Table 1 Summary of studies utilized for review

Chaput, Jean-Philippe, and Caroline Dutil. 2016

Lack of sleep as a contributor to obesity in adolescents: impacts on eating and activity behaviors

This article examines the link between sleep and obesity among adolescents. There is an association between sleep deprivation, poor sleep quality and overeating, poor diet and obesity. Hence a holistic approach to health, needs to target sleep, diet and physical activity as critical behaviors among adolescents.

Wheaton, Anne G, and Angelika H Claussen. 2021

Short Sleep Duration Among Infants, Children, and Adolescents Aged 4 Months-17 Years - United States, 2016–2018

This study evaluated data from the 2016–2018 National Survey of Children’s Health to analyze the occurrence of inadequate sleep duration among individuals from 4 months to 17 years. It was found that 34.9% of adolescents slept less than the recommended duration. The proportion was even higher in southeastern states, among racial and ethnic minorities, individuals with lower socioeconomic status or special health needs. It also found that consistent bedtime was associated with better sleep duration.

Reddy, Sujana, et al. 2023

Physiology, Circadian Rhythm

This publication describes the physiology of the circadian rhythm. It is an internal body clock in our brain, which controls sleep and alertness by reacting to environmental changes. It helps humans adapt to external factors like energy, temperature, and availability of food thereby enhancing energy expenditure and internal body functioning.

Jamieson, Daniel et al. 2020

Investigating the links between adolescent sleep deprivation, fronto-limbic connectivity, and the Onset of Mental Disorders: a review of the literature

During adolescence, the risk of sleep deprivation increases due to circadian rhythm changes around puberty which is worsened by early school start times. This may result in an increased risk of mental health challenges. Studies have shown that for the myelination of axons (linking areas of grey matter; necessary for communication speed), sufficient sleep is required. It is concluded that sleep deprivation could lead to potential life-long mental health issues.

Montie, Koen et al. 2019

The impact of delayed sleep phase disorder on adolescents and their family

This study examined the effects of delayed sleep phase disorder (DSPD) on adolescents’ school and social lives along with the lives of their parents. Adolescent DSPD impacts cognitive functioning, mental health, social and family lives. It requires increased awareness and support from physicians and the general public to reduce misunderstandings thereby enhancing their overall well-being.

Owens, Judith A, and Miriam R Weiss. 2017

Insufficient sleep in adolescents causes and consequences

This study analyses the various factors affecting sleep among adolescents and their consequences. It’s prevalent due to various factors, including biological changes during puberty and external factors like extracurricular activities, excessive homework, use of internet and social media, caffeine intake, and early school start times. The effects of inadequate sleep include inattentiveness, reduced executive functioning, poor scholastic performance, obesity, cardio-metabolic concerns, mood swings, higher suicidal thoughts, risk taking behaviors like alcohol and substance use, and increased rates of accidents like driving, occupational, and those related to sports.

Zhang, Shan, and Chunyan Yu. 2022

The Link between Sleep Insufficiency and Self-Injury among In-School Adolescents: Findings from a Cross-Sectional Survey of Multi-Type Schools in Huangpu District of Shanghai, China

This study was conducted among adolescents in Shanghai, aiming to investigate the relationship between lack of sleep and self-harm. The results showed that insufficient sleep doubled the chances of self-harm. Girls had higher chances than boys and self-harm was more in ordinary schools than in key schools. This highlights the need for interventions and suggests changes in school environments and social contexts which could lead to stress in adolescents.

Watson, Nathaniel F et al. 2017

Delaying Middle School and High School Start Times Promotes Student Health and Performance: An American Academy of Sleep Medicine Position Statement

A position statement by the American Academy of Sleep Medicine (AASM) recommending that schools implement later start times to ensure students arrive at school healthy, alert, and ready for learning. Adolescence leads to changes in sleep and wake times, hence early middle and high school start times negatively impact students’ health and well-being.

Nelson, Kathy L et al. 2022

Sleep quality: An evolutionary concept analysis

A concept analysis of sleep quality and its health consequences. Sleep quality is an individual’s overall sleep satisfaction on four attributes: sleep efficiency, sleep latency, sleep duration, and wake after sleep onset. Factors affecting sleep quality include physiological, psychological, and environmental factors. Inadequate sleep leads to illness and negative health results. Nurses and clinicians must stress the value of good sleep for better health.

Hysing, Mari et al. 2013

Sleep patterns and insomnia among adolescents: a population-based study

The study examined sleep patterns and rates of insomnia in individuals in the 16–19 years age bracket. The study found that adolescents reported sleep deficiency of about 2 h on weekdays. Most adolescents reported sleep onset latency of more than 30 min. Girls had a longer sleep onset latency and a higher rate of insomnia than boys. It highlights the prevalence of sleep issues in adolescents and its importance as a public health issue.

