Sleep, emotional and behavioral difficulties in children and adolescents

Department of Psychology, Goldsmiths, University of London, UK.
Sleep Medicine Reviews (Impact Factor: 8.51). 06/2011; 16(2):129-36. DOI: 10.1016/j.smrv.2011.03.007
Source: PubMed


Links between sleep and psychopathology are complex and likely bidirectional. Sleep problems and alteration of normal sleep patterns have been identified in major forms of child psychopathology including anxiety, depression and attention disorders as well as symptoms of difficulties in the full range. This review summarizes some key findings with regard to the links between sleep and associated difficulties in childhood and adolescence. It then proposes a selection of possible mechanisms underlying some of these associations. Suggestions for future research include the need to 1) use multi-methods to assess sleep; 2) measure sleep in large-scale studies; 3) conduct controlled experiments to further establish the effects of sleep variations on emotional and behavioral difficulties; 4) take an interdisciplinary approach to further understand the links between sleep and associated difficulties.

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Available from: Alice M Gregory, Mar 19, 2014
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    • "Since we last collaborated on a review of this topic (Gregory & Sadeh, 2012), there has been a long overdue surge of research interest in this area from those with a diverse array of expertise. This increased interest is clearly justified given that comorbidity is an epidemiological reality, with (as outlined in this review) sleep disturbances characteristic of many psychological disorders during childhood. "
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    ABSTRACT: Background: Hippocrates flagged the value of sleep for good health. Nonetheless, historically, researchers with an interest in developmental psychopathology have largely ignored a possible role for atypical sleep. Recently, however, there has been a surge of interest in this area, perhaps reflecting increased evidence that disturbed or insufficient sleep can result in poor functioning in numerous domains. Aims and scope: This review outlines what is known about sleep in the psychiatric diagnoses most relevant to children and for which associations with sleep are beginning to be understood. While based on a comprehensive survey of the literature, the focus of the current review is on the latest science (largely from 2010). There is a description of both concurrent and longitudinal links as well as possible mechanisms underlying associations. Preliminary treatment research is also considered which suggests that treating sleep difficulties may result in improvements in behavioural areas beyond sleep quality. Findings and conclusion: To maximise progress in this field, there now needs to be: (a) greater attention to the assessment of sleep in children; (b) sleep research on a wider range of psychiatric disorders; (c) a greater focus on and examination of mechanisms underlying associations; (d) a clearer consideration of developmental questions and (e) large-scale well-designed treatment studies. While sleep problems may sometimes be missed by parents and healthcare providers; hence constituting a hidden risk for other psychopathologies - knowing about these difficulties creates unique opportunities. The current excitement in this field from experts in diverse areas including developmental psychology, clinical psychology, genetics and neuropsychology should make these opportunities a reality.
    Journal of Child Psychology and Psychiatry 09/2015; DOI:10.1111/jcpp.12469 · 6.46 Impact Factor
    • "Continued sleep problems are associated with psychiatric disorders (Chorney, Detweiler, Morris, & Kuhn, 2008; Gregory & Sadeh, 2012; Ivanenko & Johnson, 2008). In anxiety disorders and depression , sleep problems are especially common (Alfano, Beidel, Turner, & Lewin, 2006; Alfano, Ginsburg, & Kingery, 2007; Charuvastra & Cloitre, 2009; Chase & Pincus, 2011; Hudson, Gradisar, Gamble, "
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    ABSTRACT: Objectives To investigate the presence of sleep problems and their reaction to CBT in pediatric obsessive compulsive disorder (OCD). Moreover, we investigated whether sleep problems predict the outcome of CBT on OCD-symptoms. Methods 269 children and adolescents, age 7–17 years, with DSM-IV primary OCD that took part in the first step of a stepwise treatment trial, were assessed with regard to both individual sleep problems and a sleep composite score (SCS) using the Child Behavior Checklist (CBCL). Their OCD symptoms were rated using the Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Results We found elevated symptoms of sleep deprivation and nightmares before treatment. However most sleep problems (e.g. nightmares (p = .03), too little sleep (p < .001), trouble sleeping (p < .001) and parasomnias p = .03)) as well as being over-tired (p < .001) reduced during CBT treatment. Co-morbidities had no effect on the reduction of SCS. Moreover, elevated levels of sleep problems using the SCS (p < .001), as well as any sleep problem at baseline (p < .001) predicted less effect of CBT on the OCD symptoms. Conclusion Sleep problems in paediatric OCD are frequent and interfere with treatment outcome. They need to be assessed using better methods in future trials. Moreover, lack of resolution of sleep problems need to be recognized and treated as it seems probable that continued sleep problems may have a negative impact on CBT efficacy.
    Journal of Anxiety Disorders 03/2015; 30(2):28-33. DOI:10.1016/j.janxdis.2014.12.009 · 2.96 Impact Factor
    • "Sleep has also been shown to significantly affect a child's resilience , that is, the ability to recover normal functioning following stressful situations. The greater the sleep disturbance, the more resilience was reduced and increased problematic behaviour (both internalising and externalising), depression and anxiety were noted [9]. Therefore, maintaining a normal sleep pattern in situations of stress, such as those associated with cancer is of vital importance for improving a child's long-term QOL. "
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    ABSTRACT: Cancer in children has detrimental effects on sleep patterns and sleep quality, which in turn impacts on the perception of, and the ability to cope with, the emotional and physical challenges associated with both the disease and its treatment. This places an added burden on their quality of life that can last many years beyond diagnosis and treatment. In addition to the effect of the cancer itself, surgery, chemotherapy and radiotherapy can all contribute both short and long term to sleep disruption. Sleep disorders have also been associated with pain, fatigue, medication and hospitalisation in children suffering from cancer. This review will explore the relationship between childhood cancer and associated sleep disorders, in the acute stage of diagnosis, during treatment and in the years following. We will discuss the possible causes and the current treatment modalities used to treat sleep disorders in children with cancer, and in childhood cancer survivors. It has been estimated that the recent advances in treatment have improved the overall five year survival rate for all childhood cancers to over 80%, with some cancers achieving a near 100% cure rate such as early stage Wilms' tumour. Thus, recognition and appropriate treatment of associated sleep disorders is essential to optimise long term quality of life. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Sleep Medicine Reviews 01/2015; 24C:71-82. DOI:10.1016/j.smrv.2015.01.001 · 8.51 Impact Factor
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