Infants with persistent sleep difficulties at increased risk for childhood anxieties, emotional disorders

Fallon Cook

Persistent sleep difficulties during the first year of life appeared associated with heightened risk for developing childhood anxieties and emotional disorders at age 10 years, according to results of a longitudinal study conducted in Australia and published in Archives of Disease in Childhood.

“Sleep problems during infancy are very common, impacting around 80% of all babies and their parents at some point during the first year,” Fallon Cook, PhD, research officer at Murdoch Children’s Research Institute, told Healio Psychiatry. “Our findings highlight the need for timely, accessible, evidence-based treatment and support for infant sleep problems.”

The investigators noted that high-quality research regarding the association between poor sleep in infancy and poorer mental health during childhood is sparse. To determine whether this association exists, they analyzed infant sleep data of 1,460 mother-infant dyads from the Maternal Health Study, a prospective longitudinal community cohort study. Questionnaire/interview data were available for 15 weeks’ gestation; 3, 6, 9 and 12 months postpartum; and when children turned 4 and 10 years old. Mothers reported infant night waking and sleep problems and child mental health via the Strengths and Difficulties Questionnaire, Spence Children’s Anxiety Scale and Development and Well-being Assessment.

Cook and colleagues reported persistent severe sleep problems among 283 (19.4%) of the infants. Moreover, 817 (56%) had moderate/fluctuating sleep problems and 360 (24.7%) were settled. Those with persistent severe sleep problems were more likely to experience emotional symptoms at age 4 years (adjusted OR [aOR] = 2.7; 95% CI, 1.21-6.05) and meet diagnostic criteria for an emotional disorder at age 10 years (aOR = 2.37; 95% CI, 1.05-5.36). They also experienced elevated symptoms of separation anxiety (aOR = 2.44; 95% CI, 1.35-4.41), fear of physical injury (aOR = 2.14; 95% CI, 1.09-4.18) and overall elevated anxiety (aOR = 2.2; 95% CI, 1.13-4.29) at age 10 years.

“We were surprised that infant sleep was associated with anxiety problems 10 years later,” Cook told Healio Psychiatry. “Clinicians should monitor infants with persistent and severe sleep difficulties for emerging mental health problems and ensure families receive support and treatment for infant sleep problems. We look forward to carrying out more longitudinal research to examine other factors that might influence the development of mental health issues in childhood, and we hope to develop and test new early interventions and support options for parents.” – by Joe Gramigna

Disclosures: Cook reports holding a life course postdoctoral fellowship supported by the Royal Children’s Hospital Research Foundation. Please see the study for all other authors’ relevant financial disclosures.