Association Between Disturbed Sleep and Depression in Children and Youths: A Systematic Review and Meta-analysis of Cohort Studies.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of prospective cohort studies
PubMed 33749768 · doi:10.1001/jamanetworkopen.2021.2373
What was done
A systematic review and meta-analysis (adhering to PRISMA and MOOSE statements) of prospective cohort studies published between 1980 and August 2019 across six electronic databases. Eligible studies examined individuals aged 5 to 24 years to evaluate the association between disturbed sleep (disturbances or insomnia) and subsequent depression, adjusted for baseline depression. Pooled effect sizes were estimated using fixed- or random-effects models based on heterogeneity.
What was found
Twenty-two studies (28,895 participants) met inclusion criteria, and 16 studies (27,073 participants) were meta-analyzed. Disturbed sleep was prospectively associated with depressive symptoms (pooled β = 0.11; 95% CI, 0.06-0.15; P < .001; n = 14,067; I2 = 50.8%) and increased odds of depression (pooled OR = 1.50; 95% CI, 1.13-2.00; P = .005; n = 13,006; I2 = 87.7%). Metaregression found no significant moderation by age, assessment type, or follow-up duration.
Why it matters
These findings show that sleep disruption in youth is an independent, modest prospective risk factor for depression that can serve as an early target in preventive interventions.
Limits
The analysis identified substantial publication bias and high heterogeneity among studies evaluating categorical depression outcomes (I2 = 87.7%). Because included studies are observational cohorts, unmeasured confounding and residual bias cannot be fully ruled out.
Cited by
- supports Sleep deprivation is associated with and can trigger depression.