleep habits, and routine activities before bedtime. Multiple measures should be taken to improve sleep quality in a targeted manner.
Collapse
Affiliation(s)
- Xingyan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Fuhao Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Office of Academic Research, Fujian Provincial Hospital, Fuzhou, China
| | - Yingying Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jie Lin
- The Second Attached Hospital of Fujian Medical University, Quanzhou, China
| | - Zhaonan Zeng
- Center for Experimental Research in Clinical Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - Shichao Wei
- Sleep Medicine Center, Fujian Provincial Hospital, Fuzhou, China
- *Correspondence: Shichao Wei
| | - Siying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Siying Wu
| |
Collapse
|
49
|
Thorburn-Winsor EA, Neufeld SAS, Rowthorn H, van Sluijs EMF, Brage S, Jones PB, Goodyer IM, Winpenny EM. Device-measured sleep onset and duration in the development of depressive symptoms in adolescence. J Affect Disord 2022; 310:396-403. [PMID: 35569606 DOI: 10.1016/j.jad.2022.05.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/04/2022] [Accepted: 05/08/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Sleep deprivation in adolescence is increasing in prevalence and may be linked to subsequent depression. Findings regarding associations between sleep duration, sleep onset time, and the development of depressive symptoms over time in adolescents are mixed, and rely on subjective measures of sleep. METHODS Sleep onset and duration were assessed using a combined heart rate monitor and accelerometer and self-report in 688 participants from the ROOTS study at age 15. Participants reported depressive symptoms at ages 14.5, 16, and 17.5, using the Mood and Feelings Questionnaire. Latent growth curve modelling was used to model development of depressive symptoms and test associations with baseline sleep onset and duration. RESULTS Cross-sectionally, falling asleep later and shorter sleep duration were both associated with higher depressive symptoms in males and females, using both device-measured and self-reported sleep. There were no longitudinal associations between baseline sleep duration and change in depressive symptoms. A later sleep onset-time was associated with a decrease in depressive symptoms over time, in females only, using device-measured sleep only. LIMITATIONS The current sample was more economically advantaged and ethnically white than the UK average, and with lower MFQ symptoms than the original cohort, which may reduce generalisability. CONCLUSIONS Adolescents who fall asleep later or sleep less have higher levels of depressive symptoms cross-sectionally, but do not show increases in depressive symptoms over time. Interventions targeting sleep onset and duration in adolescence may improve mental health in the short-term but the possibility of reverse causality should be explored further.
Collapse
Affiliation(s)
- Emily A Thorburn-Winsor
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
| | - Sharon A S Neufeld
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, United Kingdom
| | - Harriet Rowthorn
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
| | - Esther M F van Sluijs
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, United Kingdom
| | - Ian M Goodyer
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, United Kingdom
| | - Eleanor M Winpenny
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom.
| |
Collapse
|
50
|
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
|