Dickinson, David L et al. 2018

Personal sleep debt and daytime sleepiness mediate the relationship between sleep and mental health outcomes in young adults

This study identifies potential moderators of the mental health risks associated with short sleep and evening chronotype. The findings suggest that health care providers should assess hyper insomnia and sleep deficit in university students.

Sun, Wanqi et al. 2019

Associations of weekday-to-weekend sleep differences with academic performance and health-related outcomes in school-age children and youths

This study examines the co-relation of weekend to weekday differences in bedtime, risetime and sleep duration with school performance and health issues in students. It was observed that students with a difference in the weekday-to-weekend sleep duration showed lower academic performance and symptoms of depression. They are also at a higher risk of being overweight or obese (especially Asians). While it is inconclusive, larger sleep differences were seen to have potentially increased behavioral issues and suicidality. Additionally, the effect of differences in sleep duration on specific cognitive abilities, anxiety, and cardiometabolic risks had very little evidence.

Futenma, Kunihiro et al. 2023

Delayed sleep-wake phase disorder and its related sleep behaviors in the young generation

Delayed sleep-wake phase disorder (DSWPD) is a disorder that results in fatigue, reduced concentration, and week-day sleep deprivation. It could have led to often absences from school/work. This disorder could eventually lead to depression and other mental health issues. This disorder is determined by many genetic, psychological, social, and physiological factors. During the COVID-19 pandemic, prolonged sleep duration and delayed sleep have been noticed. This could lead to DSWPD, and young people could have problems academically and socially. Patients with this disorder also tend to have neuroticism and anxiety, which may lead to insomnia.

Campbell, Rebecca L et al. 2021

Greater adolescent tiredness is related to more emotional arousal during a hyperventilation task: An area under the curve approach

The study aimed to understand how tiredness predicts higher emotional arousal and adverse emotional responses in general. It confirmed that daytime tiredness is linked to emotional arousal from psychobiological stressors, increasing the mental health risks in adolescents due to common sleep deprivation among adolescents.

Touitou, Yvan et al. 2016

Disruption of adolescents’ circadian clock: The vicious circle of media use, exposure to light at night, sleep loss and risk behaviors

This paper analyzes the effect of circadian rhythm shift on adolescents, resulting from light exposure. It also discusses the relation between the clock and the pineal gland, the importance of melatonin, and impact of media and substance abuse by adolescents.

McLay, Laurie et al. 2023

The relationship between sleep duration and health among Pacific adolescents within New Zealand: Findings from the Pacific Islands families study

The aim of this study is to demonstrate that sleep insufficiency is bidirectionally linked to negative behavioral, physical, and mental health outcomes in adolescents. The study revealed a strong association between insufficient sleep and depressive symptoms. It was concluded that insufficient sleep affects the mental health of adolescents. It is suggested that public health strategies with positive sleep practices are required especially among teenagers.

Lee, Younghee. 2017

Sleep duration’s association with diet, physical activity, mental status, and weight among Korean high school students

This Korean study investigated how sleep duration is related to diet, physical activity, mental health, and nutritional uptake among Korean adolescents. Shorter sleep was seen to increase stress and suicidal ideation. It was concluded that only 16% of the students had > = 7 h of sleep a day which highly affects their physical and mental wellbeing.

Zhai, Xiaobing et al. 2021

Influencing factors of sleep quality among Chinese junior and senior high school adolescents during the COVID-19 pandemic

A study conducted in China on teenagers in junior and senior high schools discovered that at the time of the COVID-19 pandemic, poor sleep quality was common. Inadequate sleep quality was associated with several factors, including gender, education, spending time online researching COVID-19, having a friend or family member who is sick, and using electronics frequently. Poor sleep quality was eight times more likely to occur in adolescents with anxiety, and three times more probable in those with FNE. Comprehending these variables can aid in ascertaining plausible measures to enhance the caliber of sleep amidst the pandemic.

Robillard, Rebecca et al. 2021

Profiles of sleep changes during the COVID-19 pandemic: Demographic, behavioural and psychological factors

This study was conducted during the COVID-19 outbreak and aimed to analyze the changes in sleep at the time. With a sample of 5,525 Canadians, a survey was done, and it was found that the wake-times had been delayed substantially as compared to pre-pandemic times. Additionally, it was noted that sleep difficulties had also increased from 36–50.5%. Various factors including family responsibility greater exposure to television and greater stress levels were related to these sleep difficulties. This emphasizes the need for interventions specifically made for sleep problems during the pandemic.

