( 388) A 2007 study of 553 children (mean age 11.7 years) found that children experiencing episodes of major depression with diagnoses of both insomnia and hypersomnia had a longer history of illness, were more severely depressed, and were more likely to have anhedonia (an inability to feel pleasure), weight loss, psychomotor retardation, and fatigue than were those with either insomnia or hypersomnia. ![]() ( 381) A 2005 study found that people with insomnia had greater depression and anxiety levels than people not having insomnia and were 9.82 and 17.35 times as likely to have clinically significant depression and anxiety, respectively. Many children and adolescents with depression suffer from sleep problems such as insomnia or hypersomnia (excessive sleepiness) or both. The challenges of getting through an ordinary day may require increased energy for these adolescents.” ( 134) ( 134) Adolescents who are anxious, depressed, or feel less healthy “may in fact, need more sleep than those with better psychological functioning. ( 23) Depressed children often report disturbed sleep despite normal architecture measured by electroencephalography. ( 23) Similarly, students who obtained less sleep over time reported heightened levels of depressive symptoms and decreased self-esteem. ( 118)Ī 2004 study of 2,259 students, aged 11 to 14 years, found that students who obtained less sleep in sixth grade exhibited lower initial self-esteem and higher initial levels of depressive symptoms. ( 387) As previously noted (see, § III, supra), scientists have found a “general ‘cloud’ of negative daily affect” associated with chronic patterns of inadequate sleep among adolescents. ( 386) Individuals with anxiety disorders and poor sleep experience significantly worse mental health-related quality of life and increased disability relative to those with anxiety disorders alone. ![]() ( 384) One-fourth to one-half of adolescents report experiencing insomnia for periods of 1 to 4 years. ( 383) Insomnia, with all its complications, is “extraordinarily common” in children and adolescents, with an estimated prevalence of 20–30%. … This may create a perpetual cycle, where lack of sleep leads to feelings of fatigue and apathy at school, impaired academic and social functioning, reduced levels of motivation, and impaired ability to regulate mood and emotional responses.” ( 119 )Īnxiety, an abnormal or overwhelming sense of apprehension and fear, has a bidirectional relationship with insomnia. “Adolescents who present with depression display high rates of sleep disturbance and those who present with complaints of poor sleep display high rates of depression. ![]() 109), or “bidirectional causal pathway.” ( 23 ) “epression is not only a symptom of sleep deprivation but can also be a cause.” ( 382) Scientists refer to this as a “bidirectional” relationship (Dobson & Dozois, Risk Factors in Depression (Academic Press 2008) p. ( 380 ) Symptoms of depression include “persistent feelings of sadness, anxiety, hopelessness and disinterest in things that were once enjoyed” ( 381) Excessive irritability, moodiness, sleep and appetite changes may signal a vulnerability to depression. The prevalence of depression increases with age, especially after the onset of puberty. Among adolescents, “daily feelings of anxiety, depression, and fatigue are the most consistent psychological outcomes of obtaining less sleep at night.” ( 118)- Andrew Fuligini, Ph.D., Professor of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Christina Hardway, Ph.D., Assistant Professor of Psychology, University of Michigan.
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