Prospective longitudinal associations between persistent sleep problems in childhood and anxiety and depression disorders in adulthood.

Institute of Psychiatry, King's College London, London, United Kingdom.
Journal of Abnormal Child Psychology (Impact Factor: 3.09). 05/2005; 33(2):157-63. DOI: 10.1007/s10802-005-1824-0
Source: PubMed

ABSTRACT The objective of this study was to examine the associations between persistent childhood sleep problems and adulthood anxiety and depression. Parents of 943 children (52% male) participating in the Dunedin Multidisciplinary Health and Development Study provided information on their children's sleep and internalizing problems at ages 5, 7, and 9 years. When the participants were 21 and 26 years, adult anxiety and depression were diagnosed using a standardized diagnostic interview. After controlling for childhood internalizing problems, sex, and socioeconomic status, persistent sleep problems in childhood predicted adulthood anxiety disorders (OR (95% CI) = 1.60 (1.05-2.45), p = .030) but not depressive disorders (OR (95% CI) = .99 (.63-1.56), p = .959). Persistent sleep problems in childhood may be an early risk indicator of anxiety in adulthood.

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    ABSTRACT: Poor sleep and alterations in the stress-sensitive hypothalamic-pituitary-adrenal (HPA) axis may be mechanisms through which loneliness impacts adolescents' well-being. Few researchers have explored whether daily variation in experiences of social connection predict day-to-day variation in sleep and HPA axis activity among adolescents navigating the college context. Using daily diary reports of social connection, objective measures of sleep (actigraphy), and naturalistic salivary assessment, the present study examined within-person associations between first-year college students' social connection during the day and sleep that night, as well as diurnal cortisol activity the following day. The present study also explored trait-level loneliness as a moderator of these associations after adjusting for baseline loneliness assessed in high school. Seventy-one first-year college students (23 % male; M age = 18.85; 52 % non-Hispanic White) completed daily diary reports, wore a wrist-based accelerometer (actigraph watch), and provided saliva samples five times daily across three consecutive weekdays. The results from hierarchical linear models indicated that within-person increases in daily social connection were significantly associated with longer time spent in bed and more actual time asleep that night only for adolescents high on loneliness. Within-person increases in daily social connection were associated with a greater cortisol awakening response (CAR) the next day, regardless of trait loneliness. These findings illustrate that more daily social connection with others than usual may predict improved sleep quantity for lonely adolescents and a physiological index of anticipating upcoming daily demands (CAR) in general. Future intervention programs might consider including strategies focused on enhancing daily social interactions among adolescents starting college, particularly for lonely adolescents.
    Journal of Youth and Adolescence 12/2014; 44(2). DOI:10.1007/s10964-014-0244-2 · 2.72 Impact Factor
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    ABSTRACT: Parental ratings of poor sleep have been associated with early onset of substance use and substance-related problems during adolescence and young adulthood. Children of alcohol-dependent parents have an increased risk for depression as well as substance-related problems. We conducted the current study to describe sleep-wake patterns in children of alcoholics (COAs) compared to non-alcoholic families (NCOAs), to explore the relationships among sleep assessment methods by groups, and to report rates of agreement between methods by group. We assessed subjective (sleep diaries) and objective (actigraphy-measured) sleep in children with (N=68) and without (N=24) a parental history of alcohol use disorder between 7.2 and 12.9 (mean 10.2 +/-1.2) years of age. Children were instructed to complete the sleep diaries with assistance from parents only if needed. Parents provided descriptions of their child's sleep in a Pediatric Sleep Questionnaire (PSQ). Results showed that COAs reported sleeping slightly less time at night and were more likely to nap during the day. Actigraphy captured fewer hours of sleep and more nighttime motor activity. Sleep diary variables were highly correlated with parent reports on the PSQ, except for bedtimes in some COAs, which were later than parent's estimations. Conclusion: School-aged COAs showed small but significant differences in their sleep characteristics compared to NCOAs. COA self-reported sleep diaries agreed with parental reports, but differed significantly from actigraphy measurements of sleep continuity. Insufficient sleep in COAs may be an additional risk factor as they approach adolescence. Identifying sleep problems early on in life may have important implications for prevention and intervention for mood and substance use disorders. There are a myriad of potential factors that could contribute to the early onset of substance use, including, additive and interactive genetic variations, environmental factors, and childhood psychiatric disorders. Genetic factors account for about 50% of the risk for alcoholism [16]. Children of alcohol-dependent parents have an increased risk for depression as well as substance-related problems [17]. Differences in sleep or circadian rhythms may predispose to early substance use in children deemed at high risk [18], but it is not clear how such differences predispose to the development of substance related symptoms once drinking has begun. Methodological examination of sleep in the pediatric population The use of actigraphy is a method to assess normal and disturbed sleep-wake patterns in children. It is easy to use in the home environment compared to PSG. Actigraphy has been well validated as a way to measure sleep-wake patterns, sleep quality, and quantity in normal healthy children [19,20]. Studies on actigraphy in children (ages ranging from infants to 12 years of age) are typically accompanied by a sleep diary completed by the parent(s) [19,21-24]. High correlations have been found between actigraphy and parent reported sleep start and stop times [24] and with " trouble sleeping " Abbreviations COA: Children of Alcoholic; NCOA: Not a Child of an Alcoholic; SOL: Sleep Onset Latency; WASO: Wake time After Sleep Onset; TST: Total Sleep Time; SE: Sleep Efficiency
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    ABSTRACT: Sleep problems are a common complaint in the majority of people suffering from depression. While sleep complaints were traditionally seen as a symptom of mood disorders, accumulating evidence suggests that in many cases the relationship may be reverse as well. A long list of longitudinal studies shows that sleep complaints often precede the onset of depression and constitute an independent risk factor for the development of the disorder. Additionally, experimental studies in animals show that chronically restricted or disrupted sleep may gradually induce neurobiological changes that are very similar to what has been reported for depressed patients. The mechanisms through which insufficient sleep increases the risk for depression are poorly understood but may include effects of sleep disturbance on neuroendocrine stress systems, serotonergic neurotransmission, and various interacting signaling pathways involved in the regulation of neuronal plasticity and neurogenesis. Because sleep is considered to play a crucial role in regulating neuronal plasticity and synaptic strength, chronically insufficient sleep may contribute to depression through an impairment of these plasticity processes leading to altered connectivity and communication within and between brain regions involved in the regulation of mood.

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