Depression in adolescents, a problem 1 in 5 teens experiences before age 18, could be reduced or even prevented by something relatively simple yet often ignored by late-night tweeting or texting teens - sleep.
Few teenagers get the recommended nine hours of nightly sleep for people their age, staying up well past a reasonable bedtime e-mailing, e-chatting or doing homework. And in the morning, they can be groggy, cranky and distracted.
If sleep deprivation becomes chronic, however, depression can result, UC Berkeley researchers say.
This is new thinking.
In the past, the general view was that sleep disturbances were a by-product of depression. Now research is pointing to a lack of sleep as a cause, said Allison Harvey, a clinical psychologist at UC Berkeley.
Harvey is leading a team of researchers at the university's Sleep and Psychological Disorders Laboratory, which along with Kaiser Permanente Center for Health Research in Oregon is recruiting 60 middle and high school students - 30 here and 30 there - to find out if more sleep might help.
The rate of depression in teens is striking and something experts say is connected to a loss in quality of life and an increased risk of suicide, the third-leading cause of death among teenagers.
Depression is such a confusing and difficult thing to add to adolescence, during what is already a stressful and critical time of academic and social learning in their lives, Harvey said.
"It's a huge problem," she said - one without enough treatment options.
One-third of depressed teens fail to respond to existing treatments including psychotherapy and medication.
So sleep, as simple as it sounds, could be another treatment option.
Research increasingly shows the importance of sleep for emotion, Harvey said.
"We all know that anecdotally, when we don't get enough sleep, we're irritable," she said.
Studies show that the average teen gets about seven hours of sleep per night. Teenagers who wake up at 6:30 a.m. would need to be catching Z's by 9:15 the night before to get the recommended nine hours - an almost laughable concept for night-owl adolescents.
"Adolescence is a time when parents appropriately start to loosen up the controls on their teenagers and start to hand over ... the responsibility for managing their lives," said Greg Clarke, investigator at the Portland Kaiser center. "But I think sometimes we're too quick to relinquish total control or total support for some things and sleep is one of those things."
A good night's rest
San Rafael teenager Ellie Ritter tries to get at least eight hours of sleep a night, but with three high school honors courses, that doesn't always happen.
"It's usually homework that keeps me up," the sophomore said.
Ellie knows firsthand what it's like to be sleep deprived. Sleep apnea used to interrupt deep snoozing, leaving her exhausted and unhappy during the day.
Now sleeping soundly, she values a good night's rest. But, as Ellie has found, it's not always possible for teens to get those 40 winks ahead of schoolwork - or even Facebook - on their list of priorities.
The 60 teens who participate in the 12-week study will self-report their sleep habits and participate in 12 one-hour, weekly sessions of cognitive behavior therapy to focus on sleep and mood patterns.
If the researchers see evidence of what they're looking for, they'll follow up with a larger study to confirm the results.
Telling teens about the importance of a good night's sleep is one thing; getting them to commit to it is another.
San Francisco mom Vicki Symonds said her two teenage daughters and their friends often report staying up late, usually to finish schoolwork.
"There's definitely a pressure because they have an enormous amount of homework," she said. "And then they also have social lives that they want to keep up with the dramas that happen during the day."
In the morning carpool, she hears some of the teens bragging about the two to three hours of sleep they got the night before.
"It's hard to know what to do about it," Symonds said.
Results from a recent study out of Columbia University Medical Center bolstered the theory that plentiful sleep can help prevent depression.
Teens with mandated bedtimes of midnight or later were more likely to suffer from depression or suicidal thoughts than those who had bedtimes of 10 p.m. or earlier, according to the June report.
"It's kind of a wake-up call to all of us," Harvey said. "We need to prioritize (sleep) more."
Wanted: Teens to participate in study
Researchers are interested in talking to middle or high school students with symptoms of depression, including some of the following:
-- Depressed moods
-- Lack of pleasure
-- Feelings of guilt or worthlessness
-- Weight loss or weight gain
-- Sleep problems
Weekly clinical sessions will be held in Berkeley. For information, call (510) 643-3797 or e-mail email@example.com.
How to raise a well-rested teen
Bedtime: Set a bedtime that allows for nine hours of sleep
Be consistent: Encourage consistency, even on the weekends
Curfew: Set a curfew on phone use, e-mails, texting, etc.
Chores: Limit weeknight chores
Activities: Limit after-school activities
Plan ahead: Prepare for school the night before
Source: American Academy of Sleep Medicine