Slow Wave Sleep and Emotion Regulation in Adolescents With Depressive Symptoms: An Experimental Pilot Study

Emotion regulation deficits are a hallmark of adolescent depression, and sleep greatly impacts emotion regulation. Initial data indicate acute mood benefits of slow-wave sleep deprivation (SWSD) in depressed adults, but it is unclear whether this may occur through improvement in emotion regulation. In addition, this has not been tested experimentally in adolescent depression. In this pilot study, we tested the effect of SWSD on emotion regulation in adolescents with elevated depressive symptoms. Fifteen adolescents (mean age [SD] = 17.47 [1.55] years, 12 female) completed three consecutive nights of polysomnographic sleep recording: Baseline, SWSD, and Recovery. Auditory stimulation (sounds of varying pitch, duration, and volume) suppressed slow-wave sleep (SWS) during SWSD. After Baseline and SWSD nights, the Emotional Go/No-Go task was administered the next day as a behavioural assessment of cognitive control, emotion discrimination, and emotion regulation outcomes. False Discovery Rate was used to account for multiple comparison correction. We found that, at Baseline, longer SWS duration was associated with poorer emotion discrimination (β = -0.44, p = 0.012, Q = 0.036). There was no association between other sleep stages and emotion regulation. While Emotional Go/No-Go outcomes did not significantly differ between Baseline and SWSD nights, greater attenuation in SWS significantly correlated with improvement in cognitive control (β = 0.61, p = 0.021, Q = 0.038), emotion discrimination (β = -0.44, p = 0.025, Q = 0.038), and emotion regulation (β = 0.62, p = 0.049, Q = 0.049) between nights. Findings from this pilot study tie elevated SWS to impaired emotion regulation in adolescents with depressive symptoms and suggest that targeted deprivation of SWS may improve emotion regulation in depressed adolescents with elevated SWS.