Department of Psychological Science, School of Social Ecology, University of California at Irvine, Irvine, CA, USA.
Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Behavior, University of California at Los Angeles, Los Angeles, CA, USA.
Dev Psychopathol. 2020 Aug;32(3):997-1006. doi: 10.1017/S0954579419000762.
Sleep disturbance is a symptom of and a well-known risk factor for depression. Further, atypical functioning of the HPA axis has been linked to the pathogenesis of depression. The purpose of this study was to examine the role of adolescent HPA axis functioning in the link between adolescent sleep problems and later depressive symptoms. Methods: A sample of 157 17-18 year old adolescents (61.8% female) completed the Pittsburgh Sleep Quality Inventory (PSQI) and provided salivary cortisol samples throughout the day for three consecutive days. Two years later, adolescents reported their depressive symptoms via the Center for Epidemiological Studies Depression Scale (CES-D). Results: Individuals (age 17-18) with greater sleep disturbance reported greater depressive symptoms two years later (age 19-20). This association occurred through the indirect effect of sleep disturbance on the cortisol awakening response (CAR) (indirect effect = 0.14, 95%CI [.02 -.39]). Conclusions: One pathway through which sleep problems may lead to depressive symptoms is by up-regulating components of the body's physiological stress response system that can be measured through the cortisol awakening response. Behavioral interventions that target sleep disturbance in adolescents may mitigate this neurobiological pathway to depression during this high-risk developmental phase.
睡眠障碍是抑郁的症状和众所周知的风险因素。此外，HPA 轴的非典型功能与抑郁症的发病机制有关。本研究的目的是探讨青少年 HPA 轴功能在青少年睡眠问题与随后抑郁症状之间的联系中的作用。
本研究招募了 157 名 17-18 岁的青少年（61.8%为女性），他们完成了匹兹堡睡眠质量指数（PSQI），并在连续三天内每天提供唾液皮质醇样本。两年后，青少年通过流行病学研究中心抑郁量表（CES-D）报告他们的抑郁症状。
在 17-18 岁时，睡眠障碍较大的个体在两年后（19-20 岁）报告的抑郁症状更多。这种关联是通过睡眠障碍对皮质醇觉醒反应（CAR）的间接影响（间接效应=0.14，95%CI [0.02-0.39]）产生的。
睡眠问题可能导致抑郁症状的一个途径是通过上调身体生理应激反应系统的成分，这些成分可以通过皮质醇觉醒反应来测量。针对青少年睡眠障碍的行为干预措施可能会在这一高风险发育阶段减轻这种神经生物学途径导致的抑郁。
