A meta-analysis and model of the relationship between sleep and depression in adolescents: Recommendations for future research and clinical practice

Lovato, Nicole; Gradisar, Michael

doi:10.1016/j.smrv.2014.03.006

Cited by 431 publications

(392 citation statements)

References 76 publications

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“…For example, participants selected for the interventions were characterized by longer SOL, but not lower TST, compared with those not selected for the interventions. These results are also consistent with emerging empirical evidence showing that children and adolescents with anxious and depressive symptoms have particular difficulties with wakefulness in bed (Lovato & Gradisar, 2014), especially sleep initiation (Alfano et al, 2013;Forbes et al, 2008), and with the results of other sleep interventions that have found SOL among the most improved variables (Bei et al, 2013;Bootzin & Stevens, 2005;Clarke et al, 2015;de Bruin et al, 2015de Bruin et al, , 2014Garland et al, 2014;Gradisar, Dohnt, et al, 2011;Gross et al, 2011;Koffel et al, 2015;Schlarb et al, 2011;Trauer et al, 2015).…”

Section: Discussionsupporting

confidence: 89%

The SENSE study: Post intervention effects of a randomized controlled trial of a cognitive–behavioral and mindfulness-based group sleep improvement intervention among at-risk adolescents.

Blake

Waloszek

Schwartz

et al. 2016

Journal of Consulting and Clinical Psychology

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Objective: Sleep problems are a major risk factor for the emergence of mental health problems in adolescence. The aim of this study was to investigate the post intervention effects of a cognitive–behavioral/mindfulness-based group sleep intervention on sleep and mental health among at-risk adolescents. Method: A randomized controlled trial (RCT) was conducted across High schools in Melbourne, Australia. One hundred forty-four adolescents (aged 12–17 years) with high levels of anxiety and sleeping difficulties, but without past or current depressive disorder, were randomized into either a sleep improvement intervention or an active control ‘study skills’ intervention. Both programs consisted of 7 90-min-long group sessions delivered over 7 weeks. One hundred twenty-three participants began the interventions (female = 60%; mean age = 14.48, SD = 0.95), with 60 in the sleep condition and 63 in the control condition. All participants were required to complete a battery of mood and sleep questionnaires, 7 days of wrist actigraphy (an objective measure of sleep), and sleep diary entry at pre- and-post intervention. Results: The sleep intervention condition was associated with significantly greater improvements in subjective sleep (global sleep quality [with a medium effect size], sleep onset latency, daytime sleepiness [with small effect sizes]), objective sleep (sleep onset latency [with a medium effect size]), and anxiety (with a small effect size) compared with the control intervention condition. Conclusion: The SENSE study provides evidence that a multicomponent group sleep intervention that includes cognitive–behavioral and mindfulness-based therapies can reduce sleep initiation problems and related daytime dysfunction, along with concomitant anxiety symptoms, among at-risk adolescents.

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Section: Discussionsupporting

confidence: 89%

The SENSE study: Post intervention effects of a randomized controlled trial of a cognitive–behavioral and mindfulness-based group sleep improvement intervention among at-risk adolescents.

Blake

Waloszek

Schwartz

et al. 2016

Journal of Consulting and Clinical Psychology

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“…30 The possible unidirectional or bidirectional relationships between sleep and comorbid mood disorders in CFS have not been investigated. With emerging evidence that sleep problems may represent a precursor to the onset of depression and anxiety among adolescents, 31,32 exploring these relationships in patients with CFS will be an important direction for future research given the heightened risk of mood disorders in this population. 33,34 Further, the sleep hygiene practices of children and adolescents with CFS, and how they may contribute to disturb sleep, have not yet been investigated.…”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbances in Pediatric Chronic Fatigue Syndrome: A Review of Current Research

