Abstract
BackgroundSleep problems are a major risk factor for the emergence of depression in adolescence. The aim of this study was to test whether an intervention for improving sleep habits could prevent the emergence of depression, and improve well-being and cardiovascular indices amongst at-risk adolescents.Methods/DesignA longitudinal randomised controlled trial (RCT) is being conducted across Victorian Secondary Schools in Melbourne, Australia. Adolescents (aged 12–17 years) were defined as at-risk for depression if they reported high levels of anxiety and sleep problems on in-school screening questionnaires and had no prior history of depression (assessed by clinical diagnostic interview). Eligible participants were randomised into either a sleep improvement intervention (based on cognitive behavioral and mindfulness principles) or an active control condition teaching study skills. Both programs consisted of seven 90 minute-long sessions over seven weeks. All participants were required to complete a battery of mood and sleep questionnaires, seven-days of actigraphy, and sleep diary entry at pre- and post-intervention. Participants also completed a cardiovascular assessment and two days of saliva collection at pre-intervention. Participants will repeat all assessments at two-year follow up (ongoing).DiscussionThis will be the first efficacy trial of a selective group-based sleep intervention for the prevention of depression in an adolescent community sample. If effective, the program could be disseminated in schools and greatly improve health outcomes for anxious adolescents.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612001177842. Date of Registration: 06-Nov-2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-015-0096-x) contains supplementary material, which is available to authorized users.
Highlights
Sleep problems are a major risk factor for the emergence of depression in adolescence
Depression is strongly associated with disturbed sleep [2], a relationship that is marked in adolescence [3], and there is accumulating evidence that disturbed sleep can play a precipitating role in the onset of depression and other problems during adolescence [4]
There is a complex relationship between depression, sleep and cardiovascular disease (CVD) across the lifespan [6], suggesting that early intervention for sleep may impact on a mechanism jointly associated with risk for CVD and depression
Summary
Sleep problems are a major risk factor for the emergence of depression in adolescence. The aim of this study was to test whether an intervention for improving sleep habits could prevent the emergence of depression, and improve well-being and cardiovascular indices amongst at-risk adolescents. Adolescent depression is both common and harmful, with an estimated 15–20 % of adolescents experiencing clinical depression [1]. The likelihood that sleep disturbance plays a critical etiological role in adolescent depression suggests that sleep improvement might decrease risk for the development of depression. The potential public health benefits of effective early intervention for sleep problems are substantial, and a treatment trial is warranted
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