Too long, too short, or too variable? Adolescents' daily sleep variability and mood.

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1. Summary


We know that how much adolescents sleep matters a great deal to their wellbeing. This study showed that how variable (or irregular) they sleep from one day to another also matters to their psychological wellbeing.


Published in SLEEP (Dec 2016), this is the first study to:

  • Describe how adolescents’ sleep may vary from day to day (i.e., variability) without the constraints of school schedules, and
  • Examine how daily sleep variability may be related to adolescents’ mood, beyond the effects of average sleep duration and quality.

Methodology used in this study:

  • 146 adolescents from Australian secondary colleges participated in this study. They had an average age of 16.2 years, and 52.7% were female.
  • During a 15-day school vacation, participants wore an actigraph, which measured daily sleep objectively.
  • They also completed questionnaires on sleep quality and mood (symptoms of depression and anxiety).
  • We used advanced statistical modelling to analyse daily sleep data.

Highlights of the findings:

  • Adolescents who had more variable sleep duration and time to fall asleep reported their sleep quality to be worse, which in turn, was associated with higher symptoms of depression and anxiety.
  • Notably, the association between mood and the variability in time falling asleep was curvilinear: as time to fall asleep became more variable, its mood-worsening effect via perceived sleep quality, accelerated.
  • The effects of daily sleep variability in this study were over and above the effects of average sleep duration or quality.

What these findings tell us:

  • It is important to consider daily sleep variability in addition to the average sleep duration or quality.
  • Without the constraint of school schedules, variable daily sleep is linked to worse perceived sleep quality and mood in adolescents.
  • It is possible that promoting more regular and stable sleep patterns may improve both sleep and mood in adolescents.

2. Share a PubMed or DOI link to article

https://www.ncbi.nlm.nih.gov/pubmed/27855757

3. Do you have any ideas to expand upon this research? Are you looking for collaborators?


Yes! :-)

No two nights’ sleep is the same. Sleep across multiple days can be characterized along two dimensions: the mean across the days, and the daily variability around the mean. The latter is currently poorly understood and requires much research efforts going forward.

Over the past couple of years, we have worked towards further our understanding of daily sleep variability, with the goal of promoting the incorporation of variability as a second dimension in sleep research, and moving the field beyond the mean values.

The two pieces of foundational work we have done are:

1     Evidence synthesis. In 2016, we published a systematic review of nearly 4000 unique records, showing that sleep variability matters to a wide range of mental and physical health outcomes. To make it easy to access the findings and continue to add new studies as they come out, we created a website (www.sleepv.org) with an ongoing systematic review, as well as tools for researchers to incorporate variability in their own work.

2     Robust methodology. We developed a robust modelling method for analysing variability. A technical report on the method can be found here. To make this method accessible to researchers, we made a free open source R package that can be accessed via GitHub or CRAN.

By making high quality evidence synthesis and a robust methodology openly available, we hope to see more sleep researchers incorporate variability as a second dimension in their existing work, so the empirical body of work in this area could grow.

We cannot do this on our own. We would be pleased to hear from researchers who are interested in this line of work. If you have recently published relevant work, please let us know so we could add it to our ongoing review. If you are interested in looking at variability in your own work, we would be happy to discuss ideas on collaboration.

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Work related to this paper:

  • Bei, B., Wiley, J. F., Trinder, J., & Manber, R. (2016). Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns. Sleep Medicine Reviews, 28(0), 104–120. Companion website: www.sleepv.org.
  • Wiley, J. F., Bei, B., Trinder, J., & Manber, R. (2014). Variability as a Predictor: A Bayesian Variability Model for Small Samples and Few Repeated Measures. arXiv [stat.AP]. http://arxiv.org/abs/1411.2961
  • Bei, B., Allen, N. B., Nicholas, C. L., Dudgeon, P., Murray, G., & Trinder, J. (2014). Actigraphy-assessed sleep during school and vacation periods: a naturalistic study of restricted and extended sleep opportunities in adolescents. Journal of Sleep Research, 23(1), 107–117.
  • Bei, B., Wiley, J. F., Allen, N. B., & Trinder, J. (2015). A cognitive vulnerability model on sleep and mood in adolescents under naturalistically restricted and extended sleep opportunities. Sleep, 38(3), 453–461.
  • Harbard, E., Allen, N. B., Trinder, J., & Bei, B. (2016). What’s Keeping Teenagers Up? Prebedtime behaviors and actigraphy-assessed sleep over school and vacation. The Journal of Adolescent Health, 58(4), 426–432.

Comments

4
Henry McNeil
over 2 years ago

Fascinating. Ive got 3 young kids and mood is highly linked to sleep duration but never thought about variability. So i guess its best to have a 'lights out at x' rule after all? Also i have heard sleep duration is declining in kids, but is variability increasing too over last few decades? Thanks!

Bei Bei
over 2 years ago

Thanks for the comment Ben. Teenagers sleep very differently during school and non-school nights (this wouldn't be a surprise to you!). During school nights, they are often sleep restricted (on average ~ 1hr less time in bed compared to vacation). See a figure here
http://onlinelibrary.wiley.com/enhanced/figures/doi/10.1111/jsr.12080#figure-viewer-jsr12080-fig-0001

"lights out at X" rule may be especially helpful in protecting sleep duration during school days when they are sleep restricted, and a few studies support this as well:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098947/
https://www.ncbi.nlm.nih.gov/pubmed/20120626
Adding to this, because adolescents typically have a delayed body clock compared to school schedules, encouraging them to have bright light in the morning could help them fall asleep and get up easier.

Yes, there is evidence that sleep duration declined over the past century in children and adolescents (https://www.ncbi.nlm.nih.gov/pubmed/21612957). We don't know whether variability also changed. Apart from a lack of research to answer this question, there is also a lack of clear definition as what "variability" or "regularity" means in the literature.

Variation in adolescents' sleep can typically be decomposed into (1) weekday/weekend difference - this is more consistent with a major shift in average duration/timing, and is especially striking during a school week, and (2) day-to-day variability - this is very low during a school week because their sleep times are constrained by school schedules. This is why we looked at this aspect of variability during school vacation, where we see higher daily variability, and that such variability is more related to adolescents' own choice of sleep schedules compared to school days. Because different factors contribute to different aspects of variability in adolescents, how variability may have changed over the past decades depends on how variability is defined and when it is measured.

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