Snodgrass

Harvey

Scheinberg

et al. 2015

Journal of Clinical Sleep Medicine

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Objective: Children and adolescents with chronic fatigue syndrome (CFS) frequently report sleep disturbances. However, little is known about the nature and severity of sleep disturbance and factors associated with sleep problems in pediatric CFS. The purpose of this review was to synthesize and critically appraise existing literature relating to sleep disturbances in pediatric CFS. Methods: Embase, CINAHL, PsychINFO, PubMed. and Medline databases were searched to retrieve all studies that included an assessment of sleep in pediatric CFS. Two reviewers independently assessed eligibility, extracted data, and systematically assessed reporting quality. Results: Six studies were included and these were mostly case-controlled designs. Findings varied across studies; however, most studies found that children and adolescents with CFS had signifi cantly more sleep disturbances when compared to healthy controls. Signifi cant methodological variations and limitations were apparent. Conclusions: This review suggests that children and adolescents with CFS experience sleep disturbances. However, results need to be interpreted cautiously given the limited evidence available and its overall low quality. More research is required to elucidate the nature and extent of sleep disturbance in pediatric CFS and should focus on (1) identifying the specifi c types, causes, and severity of sleep disturbances; (2) the specifi c consequences of sleep disturbances; and (3) Originally thought to occur only in adults, it is becoming increasingly recognized within the pediatric population with estimates of incidence ranging from 0.001% to 2%.2-5 With typical age of onset in mid to late adolescence, the effect of CFS often occurs in the critical stages of higher education where missed schooling due to illness can have a major effect on future academic and social outcomes. Sleep problems are commonly reported by children and adolescents with CFS. 6It is well accepted that adequate amount and quality of sleep is crucial for healthy child development and the functional consequences of poor sleep for children and adolescents are well known.7 Although studies show that most children and adolescents with CFS complain of sleep disturbances, 6 the type and severity of sleep disturbance that these children and adolescents experience has not been well characterized. There has been limited investigation of factors that might contribute to sleep disturbances (physiological, psychological, and social) in this group, as well as little or no evidence supporting the effi cacy of sleep interventions in children and adolescents with CFS. Therefore, there is little guidance for clinicians in how to best manage sleep disturbances in this population, which may potentially exacerbate disease burden in this already vulnerable group.

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“…[1][2][3] While there is some suggestion that insomnia symptoms are more likely to predict depression than vice versa, a recent review of the literature concluded that the best evidence to date suggests that, within adulthood, the associations are likely bidirectional. 1 What is less well established is the reason for the association between poor sleep and depression.…”

Section: Introductionmentioning

confidence: 99%

A Longitudinal Twin and Sibling Study of Associations between Insomnia and Depression Symptoms in Young Adults

Gregory

Rijsdijk

Eley

et al. 2016

Sleep

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Study Objectives: To estimate genetic and environmental influences on the associations between insomnia and depression symptoms concurrently and longitudinally. Methods: Behavioral genetic analyses were conducted on data from the British longitudinal G1219 twin/sibling study. One thousand five hundred fiftysix twins and siblings participated at Time 1 (mean age = 20.3 years, SD = 1.76). Eight hundred sixty-two participated at Time 2 (mean age = 25.2 years, SD = 1.73 years). Participants completed the Insomnia Symptoms Questionnaire and the Short Mood and Feelings Questionnaire to assess symptoms of insomnia and depression respectively. Results: Genetic effects accounted for 33% to 41% of the variance of the phenotypes. The phenotypic correlations were moderate (r = 0.34 to r = 0.52). The genetic correlations between the variables were high (0.73-1.00). Genetic effects accounted for a substantial proportion of the associations between variables (50% to 90%). Non-shared environmental effects explained the rest of the variance and covariance of the traits. Conclusions: While genetic effects play a modest role in insomnia and depression symptoms separately, they appear to play a more central role in concurrent and longitudinal associations between these phenotypes. This should be acknowledged in theories explaining these common associations.

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A meta-analysis and model of the relationship between sleep and depression in adolescents: Recommendations for future research and clinical practice

Cited by 431 publications

References 76 publications

The SENSE study: Post intervention effects of a randomized controlled trial of a cognitive–behavioral and mindfulness-based group sleep improvement intervention among at-risk adolescents.

The SENSE study: Post intervention effects of a randomized controlled trial of a cognitive–behavioral and mindfulness-based group sleep improvement intervention among at-risk adolescents.

Sleep Disturbances in Pediatric Chronic Fatigue Syndrome: A Review of Current Research

A Longitudinal Twin and Sibling Study of Associations between Insomnia and Depression Symptoms in Young Adults

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