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The coronavirus disease 2019 (COVID-19) pandemic has significantly increased depression rates, particularly in emerging adults. The aim of this study was to examine longitudinal changes in depression risk before and during COVID-19 in a cohort of emerging adults in the U.S. and to determine whether prior drinking or sleep habits could predict the severity of depressive symptoms during the pandemic.
Participants were 525 emerging adults from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA), a five-site community sample including moderate-to-heavy drinkers. Poisson mixed-effect models evaluated changes in the Center for Epidemiological Studies Depression Scale (CES-D-10) from before to during COVID-19, also testing for sex and age interactions. Additional analyses examined whether alcohol use frequency or sleep duration measured in the last pre-COVID assessment predicted pandemic-related increase in depressive symptoms.
The prevalence of risk for clinical depression tripled due to a substantial and sustained increase in depressive symptoms during COVID-19 relative to pre-COVID years. Effects were strongest for younger women. Frequent alcohol use and short sleep duration during the closest pre-COVID visit predicted a greater increase in COVID-19 depressive symptoms.
The sharp increase in depression risk among emerging adults heralds a public health crisis with alarming implications for their social and emotional functioning as this generation matures. In addition to the heightened risk for younger women, the role of alcohol use and sleep behavior should be tracked through preventive care aiming to mitigate this looming mental health crisis.
This chapter reviews the psychometric properties, validation, and strengths and weaknesses of the most common measurement tools used for the subjective evaluation of sleepiness. Subjective measures of sleepiness described in the chapter include visual analogue scales (VAS), Stanford sleepiness scale (SSS), Karolinska sleepiness scale (KSS), Epworth sleepiness scale (ESS) pediatric sleep questionnaire, sleepiness subscale (PSQ-SS) and pediatric daytime sleepiness scale (PDSS). Children present with a variety of sleep disorders associated with excessive sleepiness. Subjective sleepiness is critical as it is often the initial symptom of underlying sleep pathology, and a major presenting complaint that clinicians must understand and address. More work is needed on potential cultural and racial differences in subjective sleepiness and in relation to specific types of measurement. It has been shown that subjective sleepiness is accompanied by EEG changes including selective slowing of specific frequency bands.