Skip to main content
Top

28-03-2024 | Anxiety | Sleep Breathing Physiology and Disorders • Original Article

Sleep duration and social jetlag in healthy adolescents. Association with anxiety, depression, and chronotype: a pilot study

Authors: Solveig Magnusdottir, Ingibjorg Magnusdottir, Audur Karen Gunnlaugsdottir, Hugi Hilmisson, Laufey Hrolfsdottir, Anna Eyfjord Eiriksdottir M. Paed

Published in: Sleep and Breathing

Login to get access

Abstract

Purpose

Misalignment between sleep opportunity and chronotype preference during adolescence may affect sleep and mental health. The aim of this study was to objectively evaluate sleep duration and social jetlag (SJL) to observe if there is a relationship with anxiety, depression, or chronotype.

Methods

Community based cohort study (n = 65) was conducted in Northern Europe. Participants recorded their sleep during the regular school schedule for 3 school nights and 2 free nights with FDA-cleared/EU Medical Device Directive (CE-02862) compliant home sleep test. They also completed validated questionnaires to assess (Morningness Eveningness Questionnaire; MEQ), sleepiness (Epworth Sleepiness Scale; ESS), and insomnia (Insomnia Severity Index; ISI), anxiety (General Anxiety Disorder-7; GAD-7), and depression symptoms (Beck’s Depression Inventory-II; BDI-II). Data were collected during the last week of February and the first 2 weeks of March, 2023.

Results

Average sleep duration on school nights was 7 h, 15 min, with 18% of participants on average sleeping ≥ 8 h. Average sleep onset was significantly later on free nights (1 hour, 47 minutes; p < 0.0001) causing a high prevalence of moderate-severe SJL, in 71% of participants.
Evening chronotypes (prevalence 15.4%) fell asleep later on free nights, causing them to have significantly more SJL (2 hours, 58 minutes) than morning chronotypes (1 hour, 32 minutes) and intermediary chronotypes (1 hour, 36 minutes). Evening chronotypes also had more severe insomnia (ISI + 4.4, p = 0.006; + 4.0, p = 0.001) and greater depressive symptoms (BDI-II + 21.6, p < 0.0001; + 17.1, p < 0.0001). A significant negative correlation was observed between MEQ scores and ESS (r =  − 0.287; p = 0.001), ISI (r =  − 0.343, p < 0.0001), GAD-7 (r =  − 0.185, p < 0.0001), BDI-II (r =  − 0.501, p = 0.0001), and suicidal thoughts (r =  − 0.294, p = 0.017).

