A meta-analysis and model of the relationship between sleep and depression in adolescents: recommendations for future research and clinical practice
Abstract
The purpose of this review was to quantify the strength of evidence for a directional relationship between sleep disturbance and depression in adolescents. A literature search was conducted to identify research investigating the relationship between sleep disturbance and depression in adolescent samples (12-20 y). Twenty-three studies were identified; 13 explored associations between depression and sleep disturbance; seven examined the prospective role of sleep disturbance in the development of depression; and three investigated the role of adolescent depression in the development of subsequent sleep disturbance. Average weighted mean differences in sleep/depression-related outcome variables were calculated between adolescents with depression, and non-clinical adolescents, or those in remission. Adolescents with depression experienced significantly more wakefulness in bed (sleep onset latency, wake after sleep onset, number of awakenings and sleep efficiency), lighter sleep (more stage 1), and reported more subjective sleep disturbance. Overall effect sizes from longitudinal and treatment studies suggest sleep disturbance acts as a precursor to the development of depression. At follow-up, depressed adolescents had significantly longer sleep onset, more wake after sleep onset, and lower sleep efficiency compared to adolescents who were non-clinical, or had undergone remission. Little support was found for a predictive role of depressive symptoms in the development of sleep disturbance. Based on these findings we propose a model to understand the development of depression from initial sleep disturbance, provide recommendations for clinicians and recommendations for future research.
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Physical activity and sleep duration are two volitational, lifestyle-related behaviors that have been identified as being associated with the prevalence of anxiety and depression among adolescents.
“Physical activity and sleep duration are two volitational, lifestyle-related behaviors that have been identified as being associated with the prevalence of anxiety and depression among adolescents [9,10,11,12,13].”
From Academic Stress, Physical Activity, Sleep, and Mental Health among Chinese Adolescents (2021) · cites this paper as [10]
No trials have tested whole-of-school approaches, or universal interventions like late school start times, or interventions that target broader social-cultural determinants.
“We note that no trials have tested whole-of-school approaches, or universal interventions like late school start times (an intervention that aligns with adolescents' circadian clock, improving the amount of sleep they get, and in turn their mood; Adolescent Sleep Working Group 2014; Gong 2020; Lovato 2014), or interventions that target broader social-cultural determinants.”
From Prevention of self-harm and suicide in young people up to the age of 25 in education settings (2024) · cites this paper as Lovato 2014
Poor sleep is a significant risk factor for depression across the lifespan.
“Poor sleep is a significant risk factor for depression across the lifespan”
From The effect of non-pharmacological sleep interventions on depression symptoms: a meta-analysis of randomised controlled trials (2019) · cites this paper as [21]
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Twenge, J. (2020) · Psychiatric Research and Clinical Practice · doi:10.1176/appi.prcp.20190015 · Cited by 255 · see citing works
“Shortened and poor quality sleep are known risk factors for mental health issues, especially depression (58).”
BackgroundSleep Patterns and Mental Health Correlates in US Adolescents
Zhang, J., Paksarian, D., Lamers, F., Hickie, I. B., He, J., & Merikangas, K. R. (2017) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.11.007 · Cited by 296 · see citing works
Youth Screen Media Habits and Sleep
Hale, L., Kirschen, G. W., LeBourgeois, M. K., Gradisar, M., Garrison, M. M., Montgomery-Downs, H., Kirschen, H., McHale, S. M., Chang, A.-M., & Buxton, O. M. (2018) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2017.11.014 · Cited by 312 · see citing works
“In a metaanalysis of longitudinal and intervention studies, adolescent sleep problems seem to precede the emergence of depression.(18) Although more work on the modifiable aspects of sleep duration, sleep quality, and regularity of sleep timing are needed, the current literature suggests that each of these factors is…”
Self-citationShort, M. A., Booth, S. A., Omar, O., Östlundh, L., & Arora, T. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101311 · Cited by 291 · see citing works
Bao, Y.-P., Han, Y., Ma, J., Wang, R.-J., Shi, L., Wang, T.-Y., He, J., Yue, J.-L., Shi, J., Tang, X.-D., et al. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.01.032 · Cited by 275 · see citing works
“Little support was found for a predictive role for depressive symptoms (DS) in the development of sleep disturbances, especially in adolescents with limited number of longitudinal studies (Lovato and Gradisar, 2014).”
