Adolescence-onset depression has also been associated with educational underachievement, low income levels and unemployment 28, 29, 30, and is a risk factor for suicidal behaviour 31.ĭepression is characterized by a diverse range of symptoms. Experiencing depression in youth can have long-term negative impacts, including an increased risk of further episodes of depression as an adult 23, 24, and developing other mental health disorders 25, 26, 27. Other risk factors include having a parent that has experienced depression 18, 19, exposure to stressful life events 20, 21 and experiencing bullying 22. Female adolescents are twice as likely as male adolescents to experience depression 16, 17. Approximately 2.6% of adolescents experience a depressive disorder at any given time 15, with the cumulative frequency of depression rising to 20% by the end of adolescence 16. This coincides with a period of increased risk for the onset of low mood and depression in adolescents 14. The rapid cascade of events that uniquely affect adolescent sleep begin around the beginning of high school and puberty 13. Although the American Academy of Pediatrics and the US Centers for Disease Control and Prevention have recommended delaying school start times to match adolescents’ natural tendency for delayed sleep timing, such policy changes have been largely unsuccessful - and are therefore not the solution 12. However, the return to in-person learning is accompanied by a return to restricted sleep for adolescents 11. Indeed, the quarantine associated with the COVID-19 pandemic eliminated the need for morning travel and therefore provided an extended sleep opportunity for adolescents, who showed increased sleep duration accordingly 9, 10, 11. Increases in sleep duration on school nights occurs when school start times are delayed 8. This restricted sleep opportunity is especially pronounced in countries that implement an early school start (for example, 7:30 am in the USA) 7. However, they are not afforded the same sleep opportunity on weekdays owing to the need to rise earlier than their natural wake time to attend school 7. A lack of morning commitments allows adolescents to potentially obtain optimal sleep duration (9.0–9.3 hours) 6 on weekends. Sleep onset for adolescents becomes later as they age (both on weekdays and weekends) 3, 4, 5, a phenomenon not observed during any other decade in life 1. Such meta-analytical and descriptive data show similar patterns of adolescent sleep in Western and Eastern societies 3, 4, 5. Data from across the world suggest that adolescents sleep too late and too little 2. Adolescents (from pubertal onset to 21 years of age) are the most chronically sleep-restricted subpopulation across human development 1.
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