Social media use predicts later sleep timing and greater sleep variability: An ecological momentary assessment study of youth at high and low familial risk for depression

IntroductionSocial media (SM) use has been increasingly recognized as a potential contributor to poor sleep. Few studies have examined SM use and sleep using ecological momentary assessment (EMA), compared different types of media use (SM, television, gaming), or examined whether youth at high and low familial risk for depression are differentially affected by SM use.MethodsThe current study included 76 youth (46% female; Mean age = 11.28 years) who were recruited based on parental history of recurrent depression (N = 35 high risk; N = 41 low risk) in the United States. Youth completed a 9-day EMA protocol, which included current activity at time of prompt and daily sleep onset and offset times. Regression and multilevel models were conducted to examine the effects of media use on sleep.ResultsResults indicated that youth who used more SM (mean and number of days) went to sleep later, but did not have shorter sleep duration. Youth with more SM use also had higher levels of variability of both sleep timing and sleep duration across the 9-day period. There were no effects of gaming or TV on sleep, and youth at high risk for depression did not have differences in SM use or its effects on sleep compared to low-risk youth.ConclusionsThese findings indicate a unique impact of SM use on sleep timing and variability for youth (regardless of risk status), which may suggest a unique and modifiable pathway through which SM use contributes to poor health.     

The relation between Internet and social media use and the demographic and clinical parameters,quality of life,depression, cognitive function and sleep quality in hemodialysis patients: Social media and hemodialysis

Objective

There are very few studies in the literature investigating the Internet use in hemodialysis (HD) patients. However, no study examined the relationship between Internet and social media use and quality of life, depression, cognitive function and sleep problems in HD patients.

Methods

The study is cross-sectional in design. All patients underwent history taking; physical examination; laboratory analysis and quality of life (by a short form of the Medical Outcomes Study), depression (by the Beck Depression Inventory), cognitive function (by the Standardized Mini Mental State Examination) and sleep problems (by the Pittsburgh Sleep Quality Index) evaluation.

Results

In total, 134 HD patients (male/female: 73/61, age: 53.0±13.4 years) were included. Patients with mail, Facebook and Twitter accounts were younger, were less depressive, had better quality of life, had higher cognitive function and were more educated compared to patients who did not have these accounts. Patients with Internet-based research about their disease were less depressive, had better quality of life and sleep quality, had higher cognitive function and were more educated compared to patients who did not have Internet-based research.

Conclusion

Internet and social media use was closely related with quality of life, depression, cognitive function and education in HD patients. Studies are needed on whether Internet use under the supervision of health care professionals will improve clinical outcomes, adherence, quality of life, depression and decision making in HD patients.     

Associations between sleep quality and anxiety and depression symptoms in a sample of young adult twins and siblings

Objectives

Little is known about the aetiology of the links between sleep disturbance and anxiety and depression symptoms. The aim of this study was to estimate genetic and environmental influences on these associations.

Methods

Questionnaires were completed by 1556 young adults from twin and sibling pairs (61.5% female).

Results

Sleep disturbance was moderately correlated with symptoms of anxiety (r=.39) and depression (r=.50). There was substantial overlap between genes influencing sleep disturbance and those influencing symptoms of anxiety (rA=.58) and depression (rA=.68). Overall, the associations between sleep and symptoms of both anxiety and depression were mainly due to genes (explaining 74% and 58% of the covariances respectively), with the remainder due to nonshared environmental factors.

Conclusions

Moderate phenotypic and genetic correlations between the phenotypes support the view that sleep disturbance is related to the presence of various psychiatric difficulties, but also warrants independent consideration and treatment.     

Social media use and the not-so-imaginary audience: Behavioral and neural mechanisms underlying the influence on self-concept

We investigated behavioral and neural mechanisms in the relation between social media use (SMU) and self-concept, as well as longitudinal developmental outcomes. Adolescents and young adults (N = 150, 11–21 years old at T1) rated themselves on 60 traits in the academic, physical and prosocial domain, and also indicated how they thought peers would judge them (reflected-peer-judgements). Longitudinal questionnaires (1- and 2-year follow-up) were collected to assess positive (prosocial behavior, self-concept clarity) and negative (clinical symptoms) long-term outcomes.Results indicated that heavier self-reported SMU was linked with lower difference scores between self-judgements and reflected-peer-judgements. Lower SMU was related to more positive ratings from self-judgements vs. reflected-peer-judgements. SMU was also associated with less positive self-concept, particularly in the academic domain (boys and girls) and physical domain (girls). Neurally, increased SMU was linked to heightened mPFC-activity during self-judgements compared to reflected-peer-judgements, and increased activity during physical compared to academic and prosocial self-judgements. Longitudinal analyses indicated no evidence for long-term effects of social media use, self/reflected-peer-difference scores and mPFC-activity on clinical symptoms, prosocial behavior or self-concept clarity. This study highlights the complex relationship between social media use and wellbeing and future research is needed to confirm the lack of long-term effects.     