BackgroundResultInfluentialGregory, A. M., & Sadeh, A. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12469 · Cited by 265 · see citing works
“Associations between sleep and depression appear stronger in adolescents as compared to children (for a meta-analysis of the associations between sleep and depression in adolescence, see Lovato & Gradisar , 2014).”
BackgroundInfluentialSystematic Review and Meta-analysis of Adolescent Cognitive–Behavioral Sleep Interventions
Blake, M. J., Sheeber, L. B., Youssef, G. J., Raniti, M. B., & Allen, N. B. (2017) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-017-0234-5 · Cited by 242 · see citing works
“Recent evidence suggests that sleep problems, particularly wakefulness in bed (e.g., prolonged sleep onset latency and poor sleep efficiency), precede the development of anxiety and depression in adolescence more than the reverse (Lovato and Gradisar 2014; McMakin and Alfano 2015).”
BackgroundMethodAssociations between sex hormones, sleep problems and depression: A systematic review
Morssinkhof, M. W. L., van Wylick, D. W., Priester-Vink, S., van der Werf, Y. D., den Heijer, M., van den Heuvel, O. A., & Broekman, B. F. P. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.08.006 · Cited by 210 · see citing works
Sleep deprivation leads to mood deficits in healthy adolescents
Short, M. A., & Louca, M. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2015.03.007 · Cited by 216 · see citing works
“Evidence for the relationship between sleep disorders and mood disorders is strong in adults and adolescents [3–6].”
BackgroundGee, B., Orchard, F., Clarke, E., Joy, A., Clarke, T., & Reynolds, S. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2018.09.004 · Cited by 212 · see citing works
“lifespan, from adolescence [21] through to older adulthood [22].”
Emergence of Sex Differences in Insomnia Symptoms in Adolescents: A Large-Scale School-Based Study
Zhang, J., Chan, N. Y., Lam, S. P., Li, S. X., Liu, Y., Chan, J. W. Y., Kong, A. P. S., Ronald, C. W., Chan, K. C. C., Li, A. M., et al. (2016) · SLEEP · doi:10.5665/sleep.6022 · Cited by 205 · see citing works
Kroshus, E., Wagner, J. H., Wyrick, D. L., Athey, A. B., Bell, L., Benjamin, H. J., Grandner, M. A., Kline, C. E., Mohler, J. M., Prichard, J. R., et al. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-100590 · Cited by 209 · see citing works
Quach, J., Nguyen, C. D., Williams, K. E., & Sciberras, E. (2017) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2017.4363 · Cited by 203 · see citing works
Becker, S. P., Langberg, J. M., & Byars, K. C. (2014) · Journal of Youth and Adolescence · doi:10.1007/s10964-014-0248-y · Cited by 198 · see citing works
“A number of longitudinal studies have shown sleep problems in childhood or adolescence to confer risk for later depressive symptoms (e.g., Danielsson et al. 2013; Roberts et al. 2002; see Lovato and Gradisar 2014, for a review).”
BackgroundRaniti, M. B., Waloszek, J. M., Schwartz, O., Allen, N. B., & Trinder, J. C. (2018) · SLEEP · doi:10.1093/sleep/zsy066 · Cited by 183 · see citing works
“Adolescent sleep problems are in turn associated with a range of impairments [12], including anxiety [13], depression [14], suicide ideation and attempts [15], reduced academic performance [16], obesity [17], cardiovascular risk [18, 19], and motor vehicle accidents [20].”
BackgroundChronotype, circadian rhythms and mood.
Bauducco, S., Richardson, C., & Gradisar, M. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.09.002 · Cited by 158 · see citing works
Orchard, F., Gregory, A. M., Gradisar, M., & Reynolds, S. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13288 · Cited by 175 · see citing works
“Although, a meta-analysis showed a stronger direction of effect from sleep problems to depression in adolescents, rather than the onset of sleep problems following depression (Lovato & Gradisar, 2014).”
