Depression is one of the most common mental illnesses that affect thousands of people around the world. Stress during teen years is one of the key contributing factors to depressive symptoms in young children. Now, a new research presented at SLEEP 2017, the 31st annual meeting of the Associated Professional Sleep Societies (APSS) held in Boston in June 2017, suggests that there is an association between sleep-disordered breathing (SDB) and persistent depression in teenagers. According to Teena Chase, resident scholar in the department of psychiatry at the University of Ottawa in Canada, the assessment of SDB in adolescents with treatment-resistant depression (TRD) may have high clinical utility since SDB can be easily treated.
For the study, Chase and her colleagues enlisted the participation of 20 outpatient adolescents with TRD and 20 healthy adolescents who served as a control group. Using polysomnography, the researchers analyzed breathing disturbances during sleep in adolescents with TRD and compared the results with the severity of their depressive symptoms. It was found that the incidence of SDB was significantly higher (50 percent) in adolescents within the TRD group than the control group (15 percent).
Mental health evaluations should screen for sleep disorders
There are no consistent findings with regard to SDB in adolescents, with estimates ranging between 1 percent and 7 percent. In previous epidemiological research, the lifetime prevalence of SDB in adolescents was found to be 5.9 percent. A 2016 population-based study conducted in Chile confirmed the high prevalence of SDB in adolescents and young adults. A past study showed that the 12-month prevalence of major depressive episodes in adolescents increased from 8.7 percent in 2005 to 11.3 percent in 2014. The increase was larger and statistically meaningful in the case of adolescents aged between 12 and 20 years.
There are mixed reactions from psychologists and pediatricians related to the study findings. According to Melisa E. Moore, a psychologist in the department of child and adolescent psychiatry and behavioral sciences at the Children’s Hospital of Philadelphia, the association between both quality and quantity of sleep, and symptoms of depression is well-known. The study goes a step further by identifying a specific reason for unsatisfactory sleep quality (obstructive sleep apnea or OSA) and linking it with a specific type of depression (TRD).
Although there is no clarity on the association between sleep apnea and depression, specialists mention that since sleep apnea affects the quality of sleep, it can cause disruptions in behavior, attentiveness, mood and retention. Hormones and the brain may be impacted by low oxygen levels, resulting in depression. The problem becomes worse in the case of obese adolescents.
Moore further adds that the findings cannot be expanded beyond the current scope of the study due to the limited number of participants, retrospective analysis and case-controlled methodology. Keeping these constraints in mind and also considering the broader research on the association between sleep and depression in adolescents, it should become a standard practice for all mental health evaluations to screen for sleep disorders.
Sanjeev Kothare, director of pediatric sleep medicine at NYU Langone Comprehensive Epilepsy Center- Sleep Center in New York, mentions that though the study has made a good observation, it holds no surprises. He explains that if individuals experience SDB and their sleep is of poor quality, they will be depressed. Kothare highlights the interdependence of such conditions, stating that if one of them is taken care of, the other one will also get fixed.
Teens need to be screened for both the disorders
Kothare, who did not take part in the study, mentions that teens are generally diagnosed by either mental health professionals or pediatricians. Pediatricians may diagnose a sleep disorder or, at times, depression but not the two disorders together. He is interested in seeing a prospective study which will focus treatment on one of the symptoms (sleep apnea) to determine if the other symptom (depression) improves.
Teen depression is a serious mental disorder and affects the way one thinks, acts and behaves in daily life. White River Academy, a residential treatment center for behavioral problems in boys aged between 12 and 17, provide the required help to teens suffering from depression and help them lead a healthy life. To know about the causes of depression in teens, call our 24/7 helpline number. You may also chat with one of our representatives now who can suggest the best treatment for teen depression.