Association of subjective anxiety, depression, and sleep disturbance with quality-of-life ratings in adults with epilepsy

Purpose :  To determine the relative contributions of subjective anxiety, depression, sleep disturbance, and seizure-related variables to quality-of-life scores in adults with epilepsy, and the interrelationships among these factors.
Methods :  Consecutive adult patients with epilepsy attending neurology outpatient clinics were recruited. Patients completed the following scales: Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Rating Scale, Medical Outcomes Study (MOS) Sleep Scale, Epworth Sleepiness Scale, and Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Univariate and multivariate linear regression models were used to identify variables associated with QOLIE-31 overall score. Path analysis model was constructed to test for interrelations between the variables.
Results :  Two hundred forty-seven patients completed the questionnaires. By multivariate analysis, in order of degree of contribution, HADS anxiety subscale score, MOS Sleep Scale Sleep Problems Index score, HADS depression subscale score, number of current antiepileptic drugs used, and seizure freedom in the past 4 weeks, significantly correlated with QOLIE-31 overall score, accounting for 65.2% of the variance. Complex interrelationships were present between these factors. A general linear model to predict QOLIE-31 overall score in the presence of these factors was constructed.
Conclusion :  Subjective anxiety, depression, and sleep disturbance exerted greater effect than short-term seizure control on quality of life scores of patients with epilepsy. These factors should be considered simultaneously when evaluating effects of treatment on quality of life.     

The independent relationships between insomnia,depression, subtypes of anxiety,and chronotype during adolescence

ObjectivesTo investigate the independent effects of depression and subtypes of anxiety on insomnia, and vice versa, and the independent effect of chronotype on insomnia, depression, and subtypes of anxiety.MethodsIn all, 318 South Australian high school students from grades 7–11 (age range, 12–18 years; mean, 14.97 ± 1.34) participated in this cross-sectional study. Validated self-report questionnaires were used to assess insomnia, depression, subtypes of anxiety, and chronotype.ResultsAfter confounder variables were controlled, insomnia predicted depression and panic disorder (PD), whereas insomnia was predicted by depression and generalized anxiety disorder (GAD). Obsessive–compulsive disorder (OCD), separation anxiety (SAD), and social phobia (SP) were not significantly related to insomnia. Eveningness predicted the models in which depression and PD predicted insomnia and vice versa. Eveningness also predicted the models in which insomnia was predicted by OCD, SAD, and SP.ConclusionsInsomnia independently predicts depression and is predicted by depression and GAD, but not by other forms of anxiety. The independent prediction of insomnia on PD is unlikely to be clinically significant. Chronotype independently predicts and hence is a risk factor for insomnia and depression, but not subtypes of anxiety. Theoretical and clinical implications are discussed.     

月经性偏头痛患者焦虑抑郁症状及睡眠质量

目的 探讨月经性偏头痛患者的焦虑抑郁症状及睡眠质量,为防治月经性偏头痛及其共病提供参考。方法根据国际头痛疾病分类第3版(ICHD-3)诊断标准,选择2019年2月-2020年2月在川北医学院附属医院门诊就诊的501例女性偏头痛患者为研究对象,包括112例月经性偏头痛患者和389例非月经性偏头痛患者。收集患者的一般资料及临床资料,采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表24项版(HAMD-24)、头痛影响测评量表(HIT-6)和匹兹堡睡眠质量指数量表(PSQI)进行评定。结果 在月经性偏头痛患者中,单纯焦虑或抑郁症状、焦虑抑郁症状共存、睡眠障碍的检出率均高于非月经性偏头痛患者(χ²=4.198、4.355、5.236、8.624,P<0.05或0.01),月经性偏头痛患者HAMA、HAMD-17、PSQI和HIT-6评分均高于非月经性偏头痛患者(Z=-3.550、-2.723、-2.482、-4.717,P<0.05或0.01)。相关分析显示,月经性偏头痛患者PSQI评分与HAMA评分(r=0.338,P<0.01)、HAMD-24评分(...     

