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Sleep problems in adolescence are prospectively linked to later depressive symptoms via the cortisol awakening response

Published online by Cambridge University Press:  07 August 2019

Kate Ryan Kuhlman ,
Jessica J. Chiang Open the ORCID record for Jessica J. Chiang [Opens in a new window] ,
Julienne E. Bower ,
Michael R. Irwin ,
Teresa E. Seeman ,
Heather E. McCreath ,
David M. Almeida ,
Ronald E. Dahl  and
Andrew J. Fuligni
Kate Ryan Kuhlman*
Affiliation:
Department of Psychological Science, School of Social Ecology, University of California at Irvine, Irvine, CA, USA Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Behavior, University of California at Los Angeles, Los Angeles, CA, USA Institute for Interdisciplinary Salivary Bioscience, University of California Irvine, Irvine, CA, USA
Jessica J. Chiang
Affiliation:
Department of Psychology, Northwestern University, Evanston, IL, USA
Julienne E. Bower
Affiliation:
Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Behavior, University of California at Los Angeles, Los Angeles, CA, USA Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA
Michael R. Irwin
Affiliation:
Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Behavior, University of California at Los Angeles, Los Angeles, CA, USA
Teresa E. Seeman
Affiliation:
Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
Heather E. McCreath
Affiliation:
Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
David M. Almeida
Affiliation:
Center for Healthy Aging, College of Health and Human Development, Pennsylvania State University, State College, PA, USA
Ronald E. Dahl
Affiliation:
Community Health & Human Development, School of Public Health, University of California at Berkeley, Berkeley, CA, USA
Andrew J. Fuligni
Affiliation:
Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Behavior, University of California at Los Angeles, Los Angeles, CA, USA Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA
*
Author for Correspondence: Kate Ryan Kuhlman, University of California Irvine, School of Social Ecology, 4201 Social & Behavioral Sciences Gateway, Irvine, CA92697; E-mail: krkuhlman@ucla.edu.
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Abstract

Sleep disturbance is a symptom of and a well-known risk factor for depression. Further, atypical functioning of the HPA axis has been linked to the pathogenesis of depression. The purpose of this study was to examine the role of adolescent HPA axis functioning in the link between adolescent sleep problems and later depressive symptoms. Methods: A sample of 157 17–18 year old adolescents (61.8% female) completed the Pittsburgh Sleep Quality Inventory (PSQI) and provided salivary cortisol samples throughout the day for three consecutive days. Two years later, adolescents reported their depressive symptoms via the Center for Epidemiological Studies Depression Scale (CES-D). Results: Individuals (age 17–18) with greater sleep disturbance reported greater depressive symptoms two years later (age 19–20). This association occurred through the indirect effect of sleep disturbance on the cortisol awakening response (CAR) (indirect effect = 0.14, 95%CI [.02 -.39]). Conclusions: One pathway through which sleep problems may lead to depressive symptoms is by up-regulating components of the body’s physiological stress response system that can be measured through the cortisol awakening response. Behavioral interventions that target sleep disturbance in adolescents may mitigate this neurobiological pathway to depression during this high-risk developmental phase.

Keywords

adolescencecortisol awakening responsedepressionHPA axissleep
Type
Regular Articles
Information
Development and Psychopathology , Volume 32 , Issue 3 , August 2020 , pp. 997 - 1006
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Copyright
Copyright © Cambridge University Press 2019

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