A new study shows that adjusting the daily routines of "night owl" teenagers, especially those with depression, can reduce their depressive symptoms. Biology, not laziness, determines their sleep patterns. Promoting healthy sleep among "night owl" teenagers can align the biological characteristics of teenagers with school requirements.
The school system is not set up for kids who go to bed later and get up later (so-called "night owls"), which may help explain why this group of teenagers is more likely to suffer from depression.
Now, researchers at the University of California, San Francisco (UCSF) have found a way to help these children adjust to their natural sleep cycle rhythms while still meeting their school responsibilities. The findings are a welcome sign for teenagers with depression, who are more likely than most to stay up late.
40% of teenagers say they are "night owls", and among patients with depression, 80% say they have a sleeping pattern of staying up late. The key to the success of the current intervention is teaching night owls to organize their lives so that they fall asleep as late as possible while gently training their bodies to fall asleep earlier.
Lauren Asarnow, Ph.D., a clinical psychologist at UCSF Health who specializes in sleep health research, said: "One of the big findings here is that there is a subgroup of adolescents for whom sleep treatment is particularly important to improve depressive symptoms. Another big finding is that they really need to live a life that's more in tune with their sleep-wake biology. "
The study, published in the Journal of Child Psychology and Psychiatry in August, analyzed data from 42 participants with clinical depression who were part of a larger study of 176 night-owl teens. Twenty-four of the teens received an intervention called the Transdiagnostic Sleep and Circadian Intervention (TransS-C), and 18 teens received educational sessions on how to live a healthy lifestyle. All participants kept sleep diaries and wore devices that measured sleep quality. In addition, they received 45 minutes of therapy each week for eight weeks.
At the start of the study, all the teens had a Children's Depression Rating Scale score of at least 40, a score that indicates they had severe clinical depression. A score of 28 or lower indicates remission. After 6 months of treatment, the average score of the intervention group dropped to 21.67 points, while the average score of the healthy lifestyle intervention group was 32.5 points. Twelve months after treatment, the average score in the intervention group was 24.97 points, compared with 32.75 points in the control group.
The National Institute of Mental Health has since funded a larger study that will open enrollment to 200 Bay Area teens this fall.
About 3 million teenagers have at least one major depressive episode each year, and about 40% of them don't respond to treatment. Studies show that teens who are naturally prone to going to bed later and getting up later are at higher risk for recurrent depression, more severe depression, suicide, and poor response to antidepressants.
Assano said: "There is a saying in our psychology and psychiatry clinics that the best way to treat depression and anxiety is to take summer vacation. We can no longer call these kids 'lazy.' A lot of times, it's just their biology. It's not their fault."