Implicit and explicit self-esteem and their reciprocal relationship with symptoms of depression and social anxiety: A longitudinal study in adolescents

Background and Objectives

A negative self-view is a prominent factor in most cognitive vulnerability models of depression and anxiety. Recently, there has been increased attention to differentiate between the implicit (automatic) and the explicit (reflective) processing of self-related evaluations. This longitudinal study aimed to test the association between implicit and explicit self-esteem and symptoms of adolescent depression and social anxiety disorder. Two complementary models were tested: the vulnerability model and the scarring effect model.

Method

Participants were 1641 first and second year pupils of secondary schools in the Netherlands. The Rosenberg Self-Esteem Scale, self-esteem Implicit Association Test and Revised Child Anxiety and Depression Scale were completed to measure explicit self-esteem, implicit self-esteem and symptoms of social anxiety disorder (SAD) and major depressive disorder (MDD), respectively, at baseline and two-year follow-up.

Results

Explicit self-esteem at baseline was associated with symptoms of MDD and SAD at follow-up. Symptomatology at baseline was not associated with explicit self-esteem at follow-up. Implicit self-esteem was not associated with symptoms of MDD or SAD in either direction.

Limitations

We relied on self-report measures of MDD and SAD symptomatology. Also, findings are based on a non-clinical sample.

Conclusions

Our findings support the vulnerability model, and not the scarring effect model. The implications of these findings suggest support of an explicit self-esteem intervention to prevent increases in MDD and SAD symptomatology in non-clinical adolescents.     

偏头痛患者伴发焦虑/抑郁及功能残疾的临床研究

目的调查偏头痛患者伴发焦虑、抑郁、睡眠障碍、偏头痛相关功能残疾及影响因素分析。方法采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、匹兹堡睡眠量表(Pittsburgh sleep quality index,PQSI)、偏头痛残疾程度评估量表(migraine disability assessment scale,MIDAS)、头痛影响测验(headache impact test-6,HIT-6)调查问卷,分别对94例符合ICHD-II诊断标准的偏头痛患者和60例健康对照者焦虑、抑郁、睡眠障碍、偏头痛情况以及相关危险因素进行对比分析。结果偏头痛患者47.9%伴发焦虑;50.0%伴发抑郁,睡眠障碍发生率58.5%。偏头痛组焦虑、抑郁和睡眠障碍发生率都明显高于健康对照组的8.3%,16.7%,30.0%,(掊2分别为28.728,20.755,10.954,P值均<0.01)。多元逐步回归分析显示:头痛程度重、病程长、头痛家族史、睡眠质量差、生活满意度低是偏头痛并发焦虑/抑郁的主要危险因素。头痛程度、发作频率、持续时间、伴发焦虑/抑郁是导致功能残疾的主要影响因素。结论头痛程度、病程、家族史、睡眠质量、生活满意度是偏头痛并发精神心理症状的主要危险因素。     

A model of BIS/BAS sensitivity,emotion regulation difficulties,and depression,anxiety, and stress symptoms in relation to sleep quality

Recent research has indicated that interactions between behavioral inhibition system (BIS)/behavioral activation system (BAS) sensitivity and emotion regulation (ER) difficulties increases risk for psychopathology. Considering sleep quality (SQ) has been linked to emotion regulation difficulties (ERD) and psychopathology, further investigation of a possible mechanism is needed. The current study examined associations between BIS/BAS sensitivity, ERD, and SQ to depression, anxiety, and stress symptoms in an undergraduate sample (n=459). Positive relationships between BIS sensitivity and both ERD and stress symptoms, and negative relationships between BAS-reward sensitivity and both ERD and depression symptoms were observed. Furthermore, ERD were positively related to depression, anxiety, and stress symptoms. Succeeding analyses revealed differential relationships between ERD and depression, anxiety, and stress symptoms among good quality and poor quality sleepers. The findings are discussed within the context of personality dimensions and self-regulatory mechanisms, along with implications for the treatment of depression, anxiety and sleep difficulties.     