InfluentialSelf-citationScott, J., Kallestad, H., Vedaa, O., Sivertsen, B., & Etain, B. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101429 · Cited by 162 · see citing works
Paiva, T., Gaspar, T., & de Matos, M. G. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2014.10.010 · Cited by 160 · see citing works
Vernon, L., Modecki, K. L., & Barber, B. L. (2018) · Child Development · doi:10.1111/cdev.12836 · Cited by 152 · see citing works
“In particular, for adolescents, disturbed sleep over time has been associated with increases in depressed mood and decreased selfesteem (Lovato & Gradisar, 2014; Roberts, Roberts, & Duong, 2009) as well as increased externalizing behaviors (McGlinchey & Harvey, 2015).”
BackgroundAcademic Stress, Physical Activity, Sleep, and Mental Health among Chinese Adolescents
Zhu, X., Haegele, J. A., Liu, H., & Yu, F. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147257 · Cited by 154 · see citing works
Mechanisms Underlying the Anti-Depressive Effects of Regular Tea Consumption
Rothenberg, D. O., & Zhang, L. (2019) · Nutrients · doi:10.3390/nu11061361 · Cited by 147 · see citing works
“This study also found that sleep quality improved significantly with LCGT compared to SGT, which is relevant to depression, as sleep disturbances have been shown to act a precursor to the development of depression [66].”
BackgroundLiu, J.-W., Tu, Y.-K., Lai, Y.-F., Lee, H.-C., Tsai, P.-S., Chen, T.-J., Huang, H.-C., Chen, Y.-T., & Chiu, H.-Y. (2019) · Sleep · doi:10.1093/sleep/zsz054 · Cited by 137 · see citing works
Yeo, S. C., Jos, A. M., Erwin, C., Lee, S. M., Lee, X. K., Lo, J. C., Chee, M. W. L., & Gooley, J. J. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2018.10.041 · Cited by 135 · see citing works
Association Between Disturbed Sleep and Depression in Children and Youths
Marino, C., Andrade, B. F., Campisi, S. C., Wong, M., Zhao, H., Jing, X., Aitken, M., Bonato, S., Haltigan, J. D., Wang, W., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.2373 · Cited by 141 · see citing works
Sleep Deprivation and Insomnia in Adolescence: Implications for Mental Health
Uccella, S., Cordani, R., Salfi, F., Gorgoni, M., Scarpelli, S., Gemignani, A., Geoffroy, P. A., Gennaro, L. D., Palagini, L., Ferrara, M., et al. (2023) · Brain Sciences · doi:10.3390/brainsci13040569 · Cited by 153 · see citing works
“In addition, it is possible that sleep disruption in adolescents, by increasing wakefulness in bed, may reinforce ruminative thinking styles, which could develop into hyperarousal and depression over time [90].”
BackgroundGoldstone, A., Javitz, H. S., Claudatos, S. A., Buysse, D. J., Hasler, B. P., de Zambotti, M., Clark, D. B., Franzen, P. L., Prouty, D., Colrain, I. M., et al. (2020) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2019.12.005 · Cited by 135 · see citing works
Tao, S., Wu, X., Zhang, Y., Zhang, S., Tong, S., & Tao, F. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14020185 · Cited by 125 · see citing works
“A prevention of depression is by improving adolescents’ sleep quality, as there is evidence that disturbed sleep is a factor for the development of depressive symptoms during adolescence [48].”
BackgroundSleep’s role in the development and resolution of adolescent depression
Gradisar, M., Kahn, M., Micic, G., Short, M. A., Reynolds, C. M., Orchard, F., Bauducco, S., Bartel, K., & Richardson, C. E. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-022-00074-8 · Cited by 130 · see citing works
Insomnia and mortality: A meta-analysis
Lovato, N., & Lack, L. C. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2018.10.004 · Cited by 117 · see citing works
Sleep mediates the association between adolescent screen time and depressive symptoms.
Li, X., Buxton, O. M., Lee, S., Chang, A.-M., Berger, L. M., & Hale, L. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2019.01.029 · Cited by 115 · see citing works
“—Poor sleep is a risk factor for the development and relapse of depression (Lopez, Hoffmann, & Armitage, 2010; Lovato & Gradisar, 2014; Okun et al., 2011; Regestein et al., 2010; Roane & Taylor, 2008).”
