Young people sometimes have trouble getting out of bed in the morning – but making sure they get enough sleep can have positive effects later.
The morning is already ending and the teenagers in the house are still sleeping soundly, long after you got up. Should you run to their room and get them out of bed?
It may be tempting, but the answer is possibly no.
There is increasing evidence that adolescent sleep is important for mental health not only today, but also the future of young people.
Thus, it is not surprising that severe insomnia, or serious sleep disorders, are among the most common symptoms of depression among teenagers.
After all, however tired you may feel, it is difficult to fall asleep if you are full of doubts or concerns. This is also true for adults: 92% of people with depression complain of difficulty sleeping.
What is perhaps less clear is that, for some, sleep disorders can begin before depression, which increases the risk of mental health problems in the future.
Does this mean that teenagers’ sleep should be taken more seriously? And that it can decrease the risk of depression later?
In a study published in 2020, Faith Orchard, a psychologist at the University of Sussex in the United Kingdom, analyzed data from a large group of teenagers who were followed from 15 to 24 years old.
Those who reported sleeping poorly at age 15, but had no depression or anxiety at the time, were more likely than their colleagues to experience anxiety or depression at age 17, 21 or 24.
In the case of adults, sleep problems can also be an indicator of future depression.
An analysis of 34 studies, which followed a total of 150,000 people over a period of three months to 34 years, showed that if people had sleep problems, the relative risk of suffering depression over the course of life doubled.
Of course, this does not mean that everyone with insomnia will develop depression later on. Most people will not. And it’s good to remember that the last thing people with insomnia need, without a doubt, is to worry about what might happen to them in the future.
But science shows why, in some cases, lack of sleep can contribute to poor mental health.
Sleep deficit has well-known negative effects on us, including a tendency to walk away from friends and family, lack of motivation and increased irritability, all of which can affect the quality of a person’s relationships, putting them at greater risk of depression.
In addition, we must consider biological factors. Lack of sleep can lead to increased inflammation in the body, which has been linked to mental health problems.
Researchers are now looking at the relationship between sleep disorders and other mental health conditions.
Neuroscientist Russell Foster of the University of Oxford in the United Kingdom found that this link does not only occur in depression.
The interruption of circadian rhythms, our body’s natural sleep-wake cycle, is not uncommon among people with bipolar disorder or schizophrenia.
In some cases, the biological clock can be so out of sync that people stay up all night and sleep during the day.
Foster’s colleague, clinical psychologist Daniel Freeman called for sleep disorders to be given a higher priority in mental health care services.
Because they are common in different diagnoses, they do not tend to be seen as central to a specific condition. And Freeman feels that they are sometimes neglected, when they could be fought.
Even when mental health problems precede sleep disturbances, lack of sleep can exacerbate a person’s difficulties. After all, a single night of sleep deprivation has a well-known negative impact on mood and reasoning.
The complex relationship between sleep and mental health is further reinforced by the discovery that, if you treat depression, sleep problems do not disappear entirely.
It is easy to understand how psychological treatments that help people reduce the rumination of negative thoughts can also make them fall asleep more easily.
But in 2020, Shirley Reynolds, a clinical psychologist at the University of Reading in the UK, and her team tested three different psychological treatments for depression.
They worked equally well in reducing depression, but they only solved the sleep problems of half of the participants.
For the other half, insomnia persisted, suggesting that it was independent of depression and needed to be treated separately.
Thus, sleep disorders and mental health problems can stem from the same causes. Traumatic or negative events, for example. Or excessive mental rumination, in addition to several genetic factors.
The genes involved in serotonin pathways and dopamine function have been shown to be factors related to both lack of sleep and depression, as well as genes that influence a person’s circadian rhythm.
And, as we have seen, insomnia and mental health problems are likely to worsen each other, making the two conditions even worse.
You are distressed and cannot sleep; you can’t sleep, then you get more distressed, and so on, like a snowball.
It is also possible that lack of sleep is not so much a cause of later depression, but more of an early warning sign.
The worry that prevents a person from falling asleep can, in some cases, be the first symptom of more serious mental health problems to come.
Foster is convinced that, from a biological perspective, the best way to unravel this intricate network of correlation and causality is to study the impact that disruption of circadian rhythms can have on the brain.
He says that we need to analyze the complex interactions between various genes, brain regions and neurotransmitters to understand what is going on.
Therefore, perhaps persistent sleep problems need to be taken more seriously in adolescents and adults. And treatments for sleep disorders are simple and, in many cases, successful.
What is already clear, from an analysis of 49 studies, is that combating lack of sleep among those with insomnia, who already show symptoms of depression, not only helps them sleep better, but also reduces depression.
The large Oasis study, led by Daniel Freeman at 26 universities in the UK, found that digital cognitive behavioral therapy for students with insomnia not only helped them sleep, but reduced the occurrence of hallucinations and paranoia, which are symptoms of psychosis.
The million-dollar question is whether sleep therapies could even prevent mental health problems in the future.
To respond, large-scale, long-term testing would be required.
An advantage of early interventions to prevent sleep deprivation, both for the disorder itself, and to potentially reduce broader mental health problems, is that there is less stigma around insomnia, so it may be easier to convince people to look for treatment.
However, anyone who has trouble sleeping can test the techniques that have proved most effective:
– Ensure that you get enough light during the day (in the morning for most people);
– Do not nap for more than 20 minutes;
– Do not eat, exercise or drink coffee late at night;
– Avoid reading emails or discussing stressful topics in bed;
– Keep the room cool, quiet and dark;
– Try to get up and go to bed at the same time every day.
Of course, sleeping better is not going to solve the mental health crisis on its own. But could it make a difference in the long run? Even if you don’t, as sleepy teenagers know, there is nothing better than a good night’s sleep.
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