Reciprocal dynamics between self-rated sleep and symptoms of depression and anxiety in young adult women: a 14-day diary study

ObjectivesThe objective of this study was to characterize the day-to-day associations among sleep disturbance, depression, and anxiety in a sample of young adult women.MethodsOne hundred and seventy-one women (20.1 ± 3.3 years) completed in-laboratory baseline assessment followed by daily online surveys across a two-week period. Daily measures included the Mood and Anxiety Symptom Questionnaire-Short Form to assess shared and disorder-specific symptoms of depression and anxiety (general distress, anhedonic depression, and anxious arousal), as well as self-reported total sleep time (TST), sleep-onset latency (SOL), and sleep quality (SQ).ResultsFindings supported bidirectional day-to-day relationships between sleep and affective symptoms. When women felt greater general distress (shared features of anxiety and depression), they experienced longer SOL and worse SQ at night. Specificity among depression, anxiety, and sleep disturbance was observed such that higher levels of depression-specific anhedonia presaged longer SOL, shorter TST, and poorer SQ. In the other direction, when women had poor-quality sleep, they later experienced greater anhedonic depression and anxious arousal. The influence of TST on anhedonia was complex such that a single night of short sleep led to less anhedonic depression the next day, whereas women who obtained shorter sleep across the two-week period reported greater anhedonia.ConclusionsReciprocal dynamics between nightly sleep disturbance and daily experiences of depression and anxiety may serve as a process by which insomnia, depression, and anxiety develop into comorbid clinical states over time in women. The associations of anhedonic depression with nightly sleep disturbance and chronic short sleep were especially toxic, offering insight into daily mechanisms driving the most prevalent phenotype of comorbid insomnia.     

Pre-sleep social media use does not strongly disturb sleep: a sleep laboratory study in healthy young participants

ObjectiveSleep is critical for our mental health and optimal cognitive functioning. Social media use is increasingly common and suspected to disturb sleep due to increasing bedtime arousal. However, most studies rely on self-reported sleep.MethodsWe tested the effects of 30 min social media use on arousal and subsequent sleep in the sleep laboratory in 32 healthy young volunteers. Effects of blue-light were excluded in this study. We compared it to 30 min progressive muscle relaxation (PMR) and neutral sleep in a within-subject design.ResultsThirty minutes of social media use immediately before sleep did not significantly increase arousal and did neither disturb objective nor subjective sleep. After social media use, participants only spent less time in sleep stage N2. In contrast, PMR had the expected positive effects on pre-sleep arousal level indicated by reduced heart rate. In addition, PMR improved sleep efficiency, reduced sleep onset latency, and shortened the time to reach slow-wave sleep compared to a neutral night. Oscillatory power in the slow-wave activity and spindle bands remained unaffected.ConclusionSocial media use before sleep (controlling for effects of blue-light) had little effect on bedtime arousal and sleep quality than what was previously expected. The most notable effect appears to be the additional time spent engaging in social media use at bedtime, potentially keeping people from going to sleep. As wake up-time is mostly determined externally, due to school or working hours, limiting personal media use at bedtime—and especially in bed—is recommended to get sufficient hours of sleep.     

Allostatic load in early pregnancy is associated with poor sleep quality

BackgroundAllostatic load (AL) measures the cumulative impact of chronic stress and is associated with adverse health outcomes. A novel scoring system has previously been developed for AL in early pregnancy that is associated with pre-eclampsia. It was hypothesized that AL, as identified by the present model, is associated with psychosocial stressors and, specifically, poor sleep quality.MethodsWomen were selected from a low-risk, community-dwelling study population who enrolled at <15 weeks gestation. Nine physiologic components were divided among the domains of cardiovascular, metabolic, and inflammatory function. Spearman's rank correlations were used to examine the association of AL with age, income, the Revised Prenatal Distress Questionnaire (NuPDQ), Inventory of Depressive Symptoms (IDS), and Pittsburgh Sleep Quality Index (PSQI). The Wilcoxon rank-sum test was used to compare AL by race and educational attainment.ResultsA total of 103 women were identified, with: a mean age of 29.8 ± 5.0 years, 17.5% black, and mean gestational age 12.2 ± 1.1 weeks. Allostatic load was positively correlated with the PSQI (ρ = 0.23, p = 0.018). There were no associations with age, income, prenatal distress, race, or depression scores. College-educated women had lower AL compared with those with less education (0.57 ± 0.43 vs 0.81 ± 0.55, p = 0.045).ConclusionHigher AL, measured by the pregnancy-specific model, was associated with poorer sleep quality and lower educational attainment, both of which were considered to be chronic stressors. These relationships were consistent with previous findings in non-pregnant populations, and suggest that AL may be useful for capturing the physiologic impact of chronic stress in early pregnancy.     