Conclusion

Adolescents are sleep-deprived and have a high prevalence of SJL that is positively correlated with depressive symptoms and evening chronotype. That evening chronotypes have shorter sleep duration, more severe SJL, and significantly more sleepiness and insomnia, anxiety, and depressive symptoms may indicate possible benefits in identifying this group with the aim to assist them in improving their sleep habits with potentially positive effects on mental health.
Appendix
Available only for authorised users
Literature
1.
go back to reference Watson NF et al (2015) Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep 38(6):843–844PubMedPubMedCentral Watson NF et al (2015) Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep 38(6):843–844PubMedPubMedCentral
4.
go back to reference Johnson EO, Roth T, Breslau N (2006) The association of insomnia with anxiety disorders and depression: exploration of the direction of risk. J Psychiatr Res 40(8):700–708PubMedCrossRef Johnson EO, Roth T, Breslau N (2006) The association of insomnia with anxiety disorders and depression: exploration of the direction of risk. J Psychiatr Res 40(8):700–708PubMedCrossRef
5.
7.
go back to reference Carskadon MA, Vieira C, Acebo C (1993) Association between puberty and delayed phase preference. Sleep 16(3):258–262PubMedCrossRef Carskadon MA, Vieira C, Acebo C (1993) Association between puberty and delayed phase preference. Sleep 16(3):258–262PubMedCrossRef
8.
go back to reference Meyerson WU et al (2023) The association between evening social media use and delayed sleep may be causal: suggestive evidence from 120 million Reddit timestamps. Sleep Med 107:212–218PubMedCrossRef Meyerson WU et al (2023) The association between evening social media use and delayed sleep may be causal: suggestive evidence from 120 million Reddit timestamps. Sleep Med 107:212–218PubMedCrossRef
9.
go back to reference Carskadon MA, Acebo C, Jenni OG (2004) Regulation of adolescent sleep: implications for behavior. Ann N Y Acad Sci 1021:276–291PubMedCrossRef Carskadon MA, Acebo C, Jenni OG (2004) Regulation of adolescent sleep: implications for behavior. Ann N Y Acad Sci 1021:276–291PubMedCrossRef
10.
go back to reference Wittmann M et al (2006) Social jetlag: misalignment of biological and social time. Chronobiol Int 23(1–2):497–509PubMedCrossRef Wittmann M et al (2006) Social jetlag: misalignment of biological and social time. Chronobiol Int 23(1–2):497–509PubMedCrossRef
11.
go back to reference Chan NY et al (2023) Sleep and academic performance among students in Hong Kong: curvilinear relationship suggesting an optimal amount of sleep. Sleep Med 106:97–105PubMedCrossRef Chan NY et al (2023) Sleep and academic performance among students in Hong Kong: curvilinear relationship suggesting an optimal amount of sleep. Sleep Med 106:97–105PubMedCrossRef
12.
go back to reference Kahn M, Sheppes G, Sadeh A (2013) Sleep and emotions: bidirectional links and underlying mechanisms. Int J Psychophysiol 89(2):218–228PubMedCrossRef Kahn M, Sheppes G, Sadeh A (2013) Sleep and emotions: bidirectional links and underlying mechanisms. Int J Psychophysiol 89(2):218–228PubMedCrossRef
13.
go back to reference Touitou Y, Touitou D, Reinberg A (2016) Disruption of adolescents’ circadian clock: the vicious circle of media use, exposure to light at night, sleep loss and risk behaviors. J Physiol Paris 110(4 Pt B):467–479PubMedCrossRef Touitou Y, Touitou D, Reinberg A (2016) Disruption of adolescents’ circadian clock: the vicious circle of media use, exposure to light at night, sleep loss and risk behaviors. J Physiol Paris 110(4 Pt B):467–479PubMedCrossRef
15.
go back to reference von Elm E et al (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596):1453–1457CrossRef von Elm E et al (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596):1453–1457CrossRef
16.
go back to reference Thomas RJ et al (2014) Relationship between delta power and the electrocardiogram-derived cardiopulmonary spectrogram: possible implications for assessing the effectiveness of sleep. Sleep Med 15(1):125–131PubMedCrossRef Thomas RJ et al (2014) Relationship between delta power and the electrocardiogram-derived cardiopulmonary spectrogram: possible implications for assessing the effectiveness of sleep. Sleep Med 15(1):125–131PubMedCrossRef
18.
go back to reference Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14(6):540–545PubMedCrossRef Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14(6):540–545PubMedCrossRef
19.
go back to reference Bastien CH, Vallieres A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2(4):297–307PubMedCrossRef Bastien CH, Vallieres A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2(4):297–307PubMedCrossRef
20.
go back to reference Spitzer RL et al (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097PubMedCrossRef Spitzer RL et al (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097PubMedCrossRef
21.
go back to reference Beck AT, Steer RA, Brown GK (1996) Manual for the Beck Depression Inventory-II. Psychological Corporation, San Antonio, TX Beck AT, Steer RA, Brown GK (1996) Manual for the Beck Depression Inventory-II. Psychological Corporation, San Antonio, TX
22.
