The direction of longitudinal associations between sleep problems and depression symptoms: A study of twins aged 8 and 10 years

I2lnstitute ofPsychiatry, King's College London, London, UK.
Sleep (Impact Factor: 4.59). 03/2009; 32(2):189-99.
Source: PubMed


To establish the direction and etiology of longitudinal associations between sleep problems and depression symptoms in children.
Data on twins aged 8 and 10 years were obtained. At assessments, parents completed the Child Sleep Habits Questionnaire, and twins completed the Children's Depression Inventory.
Participants were mainly interviewed at the Institute of Psychiatry, London.
Three hundred twin pairs initially enrolled in the study.
A genetically informative cross-lagged model examined links between sleep and depression. Sleep problems at age 8 predicted depression at age 10 (partial regression coefficient [95% confidence intervals] = 0.10 [0.01-0.18]). The converse was not found. Stability of sleep problems across time was mainly due to genes (46% of the genetic influence on sleep at 10 was due to the same genetic influence on sleep aged 8). Stability of depression was mainly due to non-shared environmental influences (19% of the nonshared environmental influence on depression at 10 was due to the same nonshared environmental influence on depression at age 8). The cross-lagged association between sleep problems at 8 and depression at 10 years was largely due to genes, although this finding was nonsignificant.
This study adds to our understanding of the temporal precedence of sleep problems and depression and the risks underlying their associations. There are implications regarding the value of specifying genes linked to sleep problems and potential opportunities for informing early intervention strategies in high-risk groups at key points in the progression to developing more serious problems.


Available from: Alice M Gregory
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    • "The reverse pattern was not significant (substance use, internalizing and externalizing problems at wave 1 predicting sleep problems at wave 2), except for alcohol use, which negatively predicted sleep problems at wave 2. This is in line with previous longitudinal research, indicating that childhood sleep problems predicted onset of alcohol, cigarette and marijuana use, and internalizing and externalizing problems in adolescents (e.g., Wong et al. 2009). In addition, it has been shown that sleep problems at age 8 predicted depression at age 10, but not the converse (Gregory et al. 2009). Moreover, sleep problems at age 4 predicted depression, anxiety, attention problems and aggression in mid-adolescence, but not the converse (except for attention problems, Gregory and O' Connor 2002). "
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    ABSTRACT: While research has shown that sleep problems and substance use are reciprocally associated in adults, much less is known about this association in early adolescence. The main aim of the current longitudinal study was to explore bidirectional relationships between sleep problems, substance use, internalizing and externalizing problems in young adolescents. A prospective design was used incorporating two waves (approximately 1 year interval). A total of 555 young adolescents (290 females, M age = 13.96) participated in this study. All participants completed self-report measures in classrooms during regular school hours (questionnaires about sleep quality and sleep hygiene were used to measure sleep problems). The results indicated that sleep problems predicted changes in substance use, internalizing and externalizing problems over time, but problem behaviours did not predict changes in sleep problems, adjusted for gender, age and puberty. One exception was that alcohol use negatively predicted changes in sleep problems. This study suggests that sleep problems are important precursors of substance use, internalizing and externalizing problems in adolescence.
    Journal of Youth and Adolescence 11/2014; 44(2). DOI:10.1007/s10964-014-0213-9 · 2.72 Impact Factor
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    • "Although the typical focus has often been on reduced sleep, nonlinear relationships are often found, with additional sleep beyond recommended amounts (i.e., C10 h/night) also being associated with increased health problems, such as depression (Fitzgerald et al. 2011). Although there are bidirectional causal effects at play between sleep duration and adolescent mood disturbances (Gregory and Sadeh 2012), longitudinal studies and experimental studies in which sleep duration is modified show that lack of sleep leads to depression more than the converse (Dewald- Kaufmann et al. 2014; Gregory et al. 2009; Kelly and El- Sheikh 2014). Given the chronic and persistent nature of depression (Judd et al. 1997), better understanding its association with sleep can lead to more effective interventions targeting sleep and help prevent or mitigate depression, as is seen in adults (Manber et al. 2008). "
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    ABSTRACT: Insufficient sleep is a risk factor for depression, suicidality, and substance use, yet little is known about gender, ethnic, and community-level differences in sleep and its associated outcomes, especially during adolescence. Further, much of the prior work has compared groups of teens getting plenty as opposed to insufficient amounts of sleep rather than examine sleep hours continuously. The present study examined adolescent weekday self-reported sleep duration and its links with hopelessness, suicidality, and substance use in a suburban community with very early high school start times. We utilized a large (N = 27,939, 51.2 % female) and ethnically diverse sample of adolescents from the 2009 Fairfax County (Virginia) Youth Survey, an anonymous, self-report, population-level survey administered to all 8th, 10th and 12th grade students in public schools in the county. High-school students reported an average 6.5 h of sleep per school night, with 20 % obtaining ≤5 h, and only 3 % reporting the recommended 9 h/night. Females and minority youth obtained even less sleep on average, and the reduction in sleep in the transition from middle school to high school was more pronounced for females and for Asian students. Hierarchical, multivariate, logistic regression analyses, controlling for background variables, indicated that just 1 h less of weekday sleep was associated with significantly greater odds of feeling hopeless, seriously considering suicide, suicide attempts, and substance use. Relationships between sleep duration and suicidality were stronger for male teens, and sleep duration was more associated with hopelessness for white students compared to most ethnic minority groups. Implications for intervention at multiple levels are discussed.
    Journal of Youth and Adolescence 09/2014; 44(2). DOI:10.1007/s10964-014-0170-3 · 2.72 Impact Factor
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    • "Studies using subjective indicators of sleep and sleep problems are mixed regarding whether poor sleep consistently occurs before anxiety or depressive symptoms, or the reverse. For example, insomnia preceded impaired psychological functioning during adolescence over the course of 1 year (Roberts et al. 2002), self-reported sleep problems at age four predicted depressive and anxiety symptoms at age 15 (Gregory and O'Connor 2002), and sleep problems in childhood predicted depression in pre-adolescence (Gregory et al. 2009). In contrast, a few other studies have shown the reverse, wherein anxiety or depression problems predict subsequent insomnia or other sleep problems (e.g., Johnson et al. 2006). "
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