重复经颅磁刺激对抑郁障碍患者睡眠质量改善的临床研究

研究背景 目前抑郁障碍患病率呈逐年升高之趋势,综合性医院就诊的抑郁障碍患者多以躯体化症状为主诉,尤以睡眠障碍最为常见,改善睡眠质量成为迫切的需要.本研究探讨重复经颅磁刺激(rTMS)对改善抑郁障碍患者睡眠质量的疗效.方法 以躯体化症状就诊的抑郁障碍患者随机分为单纯药物治疗组(药物治疗组)和rTMS联合药物治疗组(联合治疗组),分别采用汉密尔顿焦虑量表(HAMA)和抑郁量表(HAMD)评价两种治疗方法的疗效.结果 两种治疗方法在不同观察时间点,各项评分差异均有统计学意义(P=0.000),且治疗方法与观察时间点之间存在交互作用(均P=0.000).与药物治疗组相比,联合治疗组患者治疗1、2和4周时HAMA评分、HAMD总评分和躯体化症状评分降低(均P=0.000);治疗1周时睡眠障碍评分降低(P=0.001);治疗1和2周时抑郁症状评分降低(均P=0.000).与治疗前相比,药物治疗组患者各项评分除治疗后1周差异无统计学意义(P＞0.05)外,其余各观察时间点差异均有统计学意义(P=0.000);联合治疗组患者治疗后各项评分差异均有统计学意义(P=0.000).治疗后1、2和4周,两组治疗总有效率比较,联合治疗组[63.64％(14/22)、86.36％(19/22)、90.91％ (20/22)]高于药物治疗组[20％ (4/20)、55％ (11/20)、75％(15/20)],差异有统计学意义(均P=0.000).结论 重复经颅磁刺激联合药物治疗抑郁障碍患者起效早、效果好,尤其对睡眠质量的改善优于单纯药物治疗,可以提高抑郁障碍患者的治疗依从性.     

Longitudinal associations between social media use,mental well-being and structural brain development across adolescence

Youth of today grow up in a digital social world but the effects on well-being and brain development remain debated. This study tracked longitudinal associations between structural brain development, social media use and mental well-being.The study demonstrated two pathways of heterogeneity in brain development. First, adolescents who used social media more than their peers showed higher baseline cortical thickness in lateral prefrontal cortex (PFC) and medial PFC; and stronger decreases in the lateral PFC and temporal parietal junction. In contrast, adolescents with lower mental well-being showed lower baseline levels of surface area in the medial PFC and posterior superior temporal sulcus relative to their peers. Whereas the associations between structural brain development and well-being remained significant after correction for multiple testing, the results for social media use did not survive FDR correction.These findings demonstrate that although social media use and mental well-being were both associated with differential trajectories of brain development, the associations we report are distinct. These results show a nuanced perspective on the presumed relations between social media use and well-being and provide a starting point to further examine neural mechanisms that could explain which adolescents thrive by social media and which might be harmed.     

Sleep variability in adolescence is associated with altered brain development

Despite the known importance of sleep for brain development, and the sharp increase in poor sleep during adolescence, we know relatively little about how sleep impacts the developing brain. We present the first longitudinal study to examine how sleep during adolescence is associated with white matter integrity. We find that greater variability in sleep duration one year prior to a DTI scan is associated with lower white matter integrity above and beyond the effects of sleep duration, and variability in bedtime, whereas sleep variability a few months prior to the scan is not associated with white matter integrity. Thus, variability in sleep duration during adolescence may have long-term impairments on the developing brain. White matter integrity should be increasing during adolescence, and so sleep variability is directly at odds with normative developmental trends.     

Eveningness and poor sleep quality independently contribute to self-reported depression severity in psychiatric inpatients with affective disorder

Background Chronotype and insomnia have been related to the development and to an unfavourable course of depression. However, the mutual relationship of both risk factors is as yet unclear, especially in acute, clinically manifest depressive disorders. Aims The present study was carried out to elucidate the separate direct and indirect influence of chronotype and poor sleep quality on depression severity in patients hospitalized for depression. Methods Depression severity (BDI-II), chronotype (Morningness–Eveningness Questionnaire), and subjective sleep quality (Pittsburgh Sleep Quality Index total score) were assessed concurrently in inpatients with a depressive syndrome and insomnia during routine treatment. Correlations, multiple regression and bootstrapping methods for testing mediation models were applied to assess the independent direct and indirect effects of chronotype and sleep quality on depression severity, after adjusting for effects of age and gender. Results Data from 57 consecutively admitted patients (88% with major depression) were analyzed (68% women, mean age 41?±?13 years). Significant correlations between morningness–eveningness (p?<0.05) or sleep quality (p?<0.01) and depression severity were found; in a multiple regression model comprising chronotype, sleep quality, age and gender, only chronotype (p?<0.05) and sleep disturbances (p?<0.01) remained as independent significant concurrent predictors of depression severity (R²?=?0.184, p?<0.01). Two mediation models revealed no significant results. Conclusions Eveningness and poor subjective sleep quality were independently and directly associated with higher depression severity in inpatients with depressive syndromes. Chronotype and sleep quality should be taken into account not only in risk assessment and prevention but also in hospitalized patients to develop and improve treatment options.     