BackgroundBlake, M., Waloszek, J. M., Schwartz, O., Raniti, M., Simmons, J. G., Blake, L., Murray, G., Dahl, R. E., Bootzin, R., Dudgeon, P., et al. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000142 · Cited by 114 · see citing works
Wang, B., Isensee, C., Becker, A., Wong, J. W. Y., Eastwood, P. R., Huang, R., Runions, K., Stewart, R. M., Meyer, T., Brüni, L. G., et al. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01874 · Cited by 115 · see citing works
“…between sleep problems and emotional and behavioral difficulties have been well established (O’Callaghan et al., 2010; Kamphuis et al., 2012; Lovato and Gradisar, 2014), we expected that anxiety/depression, attention problems, and aggressive behaviors would predict the development of sleep…”
BackgroundSleep Loss and Affective Functioning: More Than Just Mood
Watling, J., Pawlik, B., Scott, K., Booth, S. A., & Short, M. A. (2016) · Behavioral Sleep Medicine · doi:10.1080/15402002.2016.1141770 · Cited by 109 · see citing works
“…and bidirectional relationship between sleep and mood comes from research into mood disorders (Benca, Obermeyer, Thisted, & Gillin, 1992; Cousins et al., 2011; Harvey, 2008; Krystal, Thakur, & Roth, 2008; Lovato & Gradisar, 2014; Rodin, McAvay, & Timko, 1988; Silk, Steinberg, & Morris, 2003).”
BackgroundWearable Artificial Intelligence for Anxiety and Depression: Scoping Review
Abd-Alrazaq, A. A., AlSaad, R., Aziz, S., Ahmed, A., Denecke, K., Househ, M. S., Farooq, F., & Sheikh, J. I. (2022) · Journal of Medical Internet Research · doi:10.2196/42672 · Cited by 113 · see citing works
Bacaro, V., Miletic, K., & Crocetti, E. (2023) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2023.100424 · Cited by 123 · see citing works
“In terms of quantity or quality, poor sleep is linked to emotional difficulties, depression, and anxiety symptomatology (Becker et al., 2015; Lovato & Gradisar, 2014; Marino et al., 2021).”
BackgroundÅslund, L., Arnberg, F. K., Kanstrup, M., & Lekander, M. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7498 · Cited by 104 · see citing works
“60 Research on adults with insomnia who also suffer from depression show that treatment of the sleep disorder also improves symptoms of depression, but the opposite is not true.”
Deep Physiological Affect Network for the Recognition of Human Emotions
Kim, B. H., & Jo, S. (2018) · IEEE Transactions on Affective Computing · doi:10.1109/taffc.2018.2790939 · Cited by 102 · see citing works
“For instance, epilepsy and other sleep disorders can be identified by detecting temporal abnormalities in EEG readings [21], [22].”
BackgroundBonnar, D., Gradisar, M., Moseley, L., Coughlin, A., Cain, N., & Short, M. A. (2015) · Sleep Health · doi:10.1016/j.sleh.2014.11.002 · Cited by 100 · see citing works
A meta-analysis of the relationship between subjective sleep and depressive symptoms in adolescence
O’Callaghan, V. S., Couvy‐Duchesne, B., Strike, L. T., McMahon, K. L., Byrne, E. M., & Wright, M. J. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.01.011 · Cited by 103 · see citing works
de Bruin, E. J., Bögels, S. M., Oort, F. J., & Meijer, A. M. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12834 · Cited by 95 · see citing works
“For adolescents, there appears to be little evidence that depressive symptoms predict the development of sleep disturbances (Lovato & Gradisar, 2014), although prior insomnia in adolescents is associated with a four times higher risk of subsequent depression (Johnson, Roth, & Breslau, 2006).”
