Associations of Social Jetlag With Depression and Anxiety in Adolescents and Young People: A Systematic Review and Meta-Analysis.

Background: Adolescence and young age are pivotal periods for the emergence of mental health difficulties, marked by major changes in sleep patterns, including an increase in social jetlag (SJL). SJL is often associated with inadequate sleep, shortened sleep, and greater daytime sleepiness, which could potentially lead to mental health problems. This review and meta-analysis examined the relationships between SJL, depression, and anxiety in this population. Methods: A systematic search of CINAHL, Embase, PsycINFO, PubMed, and Web of Science identified 14 studies (164,529 participants) examining the association of SJL with depression and anxiety. Pooled associations were calculated using Fisher's z values within a random-effects model. We assessed heterogeneity with the I 2 statistic and conducted subgroup and meta-regression analyses to identify possible sources. The robustness of the results was evaluated through sensitivity analyses, and Egger's test was applied to examine the possibility of publication bias. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation. Results: SJL was significantly and positively associated with depression (Fisher's z = 0.27, 95% confidence interval [CI] = 0.16-0.38) and anxiety (Fisher's z = 0.21, 95% CI = 0.12-0.29). Social jetlag of 1-2 h and >2 h was significantly associated with increased odds of depression, with odds ratios of 1.12 (95% CI = 1.05-1.20) and 1.87 (95% CI = 1.73-2.02), respectively. Conclusion: This review's findings demonstrate a possible association between SJL and increased odds of depression and anxiety among adolescents and young people, highlighting the importance of addressing sleep-wake misalignment in this population. However, as the certainty of evidence was rated as very low, the results should be interpreted with caution.