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Examining cognitive mechanisms in the relationship between adolescent sleep and depression, utilising a school-based sleep intervention design

Funder: UK Research and InnovationProject code: ES/X000370/1
Funded under: ESRC Funder Contribution: 228,053 GBP

Examining cognitive mechanisms in the relationship between adolescent sleep and depression, utilising a school-based sleep intervention design

Description

When teenagers get a good night's sleep, they are more likely to be able to concentrate, regulate their emotions and behaviours, problem-solve, learn and succeed at school, and avoid difficulties with anxiety and depression. Teenagers are naturally vulnerable to problems with sleep, because of multiple biological, psychological, and social changes. Although some teenagers will be lucky to avoid problems with their sleep, up to two thirds do not receive the recommended 8-10 hours sleep. Furthermore, many teenagers experience several unpleasant consequences of this lack of sleep. For some young people, the experience of disturbed sleep as a teenager can lead to long-term difficulties with mental health, particularly depression. Experiencing depression is not uncommon during the teenage years, with an estimated 154,000 10-19 year olds meeting diagnostic criteria for depression. Difficulties with depression can lead to difficulties at school and with friendships, as well as commonly presenting with self-harm and suicidal behaviours. Negative thinking patterns, or 'cognitions', have long been theorised to play a key role in the maintenance of various mental health problems, triggering unhelpful cycles of behaviour as well as causing distress. There is evidence that this may be the case for both insomnia and depression. There is also preliminary evidence that negative cognitions may explain why sleep problems can lead to depression, with it being theorised that sleep-specific cognitions can trigger more generalised negative thoughts about the world. Psychological treatments for sleep problems have been found to improve both sleep and mood in adults and young people, and adult psychological models of insomnia propose that these treatments help generate positive and helpful thoughts about sleep, which may generalise to positive and helpful thoughts more broadly. However, this has rarely been tested, and it is not currently known if this theory can be applied to depression or teenagers. We would like to find out: The proposed research uses an intervention design to better understand 1) how sleep and depression are linked in teenagers, 2) why improving sleep can also reduce depression, and 3) whether negative thoughts about sleep can be changed and interrupt other negative thoughts. Workshops using evidence-based techniques for improving sleep will be delivered in schools by external mental health practitioners. Workshop content will include how to create a good sleep environment and setting optimal bedtimes and waketimes as well as follow-up sessions to check in and help problem-solve. Sleep, mood and cognition will be measured pre- and post-intervention, and at a follow-up, to measure change. The study design will also allow us to examine whether offering sleep interventions in schools could improve both sleep and depression, and whether it is a scalable solution that should be tested and evaluated on a larger scale. Why this matters: This research is important because it will help us to understand how and why teenagers' sleep is crucially linked to their mood and wellbeing. The findings will provide evidence of how best to support teenagers to improve their sleep quality and quantity, with potential short- and long-term improvements in their wellbeing. To ensure that the research has long-term benefits for society, the work is being conducted within one of the recently provisioned services providing school-based mental health support, meaning that it could be scaled up nationally. The research has the potential to dramatically affect the way that schools and parents can support young people's wellbeing and to significantly decrease problems with sleep and depression as a consequence. This would improve the quality of life of teenagers across the UK and decrease the substantial societal costs associated with long-term mental health problems.

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