Social timing influences sleep quality in patients with sleep disorders

ObjectivesWe aimed to compare three variants of the Pittsburgh Sleep Quality Index (PSQI usual, work- and work-free days: PSQI_u, PSQI_w, PSQI_f) and to assess whether chronotype (MSF_sc)/social jetlag (SJL) are associated with sleep quality in patients with sleep disorders (SD).MethodsIn sum, 431 SD patients and 338 subjects from the general population (GP) were included. Participants filled in three variants of the PSQI and the Munich ChronoType Questionnaire (MCTQ). We used Generalized Estimating Equations (GEE) to investigate effects of group (GP, SD), PSQI (usual, work or free) and their interaction (group1PSQI) on scores. To investigate associations between MSF_sc/SJL and the difference between PSQI_w and PSQI_f (PSQI_diff) in patients with SD we used linear regressions (N = 352). We used Sobel to test whether there was a mediation effect of SJL on the association between MSF_sc and PSQI_diff.ResultsPSQI scores differed between groups (p < 0.001). Post-hoc analysis revealed a significant difference between PSQI_u vs. PSQI_f and PSQI_w vs. PSQI_f with PSQI_f presenting lower scores, while PSQI_u vs. PSQI_w did not differ in any group. In line with previous findings, SJL was associated to PSQI_diff in SD patients.ConclusionsPSQI_u mainly represents sleep quality on workdays also in SD patients. Being a late chronotype seems to be associated with higher differences in sleep quality on work-vs. free days mostly when it coincides with societal time constraints. Since sleep quality is poorer on workdays even in SD patients, we suggest that treatment strategies should address social aspects affecting sleep, including ways of minimizing SJL.     

Associations among sleep problems, learning difficulties and substance use in adolescence

This study investigated the relationships among sleep problems, learning difficulties and substance use in adolescence. Previous research suggests that these variables share an association with executive functioning deficits, and are intertwined. The sample comprised 427 adolescents (M age = 16 years) attending remedial schools and 276 adolescents (M age = 15 years) attending a mainstream school in Cape Town, South Africa. Participants completed anonymous self-report questionnaires. Results indicated that adolescents without learning difficulties were more likely to use tobacco, methamphetamine and cannabis, whereas those with learning difficulties engaged in more inhalant use. Adolescents who had more sleep problems were more likely to use tobacco, alcohol, methamphetamine, cannabis, inhalants, cocaine, ecstasy and any other illegal drug. Adolescents with learning difficulties had more sleep problems than those without learning difficulties. However, sleep problems remained independently associated with tobacco, cannabis and inhalant use when learning difficulties were taken into account.     

Investigating the relation among disturbed sleep due to social media use,school burnout,and academic performance

IntroductionPrevious studies have revealed the significant influence of electronic devices, especially social media use, on sleep difficulties among adolescents. In this study, disturbed sleep due to social media use (DSSM) was defined as reduced or troubled sleep caused by nighttime-specific behaviors such as waking to check updates, being notified by incoming messages, or postponed bedtime because of social media activities. Inadequate and disturbed sleep during youth interferes with daytime academic efficiency and may be associated with school burnout, which were examined in this study.MethodsUsing two data waves collected from questionnaires on school burnout and DSSM and school test scores of 2462 Taiwanese middle school students (52.5% males) from various school types with average ages of 13.9 (SD = 0.72) and 14.3 (SD = 0.66) at Time 1 and Time 2, we investigated the relationship between the variables across time.ResultsDSSM, academic performance, and school burnout were significantly correlated. Cross-lagged analyses to the group of adolescents with higher than the average DSSM scores revealed that burnout predicted lower academic achievements through DSSM as a mediator. Burnout did not have a direct effect on school performance but influenced the latter through disturbed sleep. Poor academic achievement in its turn showed a feedback effect on higher levels of burnout.ConclusionsThis research reveals a vicious cycle of burnout, disturbed sleep, and academic achievement. During adolescence, school burnout through DSSM increase can lead to a lower academic performance that may later cause even higher burnout.