BackgroundToenders, Y. J., van Velzen, L. S., Heideman, I. Z., Harrison, B. J., Davey, C. G., & Schmaal, L. (2019) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2019.100700 · Cited by 92 · see citing works
“Several studies have suggested that factors such as childhood abuse or neglect, loss of a parent or another loved one, a family history of depression, hormonal changes, anxiety and insomnia are associated with early onset depression (Angold et al., 1999; Brown et al., 1999; Franzen and Buysse, 2008; Hariri et al., 200…”
BackgroundRichdale, A. L., Baker, E., Short, M., & Gradisar, M. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2014.05.005 · Cited by 87 · see citing works
Raudsepp, L. (2019) · Journal of Adolescence · doi:10.1016/j.adolescence.2019.09.005 · Cited by 83 · see citing works
Peach, H. D., Gaultney, J. F., & Gray, D. D. (2016) · Cogent Psychology · doi:10.1080/23311908.2016.1168768 · Cited by 90 · see citing works
“The literature suggests that sleep and emotions may be bidirectional, although there is some support for the finding that sleep predicts emotion (Hall, Levenson, & Halser, 2012) and is a stronger predictor of depression, rather than depression influencing sleep (Lovato & Gradisar, 2014).”
BackgroundResultInfluentialAdolescent sleep restriction effects on cognition and mood
Short, M. A., & Chee, M. W. L. (2019) · Progress in brain research · doi:10.1016/bs.pbr.2019.02.008 · Cited by 85 · see citing works
“…to the impact of sleep loss onmood, impulsivity, or through other mechanisms, such as perfectionism (Boergers et al., 1998), nighttime rumination (Lovato and Gradisar, 2014; Miranda and NolenHoeksema, 2007), lack of positive expectations for the future (Chou et al., 2013), or failing to reach…”
BackgroundChung, K., Chan, M., Lam, Y., Lai, C. S., & Yeung, W. (2017) · Journal of School Health · doi:10.1111/josh.12509 · Cited by 83 · see citing works
Depression and sleep duration: findings from middle-aged and elderly people in China
Ouyang, P., & Sun, W. (2018) · Public Health · doi:10.1016/j.puhe.2018.10.007 · Cited by 82 · see citing works
Baldini, V., Gnazzo, M., Rapelli, G., Marchi, M., Pingani, L., Ferrari, S., Ronchi, D. D., Varallo, G., Starace, F., Franceschini, C., et al. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1341686 · Cited by 88 · see citing works
“Consequently, teenage sleep loss may promote young suicidality by increased impulsivity linked to the frontal lobe and emotional regulation circuitry that isn ’ t fully developed (24).”
Biddle, D. J., Robillard, R., Hermens, D. F., Hickie, I. B., & Glozier, N. (2015) · Sleep Health · doi:10.1016/j.sleh.2015.07.006 · Cited by 81 · see citing works
“Sleep disturbance often precedes the onset of depression and is improved upon remission.(1,2) In young people, delayed sleep phase, characterized primarily by sleep onset routinely occurring much later than average, is associated with short sleep duration,(3) which in turn represents a risk factor for obesity, chronic…”
Sleep behaviors in traditional‐age college students
Owens, H., Christian, B. J., & Polivka, B. J. (2017) · Journal of the American Association of Nurse Practitioners · doi:10.1002/2327-6924.12520 · Cited by 80 · see citing works
Kiss, O., Alzueta, E., Yüksel, D., Pohl, K. M., de Zambotti, M., Müller‐Oehring, E. M., Prouty, D., Durley, I., Pelham, W. E., McCabe, C. J., et al. (2022) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2021.11.023 · Cited by 80 · see citing works
“There is a bidirectional relationship between sleep and mood, although sleep disturbances more often preceded depression than the reverse [44], supporting sleep as a modifiable target to reduce risk for poor mental health [45], including during stressful times like the pandemic.”
BackgroundDibben, G. O., Martin, A., Shore, C. B., Johnstone, A., McMellon, C., Palmer, V., Pugmire, J., Riddell, J., Skivington, K., Wells, V., et al. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13899 · Cited by 80 · see citing works
“However, this is contested; a well-conducted meta-analysis suggests sleep problems exist only as a precursor to mental health disorders, and that current evidence for such disorders being predictive of poor sleep is weak (Lovato & Gradisar, 2014).”
Backgroundvan den Eijnden, R. J. J. M., Geurts, S. M., ter Bogt, T., van der Rijst, V. G., & Koning, I. M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18031346 · Cited by 84 · see citing works
“Insufficient or disturbed sleep is related to attention problems [6], poor school performance [7], daytime tiredness [8], depression [9], and obesity [10].”
