Sleep problems linked to mental health, behavior in late childhood, early adolescence

Key takeaways:

• Sleep issues in children were associated with behavioral and emotional problems in late childhood and early adolescence.
• The findings highlight the importance of identifying sleep issues in children.

Sleep problems in children were associated with psychopathological symptoms such as emotional and behavioral issues during childhood and into adolescence, according to a study published in JAMA Psychiatry.

Rebecca Cooper, MPO, a PhD candidate at the Melbourne Neuropsychiatry Centre at The University of Melbourne and Melbourne Health in Australia, and colleagues analyzed data collected from participants in the Adolescent Brain Cognitive Development study from September 2016 to January 2020. ABCD participants were aged 9 to 11 years at baseline and aged 11 to 13 years when they completed follow-up 2 years later.

To assess sleep, the caregiver of each participant completed the Sleep Disturbance Scale for Children (SDSC) while thinking of their child’s symptoms over the past 6 months. The SDSC specifically evaluated problems such as sleepwalking and nightmares, sleep hyperhidrosis, sleep breathing disorders and sleep onset and maintenance. Caregivers also completed the Child Behavior Checklist (CBCL), which evaluated internalized psychopathology symptoms such as depression, anxiety and somatic complaints, as well as externalized symptoms such as rule-breaking and aggressive behavior.

Among 10,313 participants, most were boys (52.4%) and white (54%).

SDSC scores were used to create four sleep profiles, which included low disturbance, sleep onset/maintenance problems, mixed disturbance and high disturbance. At baseline, the proportions of participants categorized to each profile were 25.2%, 16%, 42.3% and 16.5%, respectively. At follow-up, the proportions were 30.3%, 32.6%, 22.1% and 15%, respectively.

All sleep profiles except low disturbance were associated with greater risks for concurrent internalizing symptoms. Specifically, risk was highest with high disturbance (OR = 1.44; 95% CI, 1.4-1.49), followed by sleep onset/maintenance problems (OR = 1.3; 95% CI, 1.25-1.35) and mixed disturbance (OR = 1.29; 95% CI, 1.25-1.33).

Associations between sleep profiles and externalizing symptoms were similar, with the greatest risk for externalizing symptoms among participants with a high disturbance profile (OR = 1.24; 95% CI, 1.21-1.28), followed by sleep onset/maintenance problems (OR = 1.2; 95% CI, 1.16-1.23) and mixed disturbance (OR = 1.17; 95% CI, 1.14-1.2).

“Our findings emphasize the need for early identification and treatment of sleep problems in childhood to ameliorate or potentially prevent mental health difficulties in early adolescence,” Cooper and colleagues wrote. “Follow-up of individuals in each of the sleep profiles will elucidate the developmental trajectory of different sleep problems into mid- and late adolescence and their prospective association with later mental health outcomes.”