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.

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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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    • "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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