go back to reference Horne JA, Ostberg O (1976) A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol 4(2):97–110PubMed Horne JA, Ostberg O (1976) A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol 4(2):97–110PubMed
23.
go back to reference Thorisdottir IE et al (2023) Effect of the COVID-19 pandemic on adolescent mental health and substance use up to March, 2022, in Iceland: a repeated, cross-sectional, population-based study. Lancet Child Adolesc Health 7(5):347–357PubMedPubMedCentralCrossRef Thorisdottir IE et al (2023) Effect of the COVID-19 pandemic on adolescent mental health and substance use up to March, 2022, in Iceland: a repeated, cross-sectional, population-based study. Lancet Child Adolesc Health 7(5):347–357PubMedPubMedCentralCrossRef
24.
26.
go back to reference Weaver MD et al (2018) Dose-dependent associations between sleep duration and unsafe behaviors among US high school students. JAMA Pediatr 172(12):1187–1189PubMedPubMedCentralCrossRef Weaver MD et al (2018) Dose-dependent associations between sleep duration and unsafe behaviors among US high school students. JAMA Pediatr 172(12):1187–1189PubMedPubMedCentralCrossRef
27.
go back to reference Evanger LN et al (2023) Later school start time is associated with longer school day sleep duration and less social jetlag among Norwegian high school students: results from a large-scale, cross-sectional study. J Sleep Res 32(4):e13840PubMedCrossRef Evanger LN et al (2023) Later school start time is associated with longer school day sleep duration and less social jetlag among Norwegian high school students: results from a large-scale, cross-sectional study. J Sleep Res 32(4):e13840PubMedCrossRef
28.
go back to reference Toften S et al (2020) Validation of sleep stage classification using non-contact radar technology and machine learning (Somnofy(R)). Sleep Med 75:54–61PubMedCrossRef Toften S et al (2020) Validation of sleep stage classification using non-contact radar technology and machine learning (Somnofy(R)). Sleep Med 75:54–61PubMedCrossRef
29.
go back to reference Hrozanova M et al (2023) Quantifying teenagers’ sleep patterns and sex differences in social jetlag using at-home sleep monitoring. Sleep Med 107:1–8PubMedCrossRef Hrozanova M et al (2023) Quantifying teenagers’ sleep patterns and sex differences in social jetlag using at-home sleep monitoring. Sleep Med 107:1–8PubMedCrossRef
30.
go back to reference Hirshkowitz M et al (2015) National Sleep Foundation’s updated sleep duration recommendations: final report. Sleep Health 1(4):233–243PubMedCrossRef Hirshkowitz M et al (2015) National Sleep Foundation’s updated sleep duration recommendations: final report. Sleep Health 1(4):233–243PubMedCrossRef
31.
go back to reference Zhang Z, Cajochen C, Khatami R (2019) Social jetlag and chronotypes in the Chinese population: analysis of data recorded by wearable devices. J Med Internet Res 21(6):e13482PubMedPubMedCentralCrossRef Zhang Z, Cajochen C, Khatami R (2019) Social jetlag and chronotypes in the Chinese population: analysis of data recorded by wearable devices. J Med Internet Res 21(6):e13482PubMedPubMedCentralCrossRef
33.
go back to reference Kuula L et al (2019) Using big data to explore worldwide trends in objective sleep in the transition to adulthood. Sleep Med 62:69–76PubMedCrossRef Kuula L et al (2019) Using big data to explore worldwide trends in objective sleep in the transition to adulthood. Sleep Med 62:69–76PubMedCrossRef
34.
go back to reference Hena M, Garmy P (2020) Social jetlag and its association with screen time and nighttime texting among adolescents in Sweden: a cross-sectional study. Front Neurosci 14:122PubMedPubMedCentralCrossRef Hena M, Garmy P (2020) Social jetlag and its association with screen time and nighttime texting among adolescents in Sweden: a cross-sectional study. Front Neurosci 14:122PubMedPubMedCentralCrossRef
35.
go back to reference Tamura N et al (2022) Social jetlag among Japanese adolescents: association with irritable mood, daytime sleepiness, fatigue, and poor academic performance. Chronobiol Int 39(3):311–322PubMedCrossRef Tamura N et al (2022) Social jetlag among Japanese adolescents: association with irritable mood, daytime sleepiness, fatigue, and poor academic performance. Chronobiol Int 39(3):311–322PubMedCrossRef
36.
go back to reference Zhang K, Guhn M, Conklin AI (2023) Association between social jetlag and sugar-sweetened beverages (SSBs) in adolescents in Western Canada. Eur J Public Health 33(2):287–292PubMedCrossRef Zhang K, Guhn M, Conklin AI (2023) Association between social jetlag and sugar-sweetened beverages (SSBs) in adolescents in Western Canada. Eur J Public Health 33(2):287–292PubMedCrossRef
37.
go back to reference Huang Y et al (2023) The association between various dimensions of sleep parameters and mental health: a large cross-sectional study of 13554 Chinese students. J Psychosom Res 170:111356PubMedCrossRef Huang Y et al (2023) The association between various dimensions of sleep parameters and mental health: a large cross-sectional study of 13554 Chinese students. J Psychosom Res 170:111356PubMedCrossRef
38.
go back to reference McGowan NM, Voinescu BI, Coogan AN (2016) Sleep quality, chronotype and social jetlag differentially associate with symptoms of attention deficit hyperactivity disorder in adults. Chronobiol Int 33(10):1433–1443PubMedCrossRef McGowan NM, Voinescu BI, Coogan AN (2016) Sleep quality, chronotype and social jetlag differentially associate with symptoms of attention deficit hyperactivity disorder in adults. Chronobiol Int 33(10):1433–1443PubMedCrossRef