BackgroundBakotić, M., Radošević-Vidaček, B., & Bjelajac, A. K. (2016) · Journal of Sleep Research · doi:10.1111/jsr.12467 · Cited by 83 · see citing works
“However, based on recent reports in this field (Lovato and Gradisar, 2014; Wong et al., 2004), we find this direction of influence to be less plausible.”
BackgroundInfluentialBaiden, P., Tadeo, S. K., & Peters, K. E. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112586 · Cited by 82 · see citing works
“, 2015), and systematic reviews and meta-analyses (Belmon et al., 2019; Cain and Gradisar, 2010; Carter et al., 2016; Hale and Guan, 2015; Lovato and Gradisar, 2014) demonstrating the adverse effects of lack of adequate sleep on physical and mental health.”
BackgroundZhang, W., Yan, C., Shum, D., & Deng, C. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.157 · Cited by 80 · see citing works
Lin, C., Imani, V., Griffiths, M. D., Broström, A., Nygårdh, A., Demetrovics, Z., & Pakpour, A. H. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13076 · Cited by 78 · see citing works
“Furthermore, a recent meta-analysis examining the relationship between sleep problems and depression among adolescents (Lovato & Gradisar, 2014) concluded that (in the majority of cases) sleep problems start earlier than the symptoms of psychological distress.”
BackgroundSleep Characteristics and Mood of Professional Esports Athletes: A Multi-National Study
Lee, S., Bonnar, D., Roane, B. M., Gradisar, M., Dunican, I. C., Lastella, M., Maisey, G., & Suh, S. A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18020664 · Cited by 80 · see citing works
“While it is difficult to ascertain the causality between sleep and mood from this study, there is significant literature that supports the impact of sleep on depression [49].”
ResultFontanellaz-Castiglione, C. E. G., Schaufler, S., Wild, S., Hamann, C., Kaess, M., & Tarokh, L. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13865 · Cited by 78 · see citing works
“Along these lines, in their meta-analysis, Lovato and Gradisar (2014) proposed that increased wakefulness before sleep onset could promote rumination and reinforce depressive thinking styles, which in turn, perpetuates longer sleep latency.”
BackgroundInfluentialAssociations Among Screen Time, Sleep Duration and Depressive Symptoms Among Chinese Adolescents.
Wang, W.-X., Du, X., Guo, Y.-F., Li, W., Zhang, S., Zhang, W.-H., McIntyre, R., Tamura, J. K., Guo, L., & Lu, C.-Y. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.01.082 · Cited by 65 · see citing works
Scott, A. J., Webb, T. L., & Rowse, G. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016873 · Cited by 72 · see citing works
Pesonen, A., Gradisar, M., Kuula, L., Short, M. A., Merikanto, I., Tark, R., Räikkönen, K., & Lahti, J. M. T. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.077 · Cited by 69 · see citing works
Vandendriessche, A., Ghekiere, A., Cauwenberg, J. V., Clercq, B. D., Dhondt, K., DeSmet, A., Tynjälä, J., Verloigne, M., & Deforche, B. I. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16061072 · Cited by 68 · see citing works
“Moreover, our results are in line with a previous study, in which better sleep quantity and quality were related to a better mental health status in adolescents [32,33].”
ResultZafar, F., Alam, L. F., Vivas, R. R., Wang, J., Whei, S. J., Mehmood, S., Sadeghzadegan, A., Lakkimsetti, M., & Nazir, Z. (2024) · Cureus · doi:10.7759/cureus.56472 · Cited by 74 · see citing works
“Additionally, increased activity is also related to lower depression [81,82].”
