Circadian alignment as a modifiable target in adolescent mental health: mechanisms and preventive approaches
DOI:
https://doi.org/10.12775/JEHS.2026.88.69505Keywords
adolescents, circadian rhythm, blue light, sleep-wake problems, social jetlag, mental healthAbstract
Adolescence is a developmental period characterized by a physiologically delayed circadian phase and ongoing maturation of neural systems involved in emotional regulation and cognitive control. This developmental configuration increases susceptibility to sleep restriction and circadian misalignment, particularly in the context of contemporary lifestyle patterns marked by high evening screen exposure. Short-wavelength light emitted by electronic devices has been linked to delayed sleep timing and social jetlag, which are common among adolescents.This narrative review synthesizes current evidence on the relationships between circadian rhythm disruption, sleep disturbances and mental health outcomes in adolescents. Particular attention is given to biological mechanisms potentially underlying these associations, including alterations in melatonin signaling, dysregulation of monoaminergic neurotransmission, activation of the hypothalamic-pituitary-adrenal axis, inflammatory pathways and interactions within the gut-brain axis. The review also examines the cognitive and academic correlates of insufficient and irregular sleep during this critical developmental stage. Emerging evidence indicates that circadian misalignment and chronic sleep restriction are consistently associated with depressive and anxiety symptoms, emotional dysregulation and reduced cognitive performance in adolescents. Circadian-oriented strategies, such as reducing evening light exposure, delaying school start times and implementing structured sleep hygiene programs, are discussed as promising approaches to improve sleep patterns and support psychological functioning in this population. By integrating neurobiological, clinical and population-level findings, this review highlights the relevance of circadian health in adolescent mental well-being and underscores the importance of chronobiological considerations in preventive and educational strategies.
References
1. Wahl S, Engelhardt M, Schaupp P, Lappe C, Ivanov IV. The inner clock-Blue light sets the human rhythm. J Biophotonics. 2019 Dec;12(12):e201900102.
2. de Toledo LHS, Moraes MN, Poletini M de O, Neto JC, Baron J, Mota T. Modeling the influence of nighttime light on melatonin suppression in humans: Milestones and perspectives. J Photochem Photobiol. 2023 Aug;16:100199.
3. Bautista J, Ojeda-Mosquera S, Ordóñez-Lozada D, López-Cortés A. Peripheral clocks and systemic zeitgeber interactions: from molecular mechanisms to circadian precision medicine. Front Endocrinol (Lausanne). 2025 May 29;16:1606242.
4. Tarokh L, Saletin JM, Carskadon MA. Sleep in adolescence: Physiology, cognition and mental health. Neurosci Biobehav Rev. 2016 Nov;70:182–8.
5. Spruyt K. Neurocognitive effects of sleep disruption in children and adolescents. Child Adolesc Psychiatr Clin N Am. 2021 Jan;30(1):27–45.
6. Dollish HK, Tsyglakova M, McClung CA. Circadian rhythms and mood disorders: Time to see the light. Neuron. 2024 Jan 3;112(1):25–40.
7. Lang C, Richardson C, Micic G, Gradisar M. Understanding Sleep-Wake Behavior in Late Chronotype Adolescents: The Role of Circadian Phase, Sleep Timing, and Sleep Propensity. Front Psychiatry. 2022 Mar 11;13:785079.
8. Mantle D, Smits M, Boss M, Miedema I, van Geijlswijk I. Efficacy and safety of supplemental melatonin for delayed sleep-wake phase disorder in children: an overview. Sleep Medicine: X. 2020 Dec;2:100022.
9. Casey BJ, Jones RM, Hare TA. The adolescent brain. Ann N Y Acad Sci. 2008 Mar;1124:111–26.
10. Blakemore S-J, Mills KL. Is adolescence a sensitive period for sociocultural processing? Annu Rev Psychol. 2014;65:187–207.