Wang, Dongfang et al. 2022

Does sleep disturbance predict posttraumatic stress disorder and depression among college students during COVID-19 lockdown? A longitudinal survey

The study conducted during the COVID-19 lockdown examined the associations between sleep disruptions, PTSD and depression at the time. Sleep disturbances were high predictors of PTSD and depression in adolescents. To prevent or treat depression and PTSD, early evaluation and action against sleep disturbances could be an effective approach.

Gruber, Reut et al. 2021

Pre-pandemic sleep behavior and adolescents’ stress during Covid-19: a prospective longitudinal study

This study aimed to compare the quality of sleep in adolescents before the COVID-19 pandemic and during it to investigate its influence on stress. 62 adolescents were assessed before and during the pandemic by reporting their sleep duration, schedule, quality, bedtime activities and daytime sleepiness. They also took information from the parents of the participants. The results showed that during the pandemic, there was an increased sleep duration along with a delay in daily schedules in comparison to before the pandemic. This along with cognitive-emotional arousal was connected with adolescent stress during the pandemic.

Stone, Julia E et al. 2021

In-person vs. home schooling during the COVID-19 pandemic: Differences in sleep, circadian timing, and mood in early adolescence

The study investigated the effect of online learning on sleep and circadian rhythm in adolescents in comparison to in-person classes. The sleep-wake time was monitored with the usage of wrist actigraphy and sleep diaries. Additionally, changes in the circadian rhythm were also assessed. It was noticed that adolescents had longer sleep durations during online learning due to the lack of commute which caused them to wake up later than when attending school in person.

Puteikis, Kristijonas et al. 2022

Sleep Quality, Mental Health and Learning among High School Students after Reopening Schools during the COVID-19 Pandemic: Results of a Cross-Sectional Online Survey

Aimed to study the difference in sleep quality and mental well-being of adolescents as in-person classes started after the pandemic. They conducted a survey at three competitive high schools. The results showed that while adolescents reported better study quality and physical health, they also reported worse sleep quality, shorter duration of sleep and worse mental health. This suggests the importance of in-person learning for academic quality and physical health but also highlights its negative impact on student mental health and sleep quality.

Comsa, Monica et al. 2022

The relationship between sleep and depression and bipolar disorder in children and young people

Aimed to investigate the association between sleep and bipolar disorder and depression. In adolescents, certain sleep disorders are closely related to depression and certain disorders such as insomnia, sleep apnea and other disorders related to the circadian rhythm are related to bipolar disorders and depression. It is also noted that depression and bipolar disorder can worsen sleep disorders and cause more sleep difficulties in young people as well.

Yeo, Sing Chen et al. 2020

Associations of time spent on homework or studying with nocturnal sleep behavior and depression symptoms in adolescents from Singapore

To investigate the relationship between time spent on academics and sleep behavior at night and symptoms of depression in teenagers. There was an inverse relationship between media use and the time spent in bed and academics. Scores of depression were greater in students who spent greater amounts of time on academics. A decrease in work outside of classes could improve adolescents’ sleep, school-life balance, and mental health.

Evers, Katerina et al. 2020

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

This study aimed to investigate the association between sleep disturbances due to usage of social media, school burnout and performance academically. It revealed a vicious cycle between the three with disturbed sleep being the common factor influencing the other two.

Hysing, Mari et al. 2016

Sleep and academic performance in later adolescence: results from a large population-based study

This study intended to investigate the link between the duration of sleep, sleep patterns, and scholastic performance in teenagers between the ages of 16 to 19. It concluded that weekday bedtime and delayed sleep schedules were closely linked to poor study performance. The study implies that sleep evaluation is crucial for adolescents underperforming at school.

Chan, Ngan Yin et al. 2017

Impact of a modest delay in school start time in Hong Kong school adolescents

Aimed to analyze how adolescent sleep, behavior and overall mood are affected by a delay in the start times at school. Students from the school with a later start time showed increased time in bed as compared to the regular school. A questionnaire showed that students from the intervention school showed improved mental health, fewer emotional problems, greater attentiveness, and lessened behavioral difficulties. School administrators and policymakers need to be committed in evaluating delayed school start-times to enhance adolescent sleep times and its effect on the mental state of teenagers.

Royant-Parola, S et al. 2018

The use of social media modifies teenagers’ sleep-related behavior

The study aimed to assess how adolescent sleep patterns are affected by social media use and the consequences of sleep deprivation. It concluded that the availability of cell phones and social media in adolescents’ bedrooms is related to reduced sleep and adverse effects on daily functioning and mood which are further amplified in older teenagers.

