An hour less sleep is a risk factor for childhood conduct problems

Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton General Hospital, Highfield, Southampton, UK.
Child Care Health and Development (Impact Factor: 1.69). 07/2011; 37(4):563-70. DOI: 10.1111/j.1365-2214.2010.01203.x
Source: PubMed


There is emerging evidence that sleep problems in childhood may have enduring consequences. Studies using parental and objective sleep measurement suggest that sleep difficulties in children may be associated with behavioural problems. However, the findings using objective sleep measures are inconsistent and it is not clear what aspects of sleep quality are associated with daytime behavioural difficulties. The aim of this paper is to identify which behavioural symptoms are best predicted by actigraphic sleep measures in a general population sample of school-aged children aged 6-11 years.
Actigraphy was used to measure sleep in 91 typically developing children aged 6-11 years for 6 days. Parents completed the Strengths and Difficulties Questionnaire (SDQ). A series of multivariate linear regression models were computed to analyse the effects of sleep on SDQ subscales.
Sleep did not predict emotional symptoms or hyperactivity. After controlling for age and gender, sleep accounted for 18% of the variance in conduct problems. Only actual sleep time in minutes made a significant contribution to the model.
A child who sleeps 1 h less than the average child may be at risk of conduct problems. Clinicians should consider routinely screening for sleep difficulties when assessing children with conduct problems.

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    • "Validation studies using polysomnography have demonstrated high sensitivity (N90%) of actigraphy to detect sleep in healthy adults [19]. A number of studies have used this methodology to measure child sleep [20] [21] [22]. Hence, while there is subjective evidence of sleep disturbance in childhood epilepsy from parental report, to date, objective evidence gathered in the child's natural sleep environment is lacking. "
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    ABSTRACT: Pediatric epilepsy has been reported to be associated with both sleep problems and cognitive deficits. In turn, in healthy children, poorer sleep has been associated with deficits in cognitive functioning. We hypothesized that poor sleep in childhood epilepsy may contribute to cognitive deficits. Using actigraphy, we objectively measured the sleep of children with epilepsy alongside that of healthy controls. In contrast to previous reports, we did not find any differences in objectively measured sleep between children with epilepsy and healthy controls. However, significant deficits in cognitive functioning were demonstrated that were not explained by differences in sleep.
    Epilepsy & Behavior 06/2014; 37C:20-25. DOI:10.1016/j.yebeh.2014.05.022 · 2.26 Impact Factor
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    • "Many clinical studies in adolescents have consistently reported that reduced hours of sleep are associated with emotional problems such as depressive and anxiety symptoms [16] [17], in addition to self-harm and suicidal ideation [18]. Poor sleep also has been correlated with increased aggression, irritability, and hostility in both adults and adolescents; conduct problems and bullying behavior in schoolchildren [19] [20] [21]; and habitual substance use [22], self-injurious behaviors [23], and suicide attempt overall [24] [25] [26]. It has been hypothesized that the relationship between sleep problems and aggression may be mediated by the negative effect of sleep loss on prefrontal cortical functioning, resulting in loss of control over emotions and regulation of aggressive impulses . "
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    ABSTRACT: Objectives Anxiety and concerns in daily life may result in sleep problems and consistent evidence suggests that inadequate sleep has several negative consequences on cognitive performance, physical activity, and health. The aim of our study was to evaluate the association between mean hours of sleep per night, psychologic distress, and behavioral concerns. Methods A cross-sectional analysis of the correlation between the number of hours of sleep per night and the Zung Self-rating Anxiety Scale (Z-SAS), the Paykel suicidal Scale (PSS), and the Strengths and Difficulties Questionnaire (SDQ), was performed on 11,788 pupils (mean age±standard deviation [SD], 14.9±0.9; 55.8% girls) from 11 different European countries enrolled in the SEYLE (Saving and Empowering Young Lives in Europe) project. Results The mean number of reported hours of sleep per night during school days was 7.7 (SD, ±1.3), with moderate differences across countries (r=0.06; P<.001). A reduced number of sleeping hours (less than the average) was more common in girls (β=0.10 controlling for age) and older pupils (β=0.10 controlling for sex). Reduced sleep was found to be associated with increased scores on SDQ subscales of emotional (β=−0.13) and peer-related problems (β=−0.06), conduct (β=−0.07), total SDQ score (β=−0.07), anxiety (Z-SAS scores, β=−10), and suicidal ideation (PSS, β=−0.16). In a multivariate model including all significant variables, older age, emotional and peer-related problems, and suicidal ideation were the variables most strongly associated with reduced sleep hours, though female gender, conduct problems measured by the SDQ, and anxiety only showed modest effects (β=0.03–0.04). Conclusions Our study supports evidence that reduced hours of sleep are associated with potentially severe mental health problems in adolescents. Because sleep problems are common among adolescents partly due to maturational processes and changes in sleep patterns, parents, other adults, and adolescents should pay more attention to their sleep patterns and implement interventions, if needed.
    Sleep Medicine 12/2013; DOI:10.1016/j.sleep.2013.11.780 · 3.15 Impact Factor
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    ABSTRACT: In Australian 0-7-year olds with and without sleep problems, to compare (1) type and costs to government of non-hospital healthcare services and prescription medication in each year of age and (2) the cumulative costs according to persistence of the sleep problem. Cross-sectional and longitudinal data from a longitudinal population study. Data from two cohorts participating in the first two waves of the nationally representative Longitudinal Study of Australian Children. Baby cohort at ages 0-1 and 2-3 (n=5107, 4606) and Kindergarten cohort at ages 4-5 and 6-7 (n=4983, 4460). Federal Government expenditure on healthcare attendances and prescription medication from birth to 8 years, calculated via linkage to Australian Medicare data, were compared according to parent report of child sleep problems at each of the surveys. At both waves and in both cohorts, over 92% of children had both sleep and Medicare data. The average additional healthcare costs for children with sleep problems ranged from $141 (age 5) to $43 (age 7), falling to $98 (age 5) to $18 (age 7) per child per annum once family socioeconomic position, child gender, global health and special healthcare needs were taken into account. This equates to an estimated additional $27.5 million (95% CI $9.2 to $46.8 million) cost to the Australian federal government every year for all children aged between 0 and 7 years. In both cohorts, costs were higher for persistent than transient sleep problems. Higher healthcare costs were sustained by infants and children with sleep problems. This supports ongoing economic evaluations of early prevention and intervention services for sleep problems considering impacts not only on the child and family but also on the healthcare system.
    BMJ Open 05/2013; 3(5). DOI:10.1136/bmjopen-2012-002419 · 2.27 Impact Factor
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