Walsh Rachel F L, Maddox Mackenzie A, Smith Logan T, Olino Thomas, Zee Phyllis C, Nusslock Robin, Alloy Lauren B
Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA.
Feinberg School of Medicine, Department of Neurology, Northwestern University, Evanston, Illinois, USA.
J Sleep Res. 2025 Feb 2:e14468. doi: 10.1111/jsr.14468.
Sleep is important for adolescent development and has been linked to a variety of mental health difficulties. New research suggests that sleep irregularity may be more clinically relevant than relying on mean values. This study aimed to (1) quantify the relationship between the sleep regularity index (SRI), a novel parameter reflecting the probability that an individual will be in the same state [asleep or awake] 24 h apart, and other actigraphy-derived sleep and rest-activity metrics, (2) evaluate concurrent and prospective associations between the SRI and mental health symptoms (depressive symptoms and substance use), and (3) test sex as a moderator. At baseline, a community-based sample of adolescents (n = 295, 56.27% female, 58.98% White, age = 15.44) wore an actiwatch for 1 week to measure rest-activity rhythms and sleep-wake cycles. Actigraphy data were used to derive sleep metrics, SRI, and nonparametric rest-activity indices. Adolescents also completed self-report measures of substance use and depression at baseline and at 6-month follow-up. Partial correlations indicated that individuals with more sleep irregularity had less interdaily stability, less robust relative amplitude, lower sleep efficiency, shorter total sleep time, longer sleep onset latency, more social jetlag, and a later sleep midpoint. Regression analyses revealed that sleep irregularity was associated with a lifetime history of substance use, first-onset substance use, and a prospective increase in depressive symptoms, even after accounting for sleep duration and subjective sleep disturbances. The sleep regularity index may be a potential modifiable risk factor for enhancing adolescent mental health.
睡眠对青少年发育至关重要，且与多种心理健康问题相关。新研究表明，睡眠不规律在临床上可能比依赖平均数值更具相关性。本研究旨在：（1）量化睡眠规律指数（SRI）与其他由活动记录仪得出的睡眠及休息 - 活动指标之间的关系，SRI是一个反映个体在相隔24小时处于相同状态（ asleep或awake）概率的新参数；（2）评估SRI与心理健康症状（抑郁症状和物质使用）之间的同时期及前瞻性关联；（3）检验性别作为调节因素的作用。在基线期，一个基于社区的青少年样本（n = 295，56.27%为女性，58.98%为白人，年龄 = 15.44岁）佩戴活动记录仪1周，以测量休息 - 活动节律和睡眠 - 觉醒周期。活动记录仪数据用于得出睡眠指标、SRI和非参数化休息 - 活动指数。青少年在基线期和6个月随访时还完成了关于物质使用和抑郁的自我报告测量。偏相关分析表明，睡眠不规律程度越高的个体，日间稳定性越低、相对振幅越不稳健、睡眠效率越低、总睡眠时间越短、入睡潜伏期越长、社会时差越大，且睡眠中点越晚。回归分析显示，即使在考虑睡眠时间和主观睡眠干扰后，睡眠不规律仍与物质使用的终生史、首次使用物质以及抑郁症状的前瞻性增加相关。睡眠规律指数可能是改善青少年心理健康的一个潜在可改变风险因素。
