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

Abstract

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. Communitybased cohort study (n = 65) was conducted in Northern Europe. Participants recorded their sleep during the regular school schedule for 3 school nightsand 2 free nights with FDA-cleared/EU Medical Device Directive (CE-02862) compliant home sleep test. They also completed validated questionnaires to assess (MorningnessEveningness 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 werecollected during the last week of February and the first 2weeks of March, 2023. Average sleep duration on school nights was 7h, 15min, with 18% of participants on average sleeping ≥ 8h. Average sleep onset was significantly later on freenights (1hour, 47minutes; p < 0.0001) causing a high prevalence of moderate-severe SJL, in71%of participants. Evening chronotypes (prevalence 15.4%) fellasleep later on free nights, causing them to have significantly more SJL (2hours, 58minutes) than morningchronotypes (1hour, 32minutes) and intermediary chronotypes (1hour, 36minutes). Evening chronotypes also had more severeinsomnia (ISI + 4.4, p = 0.006; + 4.0, p = 0.001) and greater depressivesymptoms (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). Adolescents are sleep-deprived and have a high prevalence of SJL that is positively correlatedwith depressive symptoms andeveningchronotype. 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.