11. Cespedes Feliciano EM, Rifas-Shiman SL, Quante M, Redline S, Oken E, Taveras EM. Chronotype, social jet lag, and cardiometabolic risk factors in early adolescence. JAMA Pediatr. 2019 Nov 1;173(11):1049–57.
12. Sun S, Yang Y, Yu F, He Y, Luo C, Zhang M, et al. Social jetlag and depressive symptoms among young people: a systematic review and meta-analysis. BMC Psychiatry. 2025 Jul 1;25(1):664.
13. Jankovic N, Schmitting S, Krüger B, Nöthlings U, Buyken A, Alexy U. Changes in chronotype and social jetlag during adolescence and their association with concurrent changes in BMI-SDS and body composition, in the DONALD Study. Eur J Clin Nutr. 2022 May;76(5):765–71.
14. Marino C, Andrade B, Campisi SC, Wong M, Zhao H, Jing X, et al. Association Between Disturbed Sleep and Depression in Children and Youths: A Systematic Review and Meta-analysis of Cohort Studies. JAMA Netw Open. 2021 Mar 1;4(3):e212373.
15. Teresi GI, Davis M, Williamson AA, Young JF, Merranko JA, Goldstein TR. Sleep disturbances are associated with depressive symptoms and suicidality among adolescents in pediatric primary care. JAACAP Open. 2025 Sep;3(3):589–600.
16. Do MTH, Yau K-W. Intrinsically photosensitive retinal ganglion cells. Physiol Rev. 2010 Oct;90(4):1547–81.
17. Do MTH. Melanopsin and the intrinsically photosensitive retinal ganglion cells: biophysics to behavior. Neuron. 2019 Oct 23;104(2):205–26.
18. Tähkämö L, Partonen T, Pesonen A-K. Systematic review of light exposure impact on human circadian rhythm. Chronobiol Int. 2019 Feb;36(2):151–70.
19. Chang A-M, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci USA. 2015 Jan 27;112(4):1232–7.
20. Höhn C, Hahn MA, Gruber G, Pletzer B, Cajochen C, Hoedlmoser K. Effects of evening smartphone use on sleep and declarative memory consolidation in male adolescents and young adults. Brain Commun. 2024 May 17;6(3):fcae173.
21. Ricketts EJ, Joyce DS, Rissman AJ, Burgess HJ, Colwell CS, Lack LC, et al. Electric lighting, adolescent sleep and circadian outcomes, and recommendations for improving light health. Sleep Med Rev. 2022 Aug 12;64:101667.
22. Nagare R, Rea MS, Plitnick B, Figueiro MG. Nocturnal melatonin suppression by adolescents and adults for different levels, spectra, and durations of light exposure. J Biol Rhythms. 2019 Apr;34(2):178–94.
23. Uccella S, Cordani R, Salfi F, Gorgoni M, Scarpelli S, Gemignani A, et al. Sleep deprivation and insomnia in adolescence: implications for mental health. Brain Sci. 2023 Mar 28;13(4).
24. Bautista J, Hidalgo-Tinoco C, Di Capua Delgado M, Viteri-Recalde J, Guerra-Guerrero A, López-Cortés A. The gut-brain-circadian axis in anxiety and depression: a critical review. Front Psychiatry. 2025 Oct 30;16:1697200.
25. Blume C, Garbazza C, Spitschan M. Effects of light on human circadian rhythms, sleep and mood. Somnologie (Berl). 2019 Sep;23(3):147–56.
26. Zeng Y, Rong R, You M, Zhu P, Zhang J, Xia X. Light-eye-body axis: exploring the network from retinal illumination to systemic regulation. Theranostics. 2025 Jan 2;15(4):1496–523.
27. Mohd Saat NZ, Hanawi SA, Hanafiah H, Ahmad M, Farah NMF, Abdul Rahman NAA. Relationship of screen time with anxiety, depression, and sleep quality among adolescents: a cross-sectional study. Front Public Health. 2024 Nov 29;12:1459952.