BackgroundBrand, S., Kirov, R., Kalak, N., Gerber, M., Pühse, U., Lemola, S., Correll, C. U., Cortese, S., Meyer, T., & Holsboer‐Trachsler, E. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s74905 · Cited by 66 · see citing works
Prevention of internalizing disorders and suicide via adolescent sleep interventions
Blake, M. J., & Allen, N. B. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.08.027 · Cited by 66 · see citing works
Wang, W., Du, X., Guo, Y., Li, W., Teopiz, K. M., Shi, J., Guo, L., Lu, C., & McIntyre, R. S. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.03.009 · Cited by 66 · see citing works
Burani, K., Klawohn, J., Levinson, A. R., Klein, D. N., Nelson, B. D., & Hajcak, G. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1630834 · Cited by 66 · see citing works
Blake, M. J., Snoep, L., Raniti, M. B., Schwartz, O., Waloszek, J. M., Simmons, J. G., Murray, G., Blake, L. M., Landau, E. R., Dahl, R. E., et al. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.10.006 · Cited by 65 · see citing works
Sleep and eating disorders: current research and future directions
Cooper, A. R., Loeb, K. L., & McGlinchey, E. L. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.11.005 · Cited by 62 · see citing works
Association between Sleep Habits and Problems and Internet Addiction in Adolescents
Kawabe, K., Horiuchi, F., Oka, Y., & Ueno, S. (2019) · Psychiatry Investigation · doi:10.30773/pi.2019.03.21.2 · Cited by 60 · see citing works
Cliffe, B., Croker, A., Denne, M., Smith, J., & Stallard, P. (2020) · JMIR Mental Health · doi:10.2196/14842 · Cited by 56 · see citing works
“Although there is a bidirectional relationship between sleep and mental health [5], there is evidence to suggest that sleep difficulties may precede the development of depression and anxiety [8-10].”
BackgroundPublic health burden of sleep disorders: underreported problem
Filip, I., Tidman, M. M., Saheba, N., Bennett, H., Wick, B., Rouse, N. C., Patriche, D., & Radfar, A. (2016) · Journal of Public Health · doi:10.1007/s10389-016-0781-0 · Cited by 58 · see citing works
“Furthermore, of adolescents with depression, 73% also have a sleep disorder or sleep dysfunction that preceded their depressive symptoms (Lovato and Gradisar 2014; Liu et al. 2007).”
BackgroundBlake, M. J., Schwartz, O., Waloszek, J. M., Raniti, M. B., Simmons, J. G., Murray, G., Blake, L. M., Dahl, R. E., Bootzin, R. R., McMakin, D. L., et al. (2017) · SLEEP · doi:10.1093/sleep/zsx061 · Cited by 57 · see citing works
“development of anxiety and depression in adolescence more than the reverse.(15,16) Adolescence is, therefore, a critical developmental window for understanding the mechanisms of sleep disturbance to inform early intervention.”
BackgroundBlake, M. J., Blake, L. M., Schwartz, O., Raniti, M. B., Waloszek, J. M., Murray, G., Simmons, J. G., Landau, E. R., Dahl, R. E., McMakin, D. L., et al. (2017) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12842 · Cited by 57 · see citing works
Zou, L., Wu, X., Tao, S., Xu, H., Xie, Y., Yang, Y., & Tao, F. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00822 · Cited by 63 · see citing works
“A metaanalysis found that adolescents with major depressive disorder have poor sleep quality, including more sleep disruptions, sleep disturbances, insomnia, and hypersomnia (26).”
BackgroundTonon, A. C., Constantino, D. B., Amando, G. R., de Abreu, A. C. O. V., Francisco, A. P., de Oliveira, M. A. B., Pilz, L. K., Xavier, N. B., Rohrsetzer, F., Souza, L., et al. (2022) · SLEEP · doi:10.1093/sleep/zsac104 · Cited by 59 · see citing works
Wahlstrom, K. L., & Owens, J. A. (2017) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000368 · Cited by 57 · see citing works
Quality of life and mood in children with cystic fibrosis: Associations with sleep quality
Vandeleur, M., Walter, L. M., Armstrong, D., Robinson, P. J., Nixon, G. M., & Horne, R. S. C. (2017) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2017.11.021 · Cited by 56 · see citing works
“In adolescents there is however emerging evidence that sleep problems might predict future depression [38].”
BackgroundBjorvatn, B., Jernelöv, S., & Pallesen, S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.639198 · Cited by 55 · see citing works
“…are conceivably a part of the diagnostic criteria of several psychiatric disorders (Costantini et al., 2020), it is fairly well demonstrated that insomnia constitutes a risk factor for the development of depression and anxiety in particular (Lovato and Gradisar, 2014; Sivertsen et al., 2014).”
