Delayed sleep onset in depressed young people.

Nicholas Glozier,Christos Pantelis,Christos Pantelis,Patrick D Mcgorry,Daniel F Hermens,Rosemary Purcell,Ian B Hickie,Bridianne O'Dea,Elizabeth Scott,Günter Paul Amminger

doi:10.1186/1471-244x-14-33

Nicholas Glozier, Christos Pantelis + Show 8 more

Open Access

https://doi.org/10.1186/1471-244x-14-33

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Abstract

BackgroundThe circadian abnormality of delayed sleep phase has been suggested to characterise a subgroup of depressed young adults with different risk factors and course of illness. We aim to assess the prevalence and factors, particularly substance use, associated with such delay in a large help-seeking cohort of young people with mental health problems.MethodsFrom a consecutively recruited sample of 802 help-seeking young people, 305 (38%) had at least moderate depressive symptoms (QIDS-C16 >10), sleep data and did not have a chronic severe mental illness. Demographic and clinical characteristics were evaluated through self report and clinical interview. Delayed sleep phase was defined as a sleep onset between the hours of 02:00 a.m. – 06:00 a.m. and the characteristics of this group were compared to normal phase sleepers.ResultsDelayed sleep onset was reported amongst 18% (n = 56/305) of the depressed group compared to 11% of the non-depressed young people. Amongst the depressed group, delayed sleep onset was associated with tobacco, alcohol and cannabis misuse and short sleep duration (x̅: 5.8 hrs vs. x̅: 7.8 hrs). There were no differences in demographic factors, personality traits or symptoms. Tobacco smoking was very common: In logistic regression analyses only tobacco use (OR 2.28, 95% CI: 1.04 - 5.01) was associated with delayed sleep onset. There was no interaction with age.ConclusionsDelayed sleep onset was twice as common in depressed young people as the general population and young people with other mental health problems, and is a potential marker for a subgroup of mood disorders. Those with delayed sleep onset were not more severely depressed but had short sleep duration, a risk for chronic psychological ill health, and higher levels of tobacco use. Nicotine use was common in this group, has biological evidence as a sleep disrupter, and requires specifically addressing in this population.

Highlights

The circadian abnormality of delayed sleep phase has been suggested to characterise a subgroup of depressed young adults with different risk factors and course of illness
With the development of more focused treatment strategies aimed at targeting the different phenotypes and staged trajectories of mood disorders, this study aims to explore the prevalence and patterns of delayed sleep onset among depressed young people presenting to primary mental health care and, in particular, whether there is any association with substance use
As Headspace focuses on both youth mental health and early intervention, young people may present for care with varying illness severity across a range of mental health problems [36]

Summary

Introduction

The circadian abnormality of delayed sleep phase has been suggested to characterise a subgroup of depressed young adults with different risk factors and course of illness. This is partly due to the nature of their education and work schedules [15,16] which results in a short weekday sleep duration as the individual limits their sleep to match their sleep chronotype: the degree to which a person organises their daily activities in the morning or evening [17] Such short sleep duration is a risk factor for the chronicity of psychological distress [18] and mood disorders [19], poorer educational performance [20] and behavioural problems [21,22] whereas the eveningness sleep chronotype is associated with higher levels of depressed mood, conduct problems and hyperactivity [23,24]. This suggests that delayed sleep onset may represent a risk factor, or marker, for a worse trajectory of mental ill health and associated disability

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