Lemola, Sakari et al. 2015

Adolescents’ electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age

Adolescents tend to be more prone to poor mental health and sleep insufficiency is a major risk factor for this. The association between electronic use, sleep disturbances, and depressive symptoms was analyzed in this study. It was seen that smartphone usage led to later bedtimes but is not directly related to disrupted sleep and depressive symptoms. Sleep difficulties were seen to be negatively related to mental health. It is suggested that adolescents may gain from being educated on sleep hygiene and the various issues associated with electronic media use.

Charmaraman, Linda et al. 2021

Quantity, Content, and Context Matter: Associations Among Social Technology Use and Sleep Habits in Early Adolescents

The study looked at how early adolescents’ access to, use of, and social context related to social media affected the amount and timing of their sleep. The usage of social media, its content, and its social environment were found to have a substantial impact on later bedtimes and shorter sleep durations on school evenings. Delaying smartphone ownership to a later age and parental rules limiting phone use were related to increased sleep duration and earlier bedtimes.

Lang, Christin et al. 2013

Increased self-reported and objectively assessed physical activity predict sleep quality among adolescents

The study aimed to test the association between exercise and sleep quality in students at adolescent vocational schools. The data collected using questionnaires confirmed the claim that adolescents with high Physical Activity (PA) levels would have more total sleep, lesser wakening at night, lesser symptoms of insomnia, and greater quality of sleep. Results implied that increased PA is related to recovering sleep patterns and is beneficial for both mental and physical health.

Choi, Heeseung et al. 2020

Relationship Between Sedentary Time and Sleep Duration Among Korean Adolescents

In adolescents, lack of sleep and greater sedentary period have more negative implications on mental and physical health. In this study, 50 Korean adolescents were observed over a 5-day period and the analyzed data from questionnaires and sleep logs showed that sedentary time had a substantial and negative relationship with sleep duration. Interventions were suggested for schools to reduce sedentary periods and improve sleep quality and duration.

Alanazi, Eman M et al. 2023

Sleep Hygiene Practices and Its Impact on Mental Health and Functional Performance Among Adults in Tabuk City: A Cross-Sectional Study

This study discovered a strong correlation between sleep issues, depression, daytime sleepiness and poor sleep hygiene practices. It outlines a comprehensive definition of sleep hygiene, according to the study, people who practiced poor sleep hygiene were more likely to experience melancholy, excessive daytime sleepiness, and sleep issues.

Gunderson, Justine et al. 2023

Association Between Insufficient Sleep, Depressive Symptoms, and Suicidality Among Florida High School Students

This study explored the association between sleep, symptoms of depression, and suicidal ideations. They investigated two predictors of depression– sadness and hopelessness along with suicidal ideations. The results showed that lack of sleep was correlated with higher feeling of sadness and hopelessness and greater suicidal ideation. Hence, it is crucial to give more attention to sleep in adolescents as a high-risk factor for depression and suicidal thoughts.

Illingworth, Gaby et al. 2019

The Teensleep study: the effectiveness of a school-based sleep education programme at improving early adolescent sleep

The study assessed the effects on teenage sleep and understanding of Teensleep, a school-based sleep education program. Ten lessons totaling the program were taught to sophomore students from 10 state-run high schools in UK. The findings indicated significant gains in knowledge about sleep, but only modest gains in hygiene and quality of sleep. According to the study, those who have trouble sleeping might benefit directly from sleep right away. However, more investigation is required to ascertain whether sleep education works as a preventative approach over the long run.

van Rijn, Elaine et al. 2020

Evaluation of an interactive school-based sleep education program: a cluster-randomized controlled trial

The study assessed an interactive Sleep Education Program (SEP) that was implemented in schools. 210 students participated in a cluster-randomized controlled experiment, where the control group was in a program with healthy living, and SEP was given to the intervention group. The SEP students gained knowledge on the value of sleep, obstacles to adequate sleep, and time management. At follow-up, the results revealed better sleep knowledge, but there were no changes in actual sleep patterns. According to the study, changing sleep behavior may require more than just sleep education.

Quante, Mirja et al. 2022

“Let’s talk about sleep”: a qualitative examination of levers for promoting healthy sleep among sleep-deprived vulnerable adolescents.

A series of focus group studies to analyze the mediating methods and strategies that teenagers employ to enhance sleep, as well as potential levers for promoting better sleep. Identified measures for improving sleep include highlighting poor sleep’s health effects, increasing sleep hygiene awareness, addressing caffeine and screen use, and delivering sleep recommendations through more effective channels.

Biller, Anna M et al. 2022

Sleep improvements on days with later school starts persist after 1 year in a flexible start system

The study evaluated the potential benefits of flexible school start times on adolescent health and learning. By observing students and the sleep diaries maintained by them, it was noted that there was an increase in motivation, concentration, and quality of academic performance. Additionally, it improved both sleep quality and psychological wellbeing. The measure seems promising, but more research and experiments are needed.