Treatment for Insomnia in Depressed Adolescents

Abstract

Objective: Sleep undergoes dramatic changes during the adolescent years due to biological, circadian, and psychosocial influences. It is now known that sleep loss, both acute and chronic, can affect emotion regulation and can increase the likelihood of developing depression and risky behaviors. Method:The authors carried out a systematic review utilizing the PubMed database by using the search terms including: "adolescence, depression, sleep, and insomnia." The present review covers manuscripts accepted up to the year 2013. The following review discusses findings on the bidirectional relationship between insomnia and depression and will cover current evaluation and treatment options.Results: Depression can be present in up to 20 percent of adolescents and most of these children will have some form of sleep disturbance. The etiology of sleep disturbances may reflect insomnia, circadian rhythm sleep disorder, sleep apnea, or other factors. Pharmacological and cognitive behavioral therapy approaches are common, but may result in limited gains due to persistent insomnia. Antidepressant medications may be lessened and relapse may be higher in those with insomnia. Treatment monitoring may be helped by motivational interviewing techniques and examining the teen's self-report over parental sleep reports. Conclusion:Sleep disturbances that are identified, addressed, and appropriately monitored may result in improved sleep and mood. Active involvement of the teen in the therapy process may improve outcomes. Further research is needed to develop non-pharmacological strategies that are acceptable and sustainable for adolescents.

Individual and neighborhood stressors, sleep problems, and symptoms of anxiety and depression among Latino youth.

“…Understanding this relation among Latino adolescents is important given the risk of internalizing symptoms among this population (McLaughlin et al, 2007) and the developmental changes in sleep patterns among adolescents (Carskadon et al, 1993; Szymczak et al, 1993; Wolfson & Carskadon, 1998). Although sleep is sometimes a target of evidence-based interventions for anxiety and depression in children and adolescents (Conroy & Huntley, 2013; Peterman, Carper, & Kendall, 2015; Storch et al, 2008; Trockel, Manber, Chang, Thurston, & Taylor, 2011), a greater focus on targeting sleep may increase the effectiveness of these interventions. Preventive efforts aimed at improving sleep also have the potential to target this mechanism of risk in youth who have not yet developed internalizing problems.…”