Examining cognitive mechanisms in the relationship between adolescent sleep and depression, utilising a school-based sleep intervention design

当青少年晚上睡得好时，他们更有可能集中注意力，调节自己的情绪和行为，解决问题，在学校学习和取得成功，避免焦虑和抑郁的困难。由于多种生理、心理和社会变化，青少年天生就容易受到睡眠问题的影响。尽管一些青少年很幸运地避免了睡眠问题，但多达三分之二的青少年没有得到建议的8-10小时睡眠。此外，许多青少年经历了睡眠不足带来的一些不愉快的后果。对于一些年轻人来说，青少年时期睡眠紊乱的经历会导致长期的心理健康问题，尤其是抑郁症。在青少年时期经历抑郁症并不罕见，估计有154,000名10-19岁的青少年符合抑郁症的诊断标准。抑郁症的困难会导致在学校和友谊方面的困难，通常还会出现自残和自杀行为。长期以来，人们一直认为，消极的思维模式或“认知”在维持各种心理健康问题中发挥着关键作用，引发无益的行为循环，并造成痛苦。有证据表明，失眠和抑郁可能都是如此。也有初步证据表明，消极认知可以解释为什么睡眠问题会导致抑郁，理论上说，特定于睡眠的认知会引发对世界更普遍的消极想法。研究发现，对睡眠问题进行心理治疗可以改善成年人和年轻人的睡眠和情绪，成年人失眠的心理模型表明，这些治疗有助于产生关于睡眠的积极有益的想法，这些想法可能会推广到更广泛的积极有益的想法。然而，这个理论很少被测试过，而且目前还不知道这个理论是否适用于抑郁症或青少年。我们想要弄清楚的是：拟议的研究使用了干预设计来更好地理解1)青少年睡眠和抑郁之间的联系，2)为什么改善睡眠也可以减少抑郁，以及3)关于睡眠的负面想法是否可以改变并打断其他负面想法。将由外部心理健康从业人员在学校举办讲习班，利用循证技术改善睡眠。研讨会的内容将包括如何创造一个良好的睡眠环境，设定最佳的就寝时间和起床时间，以及后续的检查和帮助解决问题。睡眠，情绪和认知将在干预前后进行测量，并在随访中测量变化。研究设计还将允许我们检查在学校提供睡眠干预是否可以改善睡眠和抑郁症，以及它是否是一个可扩展的解决方案，应该在更大规模上进行测试和评估。原因：这项研究很重要，因为它将帮助我们了解青少年的睡眠如何以及为什么与他们的情绪和健康有着至关重要的联系。这些发现将为如何最好地支持青少年改善睡眠质量和睡眠时间提供证据，并有可能在短期和长期内改善他们的健康状况。为了确保这项研究对社会有长期的好处，这项工作是在最近提供的以学校为基础的心理健康支持服务之一中进行的，这意味着它可以在全国范围内扩大。这项研究有可能极大地影响学校和家长支持年轻人健康的方式，并因此显著减少睡眠和抑郁问题。这将提高全英国青少年的生活质量，并减少与长期精神健康问题相关的大量社会成本。

When teenagers get a good night's sleep, they are more likely to be able to concentrate, regulate their emotions and behaviours, problem-solve, learn and succeed at school, and avoid difficulties with anxiety and depression. Teenagers are naturally vulnerable to problems with sleep, because of multiple biological, psychological, and social changes. Although some teenagers will be lucky to avoid problems with their sleep, up to two thirds do not receive the recommended 8-10 hours sleep. Furthermore, many teenagers experience several unpleasant consequences of this lack of sleep. For some young people, the experience of disturbed sleep as a teenager can lead to long-term difficulties with mental health, particularly depression. Experiencing depression is not uncommon during the teenage years, with an estimated 154,000 10-19 year olds meeting diagnostic criteria for depression. Difficulties with depression can lead to difficulties at school and with friendships, as well as commonly presenting with self-harm and suicidal behaviours.Negative thinking patterns, or 'cognitions', have long been theorised to play a key role in the maintenance of various mental health problems, triggering unhelpful cycles of behaviour as well as causing distress. There is evidence that this may be the case for both insomnia and depression. There is also preliminary evidence that negative cognitions may explain why sleep problems can lead to depression, with it being theorised that sleep-specific cognitions can trigger more generalised negative thoughts about the world. Psychological treatments for sleep problems have been found to improve both sleep and mood in adults and young people, and adult psychological models of insomnia propose that these treatments help generate positive and helpful thoughts about sleep, which may generalise to positive and helpful thoughts more broadly. However, this has rarely been tested, and it is not currently known if this theory can be applied to depression or teenagers. We would like to find out:The proposed research uses an intervention design to better understand 1) how sleep and depression are linked in teenagers, 2) why improving sleep can also reduce depression, and 3) whether negative thoughts about sleep can be changed and interrupt other negative thoughts. Workshops using evidence-based techniques for improving sleep will be delivered in schools by external mental health practitioners. Workshop content will include how to create a good sleep environment and setting optimal bedtimes and waketimes as well as follow-up sessions to check in and help problem-solve. Sleep, mood and cognition will be measured pre- and post-intervention, and at a follow-up, to measure change. The study design will also allow us to examine whether offering sleep interventions in schools could improve both sleep and depression, and whether it is a scalable solution that should be tested and evaluated on a larger scale.Why this matters:This research is important because it will help us to understand how and why teenagers' sleep is crucially linked to their mood and wellbeing. The findings will provide evidence of how best to support teenagers to improve their sleep quality and quantity, with potential short- and long-term improvements in their wellbeing. To ensure that the research has long-term benefits for society, the work is being conducted within one of the recently provisioned services providing school-based mental health support, meaning that it could be scaled up nationally. The research has the potential to dramatically affect the way that schools and parents can support young people's wellbeing and to significantly decrease problems with sleep and depression as a consequence. This would improve the quality of life of teenagers across the UK and decrease the substantial societal costs associated with long-term mental health problems.