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健康青少年的睡眠时间和社交时差。与焦虑、抑郁和昼夜节律类型的关联:一项初步研究。

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

机构信息

MyCardio LLC, 3200 East Cherry Creek South Drive, Denver, CO, 80209, USA.

Akureyri Junior College, Akureyri, Iceland.

出版信息

Sleep Breath. 2024 Aug;28(4):1541-1551. doi: 10.1007/s11325-024-03026-z. Epub 2024 Mar 28.


DOI:10.1007/s11325-024-03026-z
PMID:38546939
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.

摘要

目的:青少年时期睡眠机会与生物钟偏好之间的不匹配可能会影响睡眠和心理健康。本研究的目的是客观评估睡眠时间和社会时差(SJL),观察其与焦虑、抑郁或生物钟之间是否存在关系。

方法:本研究是一项基于社区的队列研究(n=65),在北欧进行。参与者在学校正常上课期间的 3 个上学日和 2 个自由日记录他们的睡眠情况,使用经过美国食品药品监督管理局批准/EU 医疗器械指令(CE-02862)认证的家用睡眠测试设备进行记录。他们还完成了经过验证的问卷,以评估(Morningness Eveningness Questionnaire;MEQ)、嗜睡程度(Epworth Sleepiness Scale;ESS)和失眠严重程度(Insomnia Severity Index;ISI)、焦虑程度(General Anxiety Disorder-7;GAD-7)和抑郁症状(Beck's Depression Inventory-II;BDI-II)。数据收集于 2023 年 2 月最后一周和 3 月前两周进行。

结果:上学日平均睡眠时间为 7 小时 15 分钟,平均有 18%的参与者睡眠时间≥8 小时。自由日的平均入睡时间明显较晚(1 小时 47 分钟;p<0.0001),导致中高度 SJL 的患病率较高,在 71%的参与者中存在。晚型生物钟(患病率为 15.4%)在自由日入睡较晚,导致他们的 SJL 明显更长(2 小时 58 分钟),明显长于早型生物钟(1 小时 32 分钟)和中间型生物钟(1 小时 36 分钟)。晚型生物钟的失眠严重程度也更高(ISI+4.4,p=0.006;+4.0,p=0.001)和抑郁症状更严重(BDI-II+21.6,p<0.0001;+17.1,p<0.0001)。MEQ 评分与 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)和自杀念头(r=-0.294,p=0.017)呈显著负相关。

结论:青少年睡眠不足,社会时差发生率较高,且与抑郁症状和晚型生物钟呈正相关。晚型生物钟的睡眠时间更短,社会时差更长,嗜睡和失眠、焦虑和抑郁症状更为严重,这可能表明,识别这一群体可能有助于改善他们的睡眠习惯,从而可能对心理健康产生积极影响。

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本文引用的文献

[1]
The association between evening social media use and delayed sleep may be causal: Suggestive evidence from 120 million Reddit timestamps.

Sleep Med. 2023-7

[2]
The association between various dimensions of sleep parameters and mental health: A large cross-sectional study of 13554 Chinese students.

J Psychosom Res. 2023-7

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Associations between sleep characteristics and risk for high blood pressure among students aged 9-18: A cross-sectional study in China.

Sleep Med. 2023-7

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Sleep Med. 2023-7

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Sleep Med. 2023-6

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Lancet Child Adolesc Health. 2023-5

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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. 2023-8

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Cell Rep Med. 2023-1-17

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Eur J Public Health. 2023-4-1

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Chronotype, Longitudinal Volumetric Brain Variations Throughout Adolescence, and Depressive Symptom Development.

J Am Acad Child Adolesc Psychiatry. 2023-1

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