Cited by 594Sleep and related disordersChild and Adolescent Psychosocial and Emotional DevelopmentSleep and Wakefulness Research

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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

Lovato, Nicole, Gradisar, Michael·2014·Sleep Medicine Reviews

DOI 10.1016/j.smrv.2014.03.006

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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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Background
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“Earlier research indicated that insufficient sleep was associated with various adverse outcomes, including poor academic performance [47,48], increased risk of mental health issues [49,50], and behavioral problems [51,52].”
Sleep Disturbances Are Associated With Depressive Symptoms and Suicidality Among Adolescents in Pediatric Primary Care
Teresi, G. I., Davis, M., Williamson, A. A., Young, J. F., Merranko, J. A., & Goldstein, T. R. (2024) · JAACAP Open · doi:10.1016/j.jaacop.2024.11.004 · Cited by 4
“While meta-analyses examining sleep disturbances, depression, and STBs in youth demonstrate signi ﬁ cant positive linkages overall, 19,20,26,27,35 considerable heterogeneity exists across study methods, measures, de ﬁ nitions of sleep disturbances, and effect sizes, obscuring research to practice…”

Authors: Lovato, N., & Gradisar, M.
Affiliations: Flinders University (AU)
Corresponding author: Lovato, Nicole
ORCID: Lovato, Nicole
Gradisar, Michael
Venue: Sleep Medicine Reviews
Publisher: Elsevier BV
Published: 2014-12
Volume: 18
Issue: 6
Pages: 521-529
ISSN: 1087-0792 (ISSN-L)
DOI: 10.1016/j.smrv.2014.03.006
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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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A meta-analysis and model of the relationship between sleep and depression in adolescents: Recommendations for future research and clinical practice

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