Magazine article Clinical Psychiatry News

Sleep, Behavioral Problems Often Linked in Teens: Study Found Increased Cortisol near Sleep Onset and REM Density Were Predictive of Future Depression

Magazine article Clinical Psychiatry News

Sleep, Behavioral Problems Often Linked in Teens: Study Found Increased Cortisol near Sleep Onset and REM Density Were Predictive of Future Depression

Article excerpt

PITTSBURGH -- Adolescence is physically the healthiest period of the life span, but early adolescence appears to be a time of developmental vulnerability in relation to sleep, arousal, and emotional regulation, Dr. Ronald E. Dahl said at the International Congress of Neuroendocrinology.

This key phase of development has broad relevance to adolescent behavioral and emotional health, and should be viewed as a time of opportunity for early intervention.

Dr. Dahl and his colleagues at Western Psychiatric Institute and Clinic in Pittsburgh carried out a series of studies in children and adolescents, aged 8-16, with affective disorders that included several measures of sleep and hypothalamic-pituitary-adrenal (HPA) axis regulation.

The subjects included 128 children studied during an episode of depression, 102 children with anxiety disorders, and 102 age-matched controls who were medically and psychiatrically healthy and had negative family histories for depression.

Despite extensive subjective sleep complaints in depressed children and adolescents, younger prepubertal adolescents showed little or no objective evidence of sleep and cortisol dysregulation.

But midpubertal and older adolescents with major depressive disorder revealed evidence of EEG sleep and cortisol changes associated with adult depression, including increased sleep latency, decreased REM-latency, increased REM-density, and cortisol and growth hormone changes near sleep onset.

Increased cortisol near sleep onset and REM density were predictive of future episodes of depression, said Dr. Dahl, also the Staunton Professor of Psychiatry and Pediatrics at the University of Pittsburgh.

In contrast, children with anxiety disorders showed evidence of earlier EEG sleep and cortisol changes. The anxiety group took significantly longer to fall asleep, had less total sleep time, less slow-wave sleep, and higher levels of cortisol at bedtime, compared with the healthy controls and with children with depression.

Some changes in sleep regulation are biologic and linked to puberty; others are linked to social habits and environmental influences. Puberty is marked by increased daytime sleepiness, while changes in biologic timing systems related to the circadian system push adolescents toward more owl-like tendencies to stay up late and sleep in late. …

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