ABSTRACT
Changes in Sleep, Circadian Rhythms, and Behavior ................................... 279 Inadequate, Irregular Sleep Patterns and Depressed Mood .......................... 282 Subjective Sleep Disturbances in Depression ................................................ 284 Sleep Polysomnography in Adolescent MDD ................................................. 285
Sleep Macroarchitecture (Polysomnographic Data) .................................. 286 Sleep Microarchitecture (Computer Analysis of
Sleep EEG Frequencies) .......................................................................... 287 Sleep Disorders and Depressed Mood ............................................................ 288 Interventions .................................................................................................... 290 Conclusions ...................................................................................................... 293 Note .................................................................................................................. 293 References ........................................................................................................ 293
There is a close association between sleep and depression throughout the life cycle, but the developmental changes in sleep and circadian rhythms that occur during adolescence may confer additional risk. Sleep disorders such as insomnia, sleep apnea, and delayed sleep phase syndrome (DSPS) often create a situation where the adolescent is not able to get an adequate amount of sleep on a regular basis. In turn, lack of sleep and irregular sleep patterns may contribute to excessive daytime sleepiness, irritability, and anhedonia for the adolescent. This may exacerbate daytime functioning diffi culties, such as decreased academic performance, tardiness and absenteeism, and accidents (e.g., drowsy driving, etc.). This vicious cycle may lead to or explain adolescent depression. This chapter will discuss the relationship between sleep and depression in adolescents in more detail, highlighting how developmental changes in sleep may contribute to depression, the subjective and laboratory-based sleep characteristics of depression, and the relationship between depression and sleep disorders. Which sleep measures best predict relapse and recurrence and the clinical signifi cance of these fi ndings will also be discussed.
