Open Access Highly Accessed Research article

Delayed sleep onset in depressed young people

Nicholas Glozier1*, Bridianne O’Dea1, Patrick D McGorry2, Christos Pantelis3, Günter Paul Amminger24, Daniel F Hermens1, Rosemary Purcell2, Elizabeth Scott1 and Ian B Hickie1

Author Affiliations

1 Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia

2 Orygen Youth Health Research Centre, Centre for Youth Mental Health, Melbourne, Australia

3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia

4 Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria

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BMC Psychiatry 2014, 14:33  doi:10.1186/1471-244X-14-33

Published: 8 February 2014



The circadian abnormality of delayed sleep phase has been suggested to characterise a subgroup of depressed young adults with different risk factors and course of illness. We aim to assess the prevalence and factors, particularly substance use, associated with such delay in a large help-seeking cohort of young people with mental health problems.


From a consecutively recruited sample of 802 help-seeking young people, 305 (38%) had at least moderate depressive symptoms (QIDS-C16 >10), sleep data and did not have a chronic severe mental illness. Demographic and clinical characteristics were evaluated through self report and clinical interview. Delayed sleep phase was defined as a sleep onset between the hours of 02:00 a.m. – 06:00 a.m. and the characteristics of this group were compared to normal phase sleepers.


Delayed sleep onset was reported amongst 18% (n = 56/305) of the depressed group compared to 11% of the non-depressed young people. Amongst the depressed group, delayed sleep onset was associated with tobacco, alcohol and cannabis misuse and short sleep duration (: 5.8 hrs vs. x̅: 7.8 hrs). There were no differences in demographic factors, personality traits or symptoms. Tobacco smoking was very common: In logistic regression analyses only tobacco use (OR 2.28, 95% CI: 1.04 - 5.01) was associated with delayed sleep onset. There was no interaction with age.


Delayed sleep onset was twice as common in depressed young people as the general population and young people with other mental health problems, and is a potential marker for a subgroup of mood disorders. Those with delayed sleep onset were not more severely depressed but had short sleep duration, a risk for chronic psychological ill health, and higher levels of tobacco use. Nicotine use was common in this group, has biological evidence as a sleep disrupter, and requires specifically addressing in this population.

Depression; Delayed sleep onset; Youth mental health; Clinical staging