Abstract
Purpose
The purpose of this paper was to understand associations between low sleep duration
(<8 hours) and positive mental health screens among adolescents (ages 13-18) seen
for preventive visits in primary care.
Methods
Data were from two randomized controlled trials testing the efficacy of an electronic
health risk behavior screening and feedback tool for adolescent preventive visits. Participants (n=601) completed screeners at baseline, 3-, and 6-months which included sleep duration in
hours and the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 screeners
for depression and anxiety, respectively. Main analyses included adjusted logistic
regressions testing associations between low sleep duration and positive mental health
screens.
Results
Adjusted models showed that low sleep duration was associated with significantly greater
odds of a positive depression screen (OR=1.58, 95% CI: 1.06-2.37) but not with a positive
anxiety screen or co-occurring positive depression and anxiety screens. However, follow-up
analyses indicated an interaction between sleep duration and anxiety in the association
with a positive depression screen, such that the association between low sleep and
a positive depression screen was driven by those who did not screen positive for anxiety.
Conclusions and Implications
As pediatric primary care guidelines for sleep continue to evolve further research,
training, and support for sleep screening are warranted to ensure effective early
intervention for sleep and mental health problems during adolescence.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic PediatricsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19.JAMA Pediatr. 2021;
- Anxiety and depression as bidirectional risk factors for one another: A meta-analysis of longitudinal studies.Psychol Bull. 2017; 143: 1155-1200
- Consequences and correlates of adolescent depression.Arch Pediatr Adolesc Med. 2002; 156: 1009
- Life course outcomes of young people with anxiety disorders in adolescence.J Am Acad Child Adolesc Psychiatry. 2001; 40: 1086-1093
- Screening for behavioral health conditions in primary care settings: A systematic review of the literature.J Gen Intern Med. 2018; 33: 335-346
- Clarifying the role of sleep in depression: A narrative review.Psychiatr Res. 2020; 291113239
- The bidirectional association between sleep problems and anxiety symptoms in adolescents: A TRAILS report.Sleep Med. 2020; 67: 39-46
- Recommended amount of sleep for pediatric populations: A consensus statement of the American Academy of Sleep Medicine.J Clin Sleep Med. 2016; 12: 785-786
- National Sleep Foundation’s sleep time duration recommendations: Methodology and results summary.Sleep Health. 2015; 1: 40-43
CDC. Youth Risk Behavior Surveillance System (YRBSS) Youth Online High School Results. 2021 ; 〈https://nccd.cdc.gov/Youthonline/App/Results.aspx〉.
- Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice preparation, identification, assessment, and initial management.Pediatrics. 2018; 141 (GLAD-PC Steering Group): 3
- Sleep in pediatric primary care: A review of the literature.Sleep Med Rev. 2016; 25: 31-39
- Grove Elk Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4 ed. IL: American Academy of Pediatrics, 2017
- Testing a clinic-based program to reduce risky behaviors among teens.Patient Centered Outcomes Research Institute (PCORI), 2020
- Electronic health risk behavior screening with integrated feedback among adolescents in primary care: Randomized controlled trial.JMIR. 2021; 23e24135
- Effect of electronic screening with personalized feedback on adolescent health risk behaviors in a primary care setting: A randomized clinical trial.JAMA Netw Open. 2019; 2e193581
- The PHQ-9: Validity of a brief depression severity measure.J Gen Intern Med. 2001; 16: 606-613
- A brief measure for assessing generalized anxiety disorder: The GAD-7.Arch Intern Med. 2006; 166: 1092-1097
- Mental health diagnoses and seasonal trends at a pediatric emergency department and hospital, 2015–2019.Hosp Pediatr. 2021; 11: 199-206
- Stata Statistical Software: Release 14.StataCorp LP, College Station, TX2015
- Research in the integration of behavioral health for adolescents and young adults in primary care settings: A systematic review.J Adolesc Health. 2017; 60: 261-269
- Changes in sleep as a function of adolescent development.Neuropsychol Rev. 2011; 21: 5-21
- Self‐reported sleep patterns and quality amongst adolescents: Cross‐sectional and prospective associations with anxiety and depression.J Child Psychol Psychiatry. 2020; 61: 1126-1137
- Measuring sleep duration in adolescence: Comparing subjective and objective daily methods.Sleep Health. 2021; 7: 79-82
- Adverse childhood experiences and insufficient sleep among U.S. children and adolescents.Acad Pediatr. 2022; 22: 965-971
Article info
Publication history
Accepted:
February 24,
2023
Received:
June 30,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
All rights reserved.
