A longitudinal Australian study has explored the role sleep plays in the development of depression and anxiety in adolescents.
The bidirectional relationship between sleep and mental health affects adolescents too.
New research from the Black Dog Institute has identified four unique trajectories of how depression and anxiety affect students as they progress through high school, with sleep quality playing a major role in which pathway adolescents fell into.
Based on responses to annual surveys about their mental health between year 8 and year 11, Australian students were assigned to one of four trajectories of depression and anxiety: no to minimal symptoms throughout, initially high symptoms that decrease over time, a moderate level of symptoms that increases over time or persistently high symptoms.
The majority of students (72% for depression and 67% for anxiety) reported no symptoms as they progressed through high school, and a small proportion of students suggested that their symptoms got better (7% for both depression and anxiety).
But concerningly, 8% of students said they had developed moderate symptoms of depression or anxiety over time – and a larger proportion indicated they had experienced persistent problems throughout their schooling (12% for depression and 18% for anxiety).
“Our research shows that while most young people navigate adolescence without significant mental health difficulties, a substantial number experience symptoms that worsen over time. This highlights the need for earlier intervention and more targeted support,” said Professor Aliza Werner-Seidler, co-lead of the Future Proofing Study at the Black Dog Institute.
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Thirty-eight percent of participants reported the experienced persistent or increasing insomnia symptoms between year 8 and year 11. Getting at least eight hours of sleep each night was identified as a powerful predictor of adolescent mental health.
The report found that students with clinically significant insomnia were six times more likely to experience greater depressive symptoms and four times more likely to experience greater anxiety symptoms compared to patients without difficulties in falling or staying asleep.
“Sleep is often overlooked in conversations about youth mental health, but our findings show it plays a critical role in mental health and wellbeing. Improving how we identify and treat sleep problems in young people could make a significant difference to mental health outcomes,” said Kate Maston, senior research program manager at the Black Dog Institute.
These findings led Ms Maston to call for increased focus on supporting good sleep among adolescents from a healthcare, school and public health perspective.
“Routine screening for sleep problems in primary care, stronger sleep education in schools, and greater investment in training clinicians to treat insomnia could all help improve mental health outcomes for young people.”
Being female, experiencing problems with peers and having a history of adverse childhood events were all additional factors associated with belonging to the persistent depression and anxiety trajectories.
The Future Proofing Study was launched back in 2019, when 6388 year 8 students were enrolled from more than 130 schools across New South Wales and other capital cities around Australia. Most students (76%) came from metropolitan areas and 5% identified as Aboriginal and Torres Strait Islander.
Participants complete an annual survey about a range of factors, including their mental health, sleep, peer and family relationships, school life and technology use. The most recent tranche of data comes from surveys completed by students in years 8 to 11 between 2019 and 2024.
Further information about the Future Proofing Study, including the latest research insights report, can be found on the Black Dog Institute website.
