Sleep duration and social jetlag in healthy adolescents. Association with anxiety, depression, and chronotype: a pilot study

Solveig Magnusdottir; Ingibjorg Magnusdottir; Audur Karen Gunnlaugsdottir; Hugi Hilmisson; Laufey Hrolfsdottir; Anna Eyfjord Eiriksdottir M Paed

doi:10.1007/s11325-024-03026-z

Sleep duration and social jetlag in healthy adolescents. Association with anxiety, depression, and chronotype: a pilot study

Sleep Breath. 2024 Mar 28. doi: 10.1007/s11325-024-03026-z. Online ahead of print.

Authors

Solveig Magnusdottir¹, Ingibjorg Magnusdottir^{2

3}, Audur Karen Gunnlaugsdottir^{2

3

4}, Hugi Hilmisson⁵, Laufey Hrolfsdottir⁶, Anna Eyfjord Eiriksdottir M Paed²

Affiliations

¹ MyCardio LLC, 3200 East Cherry Creek South Drive, Denver, CO, 80209, USA. solveig.magnusdottir@sleepimage.com.
² Akureyri Junior College, Akureyri, Iceland.
³ University of Akureyri, Akureyri, Iceland.
⁴ The Healthcare Institution of North Iceland, Husavik, Iceland.
⁵ MyCardio LLC, 3200 East Cherry Creek South Drive, Denver, CO, 80209, USA.
⁶ Institution of Health Science Research, University of Akureyri and Akureyri Hospital, Akureyri, Iceland.

PMID: 38546939
DOI: 10.1007/s11325-024-03026-z

Abstract

Purpose: Misalignment between sleep opportunity and chronotype preference during adolescence may affect sleep and mental health. The aim of this study was to objectively evaluate sleep duration and social jetlag (SJL) to observe if there is a relationship with anxiety, depression, or chronotype.

Methods: Community based cohort study (n = 65) was conducted in Northern Europe. Participants recorded their sleep during the regular school schedule for 3 school nights and 2 free nights with FDA-cleared/EU Medical Device Directive (CE-02862) compliant home sleep test. They also completed validated questionnaires to assess (Morningness Eveningness Questionnaire; MEQ), sleepiness (Epworth Sleepiness Scale; ESS), and insomnia (Insomnia Severity Index; ISI), anxiety (General Anxiety Disorder-7; GAD-7), and depression symptoms (Beck's Depression Inventory-II; BDI-II). Data were collected during the last week of February and the first 2 weeks of March, 2023.

Results: Average sleep duration on school nights was 7 h, 15 min, with 18% of participants on average sleeping ≥ 8 h. Average sleep onset was significantly later on free nights (1 hour, 47 minutes; p < 0.0001) causing a high prevalence of moderate-severe SJL, in 71% of participants. Evening chronotypes (prevalence 15.4%) fell asleep later on free nights, causing them to have significantly more SJL (2 hours, 58 minutes) than morning chronotypes (1 hour, 32 minutes) and intermediary chronotypes (1 hour, 36 minutes). Evening chronotypes also had more severe insomnia (ISI + 4.4, p = 0.006; + 4.0, p = 0.001) and greater depressive symptoms (BDI-II + 21.6, p < 0.0001; + 17.1, p < 0.0001). A significant negative correlation was observed between MEQ scores and ESS (r = - 0.287; p = 0.001), ISI (r = - 0.343, p < 0.0001), GAD-7 (r = - 0.185, p < 0.0001), BDI-II (r = - 0.501, p = 0.0001), and suicidal thoughts (r = - 0.294, p = 0.017).

Conclusion: Adolescents are sleep-deprived and have a high prevalence of SJL that is positively correlated with depressive symptoms and evening chronotype. That evening chronotypes have shorter sleep duration, more severe SJL, and significantly more sleepiness and insomnia, anxiety, and depressive symptoms may indicate possible benefits in identifying this group with the aim to assist them in improving their sleep habits with potentially positive effects on mental health.

Keywords: Adolescents; Anxiety; Chronotype; Depression; Sleep duration; Sleep timing.