Early psychosomatic problems, sleep trajectories, and subsequent depression risk in adolescence

Background

Short sleep duration during adolescence is linked to adverse mental health outcomes, yet longitudinal sleep patterns and their determinants remain unclear. This study examined sleep duration trajectories across adolescence, whether early psychosomatic problems (PSP) predict trajectory membership, and whether these trajectories are associated with later depression.

Methods

Data were drawn from the longitudinal STARS cohort (n = 1249; 62.4% females). Group-based trajectory modelling identified distinct school-day sleep duration trajectories across ages 13, 15, and 18. Logistic regression assessed associations of PSP at age 13 with trajectory membership and depression at age 18, adjusting for sex, immigrant background, and parental education. Additional models examined attenuation after adjustment for PSP.

Results

Three trajectories were identified: “Moderate decline” (8.7 hours at age 13 to 7.8 hours at age 18), “Steep decline” (8.2 to 5.7 hours), and “Persistently insufficient” (6.5 to 7.5 hours). Higher PSP at age 13 was associated with increased odds of the “Steep decline” [OR 1.07 (95% CI: 1.04–1.10)] and “Persistently insufficient” [1.14 (1.09–1.20)] trajectories. PSP was also associated with higher depression risk at age 18 [1.10 (1.08–1.13)]. Compared with “Moderate decline”, both “Steep decline” and “Persistently insufficient” were associated with elevated depression risk [2.26 (1.56–3.27) and 1.95 (1.08–3.51)]. After adjusting for PSP, the association remained significant for “Steep decline” [1.94 (1.33–2.84)] but not for “Persistently insufficient” [1.34 (0.72–2.48)].

Conclusions

Distinct sleep trajectories across adolescence are differentially associated with depression risk. Early PSP may partly account for these associations, particularly for persistently insufficient sleep. Interventions targeting PSP in early adolescence may help reduce adverse sleep patterns and later depression.

Key messages

• Early psychosomatic problems increase the likelihood of adverse sleep trajectories and later depression in adolescence.

• Preventing psychosomatic problems in early adolescence may help reduce both insufficient sleep and depression risk.