28. McClung CA. Circadian genes, rhythms and the biology of mood disorders. Pharmacol Ther. 2007 May;114(2):222–32.
29. Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep: effects on autonomic function, neuroendocrine stress systems and stress responsivity. Sleep Med Rev. 2008 Jun;12(3):197–210.
30. Luna B, Padmanabhan A, O’Hearn K. What has fMRI told us about the development of cognitive control through adolescence? Brain Cogn. 2010 Feb;72(1):101–13.
31. Chai R, Bian W-J. Adolescent sleep and its disruption in depression and anxiety. Front Neurosci. 2024 Nov 7;18:1479420.
32. Wang M, Chen Z, Han N, Yao H. Sleep duration and subject-specific academic performance among adolescents in China. NPJ Sci Learn. 2025 Sep 30;10(1):71.
33. Ma Q, Sahakian BJ, Zhang B, Li Z, Yu J-T, Li F, et al. Neural correlates of device-based sleep characteristics in adolescents. Cell Rep. 2025 May 27;44(5):115565.
34. Grzelak A. Managing blue light exposure: impacts on sleep quality and circadian health. QS. 2024 Dec 27;25:56741.
35. Więsyk PJ, Urbańska K, Wójcik P, Jasiński K, Wojdat A. Blue light and visual health: mechanisms, risks, and protective strategies. QS. 2024 Oct 30;30:55218.
36. Maeda-Nishino NJ, Yoshimoto R, Ono T, Chiba S, Nishino S. Partial blue light blocking glasses at night advanced sleep phase and reduced daytime irritability, disruptive behavior and improved morning mood, but did not alter salivary melatonin secretion in Japanese male schoolchildren. PLoS ONE. 2025 Oct 30;20(10):e0332877.
37. Luna-Rangel FA, Gonzalez-Bedolla B, Salazar-Ortega MJ, Torres-Mancilla XM, Martinez-Cadena S. Efficacy of blue-light blocking glasses on actigraphic sleep outcomes: a systematic review and meta-analysis of randomized controlled crossover trials. Front Neurol. 2025 Nov 18;16:1699303.
38. Singh S, Keller PR, Busija L, McMillan P, Makrai E, Lawrenson JG, et al. Blue-light filtering spectacle lenses for visual performance, sleep, and macular health in adults. Cochrane Database Syst Rev. 2023 Aug 18;8(8):CD013244.
39. Thacher PV, Onyper SV. Longitudinal outcomes of start time delay on sleep, behavior, and achievement in high school. Sleep. 2016 Feb 1;39(2):271–81.
40. Sadikova E, Widome R, Robinson E, Aris IM, Tiemeier H. Delaying high school start times impacts depressed mood among students: evidence from a natural experiment. Soc Psychiatry Psychiatr Epidemiol. 2024 Nov;59(11):2073–82.
41. Lin C-Y, Strong C, Scott AJ, Broström A, Pakpour AH, Webb TL. A cluster randomized controlled trial of a theory-based sleep hygiene intervention for adolescents. Sleep. 2018 Nov 1;41(11).
42. Kira G, Maddison R, Hull M, Blunden S, Olds T. Sleep education improves the sleep duration of adolescents: a randomized controlled pilot study. J Clin Sleep Med. 2014 Jul 15;10(7):787–92.
43. Forest G, Gaudreault P, Michaud F, Green-Demers I. Gender differences in the interference of sleep difficulties and daytime sleepiness on school and social activities in adolescents. Sleep Med. 2022 Dec;100:79–84.
44. Li SH, Graham BM, Werner-Seidler A. Gender Differences in Adolescent Sleep Disturbance and Treatment Response to Smartphone App-Delivered Cognitive Behavioral Therapy for Insomnia: Exploratory Study. JMIR Formativ Res. 2021 Mar 23;5(3):e22498.
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