The Insight Corner Hub: For teens with depression, sleep-wake therapy offers new hope: Research

Depression is a common and serious mental health problem that affects many adolescents. One of the factors that may worsen depression symptoms in teens is their sleep-wake cycle, which is often misaligned with their school schedule. Many teens are "night owls", meaning they prefer to stay up late and wake up late, but they have to adjust to early school start times. This can lead to chronic sleep deprivation, poor academic performance, and increased risk of depression.

However, a new study by researchers from the University of California, San Francisco (UCSF) has found a promising way to help these teens cope with their natural sleep rhythms and improve their mood. The study, published in the Journal of Child Psychology and Psychiatry¹, tested a novel intervention called the Transdiagnostic Sleep and Circadian Intervention (TransS-C), which aims to promote appropriate sleep patterns in adolescent night owls.

The TransS-C intervention consists of eight weekly sessions of cognitive-behavioral therapy (CBT) that teach teens how to optimize their sleep quality and quantity, as well as how to adjust their circadian rhythms (the internal clock that regulates the sleep-wake cycle). The intervention also involves light exposure therapy, which uses bright light in the morning and dim light in the evening to shift the timing of the sleep-wake cycle.

The study involved 42 teens with clinical depression who were part of a larger study of 176 night-owl adolescents. The participants were randomly assigned to receive either the TransS-C intervention or an educational intervention that provided information on healthy lifestyle habits. The researchers measured the participants' depression symptoms, sleep patterns, and circadian alignment before, during, and after the treatment, as well as at six and 12 months follow-up.

The results showed that the TransS-C intervention was more effective than the educational intervention in reducing depression symptoms and improving sleep-wake alignment in teens with depression. The TransS-C group showed a significant decrease in depression scores from 40 (indicating severe depression) at baseline to 22 (indicating mild depression) at six months follow-up, while the educational group only decreased from 40 to 33. The TransS-C group also showed an increase in circadian alignment from -2.5 hours (indicating a large mismatch between their sleep-wake cycle and school schedule) at baseline to -1 hour at six months follow-up, while the educational group only increased from -2.5 hours to -2 hours.

The researchers concluded that the TransS-C intervention is a feasible and effective way to help teens with depression who are night owls. They suggested that the intervention works by allowing teens to live a life that is more in line with their biological rhythms, while also helping them fall asleep earlier and wake up earlier. They also noted that the intervention may have long-term benefits for preventing relapse and improving academic outcomes.

The study was led by Lauren Asarnow, PhD, a clinical psychologist with UCSF Health who specializes in sleep health²³  . A larger study funded by the National Institute of Mental Health is currently underway to test the TransS-C intervention in 200 teens in the Bay Area².

References

1. Ani. (2023, September 10). For teens with depression, sleep-wake therapy offers new hope: Research. Hindustan Times. https://www.hindustantimes.com/lifestyle/health/for-teens-with-depression-sleep-wake-therapy-offers-new-hope-research-101694341713141.html
2. X, S. (2023, September 11). Sleep–wake therapy gives new hope for teens with depression. Medical Xpress. https://medicalxpress.com/news/2023-09-sleepwake-therapy-teens-depression.html
3. Moate, M. (2023, September 9). Sleep-Wake Therapy Gives New Hope for Teens with Depression. Psychreg. https://www.psychreg.org/sleep-wake-therapy-gives-new-hope-teens-depression/