Study to explore if more sleep will help teens shake off depression

After a late night of texting, instant-messaging or updating Facebook, it’s hardly surprising that many teenagers show up groggy for school. And, studies show, sleep deprivation can lead to poor academic performance, truancy and greater dropout rates, especially for those prone to depression.

To address this troubling trend, the Sleep and Psychological Disorders Laboratory at the University of California, Berkeley – in conjunction with Kaiser Permanente, Oregon – has begun recruiting middle and high school students for a study to see if depression can be alleviated if they get enough sleep. This hypothesis was proven in a previous study of adults with insomnia and depression, and researchers expect to see similar results in teens, who they say should try to get at least nine hours of sleep a night. Currently, 13-to-19-year-olds average seven hours a night.

In a 1988 survey of 10th and 12th graders, 45 percent reported going to bed after midnight on school nights. And in today’s 24/7 digital age, researchers expect that percentage has risen significantly. A recent study conducted in Taiwan showed that teenagers with psycho-social disorders, including depression, are more likely to get addicted to the Internet. Meanwhile, one in five U.S. teenagers reports a depressive episode by age 18, recent studies show.

“Our hypothesis is that insomnia is not just a symptom or byproduct of depression, but that in many patients it contributes to the onset and/or maintenance of depression,” said clinical psychologist Allison Harvey, who directs the UC Berkeley portion of the sleep study. “Thus, we want to see if the direct treatment of a sleep disorder, together with a depression treatment, improves depression outcomes.”

But while stressing that a growing body and brain needs a good night’s rest, researchers say they must be careful not to overemphasize sleep’s importance to the point that study participants lie awake at night worrying about what will happen if they don’t get enough sleep.

“Children need to feel safe, rather than anxious, for them to experience quality sleep,” Harvey said.

About 60 teenagers who have been diagnosed with or are at risk for depression are being recruited for the UC Berkeley-Kaiser study, with half being treated at UC Berkeley and the other half at the Kaiser Permanente Center for Health Research in Portland, Ore. Greg Clarke is the senior investigator in the Oregon study.

Unlike studies of adults with insomnia, teenagers will not be sleeping at either of the research facilities, but will self-report about their sleep habits and receive a dozen weekly sessions of cognitive behavior therapy addressing their sleep and mood patterns. Cognitive behavior therapy, which attempts to change negative thinking and behavior, is preferable to drug therapy, especially in children and teenagers, because the impact of medications on the developing body and brain have not been adequately studied, Harvey said.

Sleep is key to a broad range of mental, emotional, behavioral and physical health outcomes, including metabolic regulation, obesity, cardiovascular health and immune function, Harvey said. Lack of sleep can lead to mental and physical health problems.

After a sleepless night, young and older adults are more likely to call in sick, indulge in couch potato behavior and are less likely to take on intellectual or physical challenges, including exercise: “When you’re feeling sluggish, you don’t exercise and tend to go for snack food that will give you quick energy boost,” Harvey said.

Typically during the night, the brain goes through five stages of sleep: Rapid Eye Movement (REM) and non-REM. REM sleep is needed to process the day’s emotional experiences and to regulate the brain, while non-REM sleep is necessary for the growth and repair of brain cells and neurological connections and for memory and information retention. In children and adolescents, the growth hormone is released during sleep.

In addition to this study, the UC Berkeley sleep group is conducting studies to develop and compare talk therapies for adults with chronic insomnia and for adults with bipolar disorder. Bipolar disorder is a serious mental illness characterized by reduced need for sleep during periods of mania and periods of insomnia or hypersomnia (excessive daytime sleepiness) during periods of depression.

“We are also testing the possibility that by improving sleep we can reduce episodes of mania and depression and improve overall health and well-being in those who have bipolar disorder,” Harvey said.

Both the teen and the adult studies are being funded by the National Institute of Mental Health.