BackgroundInsomnia symptoms and short sleep duration predict trajectory of mental health symptoms
Biddle, D. J., Hermens, D. F., Lallukka, T. M., Aji, M., & Glozier, N. (2018) · Sleep Medicine · doi:10.1016/j.sleep.2018.10.008 · Cited by 54 · see citing works
Sleep and mental health in children and adolescents
Short, M. A., Bartel, K., & Carskadon, M. A. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815373-4.00032-0 · Cited by 59 · see citing works
Olbrich, S., Tränkner, A., Surova, G., Gevirtz, R., Gordon, E., Hegerl, U., & Arns, M. (2015) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2015.12.001 · Cited by 53 · see citing works
Ahmadpanah, M., Akbari, T., Akhondi, A., Haghighi, M., Jahangard, L., Bahmani, D. S., Bajoghli, H., Holsboer‐Trachsler, E., & Brand, S. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.07.030 · Cited by 57 · see citing works
“Second, sleep was not assessed, though several studies have shown poor sleep to be causally related to poor mental health (Lovato and Gradisar, 2014), and that, compared to males, females complain more about insomnia (Zhang and Wing, 2006).”
Taking a Break from Social Media Improves Wellbeing Through Sleep Quality
Graham, S., Mason, A., Riordan, B. C., Winter, T. J., & Scarf, D. (2021) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2020.0217 · Cited by 53 · see citing works
“13 For example , meta-analyses have demonstrated that sleep quality is predictive of depression 14 and may be a unique risk factor for suicidal thoughts and behaviors.”
Ghaleiha, A., Davari, H., Jahangard, L., Haghighi, M., Ahmadpanah, M., Rabiei, M. A. S., Bajoghli, H., Holsboer‐Trachsler, E., & Brand, S. (2016) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-016-0685-6 · Cited by 52 · see citing works
“Lovato and Gradisar [40]), it is conceivable that TD indirectly causes depression via its impact on sleep.”
BackgroundGoril, S., Zalai, D. M., Scott, L., & Shapiro, C. M. (2016) · Sleep Medicine · doi:10.1016/j.sleep.2016.06.002 · Cited by 51 · see citing works
“There is mounting evidence concerning the association between sleep disorders and depression in children and adolescents (46-48).”
Zhao, J., Xu, J., He, Y., & Xiang, M. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.123 · Cited by 51 · see citing works
Bosch, R., Pagerols, M., Prat, R., Español‐Martín, G., Rivas, C., Dolz, M., Haro, J. M., Ramos‐Quiroga, J. A., Ribasés, M., & Casas, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19074120 · Cited by 47 · see citing works
“These results are consistent with studies showing that sleep disturbances can predict later depression and anxiety [38,39].”
ResultKeller, L. K., Grünewald, B., Vetter, C., Roenneberg, T., & Schulte‐Körne, G. (2017) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-017-0977-z · Cited by 45 · see citing works
Peach, H. D., Gaultney, J. F., & Ruggiero, A. R. (2018) · The Journal of Primary Prevention · doi:10.1007/s10935-018-0526-7 · Cited by 48 · see citing works
Latina, D., Bauducco, S., & Tilton‐Weaver, L. C. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13190 · Cited by 47 · see citing works
“In addition, adolescents who report NSSI and/or sleep difficulties are likely to experience depressive symptoms (e.g. Lovato & Gradisar, 2014).”
Background
- Authors
- Lovato, N., & Gradisar, M.
- Affiliations
- Flinders University (AU)
- Corresponding author
- Lovato, Nicole
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 18
- Issue
- 6
- Pages
- 521-529
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2064090130
- Cited by
- 594
- References
- 98
- Citations by year
- 2026: 59 · 2025: 65 · 2024: 61 · 2023: 59 · 2022: 64 · 2021: 58 · 2020: 42 · 2019: 62 · 2018: 43 · 2017: 33 · 2016: 27 · 2015: 15 · 2014: 4
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep disorders, adolescent depression, sleep latency, wake after sleep onset, sleep efficiency, depression onset, remission, clinical guidelines
- MeSH terms
- Adolescent, Child, Depression, Major Depressive Disorder, Humans, Models, Theoretical, Sleep Wake Disorders, Young Adult
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