Sleep and mental wellbeing Exploring the links Technical report prepared by Kate Bartel, Cele Richardson and Michael Gradisar vichealth.vic.gov.au © VicHealth 2018 April 2018 P-MW-604 Suggested citation Bartel, K, Richardson, C & Gradisar M 2018, Sleep and mental wellbeing: exploring the links, Victorian Health Promotion Foundation, Melbourne. Acknowledgements The authors are grateful for the helpful comments of Emeritus Professor Dorothy Bruck, Chair of the Sleep Health Foundation, on an earlier draft of this report. Contents Acknowledgements ................................................................................................................................... i Key definitions .......................................................................................................................................... v Abbreviations ......................................................................................................................................... vii Executive summary ............................................................................................................................... viii Australian sleep patterns .................................................................................................................. viii Sleep and mental health.................................................................................................................... viii Lifestyle factors associated with sleep .............................................................................................. viii Behavioural solutions to improve sleep and mental health in young people..................................... ix Summary and conclusions ................................................................................................................... ix Chapter 1: Introduction ............................................................................................................................1 Brief biology of sleep ............................................................................................................................1 Sleep over the lifespan .........................................................................................................................1 Behavioural factors ..............................................................................................................................2 Two common sleep disorders explained ..............................................................................................2 Focus of this review ..............................................................................................................................3 Chapter 2: Australian sleep patterns ........................................................................................................4 Adolescents ..........................................................................................................................................4 Young adults .........................................................................................................................................4 Adults ....................................................................................................................................................5 Older adults ..........................................................................................................................................5 Key findings of Chapter 2 .....................................................................................................................5 Chapter 3: Sleep and mental health .........................................................................................................6 Adolescents and young adults ..............................................................................................................6 Adults ....................................................................................................................................................7 Older adults ..........................................................................................................................................9 Are young people at risk due to sleep/wake patterns? .................................................................... 10 Key findings of Chapter 3 .................................................................................................................. 10 Chapter 4: Lifestyle factors associated with sleep ................................................................................ 11 Adolescents and young adults ........................................................................................................... 11 Media use .........................................................................................................................................11 Evening light .....................................................................................................................................13 Caffeine ............................................................................................................................................13 Family factors ...................................................................................................................................14 Peer factors ......................................................................................................................................14 Extracurricular activities and homework .........................................................................................15 Mixed protective and risk factors measured simultaneously ..........................................................15 Summary...........................................................................................................................................16 Adults ................................................................................................................................................. 16 Electronic media and evening light ..................................................................................................17 Caffeine ............................................................................................................................................18 Physical activity ................................................................................................................................18 Summary...........................................................................................................................................20 Older adults ....................................................................................................................................... 20 Caffeine ............................................................................................................................................20 Peer factors ......................................................................................................................................20 Physical activity ................................................................................................................................21 Summary...........................................................................................................................................21 Key findings of Chapter 4 .................................................................................................................. 21 Chapter 5: Behavioural solutions to improve sleep and mental health in young people ..................... 23 Clinical interventions ......................................................................................................................... 23 Cognitive behavioural therapy for insomnia (CBT-i) ........................................................................23 Chronobiological treatment for DSWPD ..........................................................................................24 Cognitive behavioural therapy for DSWPD ......................................................................................25 Current evidence for clinical sleep interventions for young people ................................................. 25 Sleep disturbance .............................................................................................................................25 Insomnia ...........................................................................................................................................27 Delayed sleep-wake phase disorder .................................................................................................28 School-based and non-clinical interventions .................................................................................... 29 Sleep hygiene ...................................................................................................................................30 Studies involving relaxation, mindfulness and hypnotherapy .........................................................30 Other interventions ..........................................................................................................................30 School-based interventions ..............................................................................................................31 Gratitude interventions ....................................................................................................................32 Media use .........................................................................................................................................32