39.
go back to reference Cui L et al (2023) Associations between sleep characteristics and risk for high blood pressure among students aged 9–18: a cross-sectional study in China. Sleep Med 107:72–80PubMedCrossRef Cui L et al (2023) Associations between sleep characteristics and risk for high blood pressure among students aged 9–18: a cross-sectional study in China. Sleep Med 107:72–80PubMedCrossRef
41.
go back to reference Mathew GM et al (2019) Sleep duration and social jetlag are independently associated with anxious symptoms in adolescents. Chronobiol Int 36(4):461–469PubMedPubMedCentralCrossRef Mathew GM et al (2019) Sleep duration and social jetlag are independently associated with anxious symptoms in adolescents. Chronobiol Int 36(4):461–469PubMedPubMedCentralCrossRef
42.
go back to reference de Souza CM, Hidalgo MP (2014) Midpoint of sleep on school days is associated with depression among adolescents. Chronobiol Int 31(2):199–205PubMedCrossRef de Souza CM, Hidalgo MP (2014) Midpoint of sleep on school days is associated with depression among adolescents. Chronobiol Int 31(2):199–205PubMedCrossRef
44.
go back to reference Racine N et al (2021) Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis. JAMA Pediatr 175(11):1142–1150PubMedCrossRef Racine N et al (2021) Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis. JAMA Pediatr 175(11):1142–1150PubMedCrossRef
45.
go back to reference Diaz-Morales JF, Escribano C (2015) Social jetlag, academic achievement and cognitive performance: understanding gender/sex differences. Chronobiol Int 32(6):822–831PubMedCrossRef Diaz-Morales JF, Escribano C (2015) Social jetlag, academic achievement and cognitive performance: understanding gender/sex differences. Chronobiol Int 32(6):822–831PubMedCrossRef
46.
go back to reference Saxvig IW et al (2021) Circadian typology and implications for adolescent sleep health. Results from a large, cross-sectional, school-based study. Sleep Med 83:63–70PubMedCrossRef Saxvig IW et al (2021) Circadian typology and implications for adolescent sleep health. Results from a large, cross-sectional, school-based study. Sleep Med 83:63–70PubMedCrossRef
47.
go back to reference Russo PM et al (2007) Sleep habits and circadian preference in Italian children and adolescents. J Sleep Res 16(2):163–169PubMedCrossRef Russo PM et al (2007) Sleep habits and circadian preference in Italian children and adolescents. J Sleep Res 16(2):163–169PubMedCrossRef
50.
go back to reference Jalbrazikowski M, Hayes RA, Scully KE, Franzen PL, Hasler BP, Siegle GJ, Buysse DJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Joldstein TR, Soehner AM (2021) Associations between brain structure and sleep patterns across adolescent development. Sleep 44(10):zsab120. https://doi.org/10.1093/sleep/zsab120 Jalbrazikowski M, Hayes RA, Scully KE, Franzen PL, Hasler BP, Siegle GJ, Buysse DJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Joldstein TR, Soehner AM (2021) Associations between brain structure and sleep patterns across adolescent development. Sleep 44(10):zsab120. https://​doi.​org/​10.​1093/​sleep/​zsab120
51.
go back to reference Vulser H et al (2023) Chronotype, longitudinal volumetric brain variations throughout adolescence, and depressive symptom development. J Am Acad Child Adolesc Psychiatry 62(1):48–58PubMedCrossRef Vulser H et al (2023) Chronotype, longitudinal volumetric brain variations throughout adolescence, and depressive symptom development. J Am Acad Child Adolesc Psychiatry 62(1):48–58PubMedCrossRef
53.
go back to reference Au J, Reece J (2017) The relationship between chronotype and depressive symptoms: a meta-analysis. J Affect Disord 218:93–104PubMedCrossRef Au J, Reece J (2017) The relationship between chronotype and depressive symptoms: a meta-analysis. J Affect Disord 218:93–104PubMedCrossRef
55.
go back to reference Illingworth G et al (2020) The teensleep study: the effectiveness of a school-based sleep education programme at improving early adolescent sleep. Sleep Med: X 2:100011PubMed Illingworth G et al (2020) The teensleep study: the effectiveness of a school-based sleep education programme at improving early adolescent sleep. Sleep Med: X 2:100011PubMed
58.
go back to reference Sletten TL et al (2018) Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: a double-blind, randomised clinical trial. PLoS Med 15(6):e1002587PubMedPubMedCentralCrossRef Sletten TL et al (2018) Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: a double-blind, randomised clinical trial. PLoS Med 15(6):e1002587PubMedPubMedCentralCrossRef
Metadata
Title
Sleep duration and social jetlag in healthy adolescents. Association with anxiety, depression, and chronotype: a pilot study
Authors
Solveig Magnusdottir
Ingibjorg Magnusdottir
Audur Karen Gunnlaugsdottir
Hugi Hilmisson
Laufey Hrolfsdottir
Anna Eyfjord Eiriksdottir M. Paed
Publication date
28-03-2024
Publisher
Springer International Publishing
Published in
Sleep and Breathing
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-024-03026-z
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.