Xiao Ming (pseudonym) had always been a model student who excelled academically and behaved well, bringing his parents peace of mind. However, after entering ninth grade, increased homework and heightened pressure to advance to higher education meant Xiao Ming often worked on assignments until midnight or later. He still had to wake up on time in the morning, gradually showing signs of declining energy and waning interest in his studies. He constantly fell asleep in class, and repeated criticism from teachers failed to change his habits.Not only did he doze off in class, but he also lacked energy during breaks, often appearing gloomy. After medical evaluation, Xiaoming was diagnosed with depressive symptoms stemming from chronic sleep deprivation.
Sleep Deprivation: A "Common Ailment" Among Children and Adolescents
Zhang Weihua, Associate Chief Physician at Peking University Sixth Hospital's Department of Psychiatry, explained that sleep deprivation is relatively common among children and adolescents.
Zhang explained that sleep deprivation refers to the intentional reduction of daily sleep duration. It falls into two categories: acute total sleep deprivation and chronic partial sleep deprivation. Acute total sleep deprivation involves going without sleep for 24 to 48 hours, while chronic partial sleep deprivation occurs when the necessary sleep time is infringed upon or reduced."Everyone needs sufficient sleep to meet their body's fundamental sleep requirements. Generally, children and adolescents should sleep no less than 8 hours daily. While the body can compensate for 6 hours of sleep for one or two days, chronic partial sleep deprivation—if habitual—can easily trigger symptoms like depression, anxiety, and insomnia. Individuals with sensitive constitutions face an even higher risk of experiencing these issues."
The 2019 "White Paper on Sleep Index of Chinese Children and Adolescents" released by the China Sleep Research Association revealed that 62.9% of children aged 6 to 17 sleep less than 8 hours daily, while the proportion rises to 81.2% among those aged 13 to 17. Researchers found academic pressure to be the primary factor affecting children's sleep.Survey data indicates that 8.64% of students were still engaged in homework at 11 p.m. from Monday to Thursday.
Chronic sleep deprivation severely harms children's mental health, potentially triggering insomnia, anxiety, and depression. Zhang Weihua illustrated: "Some children develop disrupted sleep rhythms because they cannot sleep when they should. After prolonged disruption, they become unable to fall asleep when they actually feel tired;Others, deprived of sleep at night, fall asleep during daytime classes, frequently facing criticism or punishment from teachers. Over time, this breeds anxiety. Still others, due to insufficient sleep, find their bodies operating below normal capacity—lacking energy and vitality, experiencing slowed mental responses, feeling low in mood, and losing interest in everything. This prevents them from learning and living normally, leading to depressive symptoms."
Moreover, sleep deprivation negatively impacts cognitive abilities and memory function. Chronic sleep deprivation leads to memory decline. "Many people experience this: if they didn't sleep well the night before, they immediately feel their memory deteriorate the next day. Occasional instances allow the brain to self-regulate, but prolonged deprivation may prevent the brain from fully recovering to its original state," Zhang Weihua explains.
Staying up late and sleeping in: Circadian rhythm disorders plague young people
If sleep deprivation is a prevalent "disease of the times" among children and adolescents, then circadian rhythm disorders are a common sleep issue among young adults.
Zhang Weihua explained to China Youth Daily that young people are in the prime of their physical health and vitality, making them particularly prone to irregular schedules.Staying up late surfing the internet, scrolling through phones, or gaming is a common phenomenon. While short-term irregular schedules rarely cause serious consequences, they can disrupt circadian rhythms in individuals with more sensitive constitutions."For instance, some young people feel no drowsiness after midnight, so they play games or engage in other entertainment. Gradually, their bodies adapt to this pattern, becoming relatively active at that hour and making it harder to fall asleep. By the time they feel sleepy, it's already 2 or 3 a.m. The next morning, they might wake up after 10 a.m. or even noon. Slowly, a circadian rhythm disorder takes shape."
Zhang Weihua notes that circadian rhythm disorders are complex and rarely occur in isolation clinically, often co-occurring with other mental health issues. "Generally, individuals with circadian rhythm disorders frequently exhibit anxiety or depressive tendencies, or display characteristics consistent with other mental illnesses. Strictly speaking, they may not meet the diagnostic criteria for a specific mental disorder, but their thought patterns, emotional responses, and behavioral traits may align with certain mental health conditions."
Zhang Weihua emphasized that sleep-wake rhythm disorders differ from sleep deprivation. Simply put: "If you go to bed late but wake up at the same time each morning, resulting in insufficient sleep throughout the night, this is sleep deprivation. If you go to bed late and wake up late, achieving the required amount of sleep, this is a sleep-wake rhythm disorder."
Circadian rhythm sleep disorders manifest in various forms. Among younger populations, delayed sleep phase syndrome is relatively common. This refers to "a significant mismatch with the customary sleep-wake schedule within a given sociocultural context, typically delayed by at least two to three hours, thereby adversely affecting daily activities." Zhang Weihua illustrated: "Generally, an individual might sleep no later than midnight and wake by 8 a.m.But if this is delayed by two hours—sleeping at 2 a.m. and waking at 10 a.m.—it indicates circadian rhythm disorder. For those with this disorder, waking at 10 a.m. might feel perfectly adequate and restful. However, if they need to rise at 8 a.m. for obligations, the loss of two hours of sleep causes distress and disruption, leaving them in poor condition with heightened emotional experiences."
When not participating in social activities, disrupted circadian rhythms may not pose problems or affect mood. However, when synchronizing with others for tasks, individuals with circadian rhythm disorders experience significant distress from sleep deprivation. Over time, this leads to symptoms like fatigue, irritability, impatience, slowed cognitive response, and poor concentration.
Sleep issues often mask underlying mental disorders
In reality, sleep problems extend beyond sleep itself. Common mental disorders frequently manifest with sleep-related symptoms. Anxiety and depression often co-occur with sleep disturbances during active phases. Zhang Weihua notes that over 80% of depression patients experience sleep issues.Sleep issues predominantly manifest as insufficient sleep, including insomnia and early morning awakening. A minority of patients, however, experience excessive sleepiness, feeling fatigued and drained regardless of how long they sleep. In other words, sleep loses its intended function of alleviating fatigue.
The relationship between anxiety and insomnia is more complex. Anxiety sufferers often experience initial insomnia—difficulty falling asleep—and may even lie awake all night. However, what truly impacts their quality of life and causes significant distress are the emotional symptoms. Zhang Weihua notes: "Simply not getting enough sleep doesn't cause severe physical harm, intense suffering, or excessive preoccupation with sleep.The request, 'I really want to get a good night's sleep,' often masks underlying anxiety. The priority here is addressing emotional issues, not sleep itself. Treating sleep solely with hypnotics rarely achieves lasting improvement. Antidepressants and anti-anxiety medications are necessary, and some patients may also require antipsychotics or antiepileptics."Zhang Weihua emphasized: "Although some medications are classified as antipsychotics or antiepileptics, they are not exclusively used to treat mental illness or epilepsy. Patients should not jump to conclusions like 'If I'm prescribed antipsychotics, it means I have a mental illness.' Without resolving the underlying emotional issues, taking sleeping pills alone won't lead to better sleep."