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Children with prolonged sleep latency are at increased risk for symptoms of depression, attention-deficit/hyperactivity disorder (ADHD), conduct issues, and oppositional behavior in adolescence, according to findings from a longitudinal study published in Sleep Advances.
Childhood sleep problems are relatively common, such as trouble falling asleep and frequent night wakings. Previous research has found that sleep problems early in development can often either co-occur or precede mental health problems and disorders such as anxiety, depression, and ADHD. However, relatively little is known about the relationship between childhood sleep issues and externalizing problems or other mental health disorders. To this aim, investigators used data from the Quebec Longitudinal Study of Child Development to assess the association between childhood sleep trajectories and adolescent mental health symptoms.
All participants were recruited using the Quebec Master Birth Registry and the first data collection began when children were 5 months of age (n=2120). Once participants reached 15 years of age, adolescents completed a self-reported questionnaire (n=1446) evaluating internalizing problems (social phobia, generalized anxiety, and depression), and externalizing problems (ADHD, conduct disorder, and oppositional defiant disorder) over the past year. Additionally, childhood sleep dimensions were measured using maternal reports at 2.5, 3.5, 4, 6, 8, 10, and 12 years of age. The measures evaluated nighttime sleep duration, sleep latency, and wakefulness after sleep onset.
Of the 2120 children who participated in initial data collection, 51.2% were boys. The investigators used Bayesian Information Criterion and Akaike Information Criterion to categorize children into sleep trajectories. For sleep duration, 7.5% of children displayed a short pattern, 5.8% had a short-increasing pattern, 50.7% had a 10-hour pattern, and 36% had an 11-hour pattern. For childhood sleep latency, 3 trajectories were observed: short pattern (31.7%), intermediate pattern (59.9%), and long pattern (8.4%). Additionally, the investigators identified 2 trajectories of wakefulness after sleep onset – a normative pattern (73%) and a long pattern (27%).
“This could lead to better promote preventive sleep interventions during childhood in order to reduce the risk of developing mental health problems in adolescence.
In a path analysis examining adolescent mental health outcomes at 15 years of age, participants with a long childhood sleep latency trajectory had a higher likelihood of experiencing symptoms of depression (β=0.06; 95% CI, 0.01-0.12; P = .02), ADHD (β=0.07; 95% CI, 0.02-0.13; P = .01), conduct problems (β=0.05; 95% CI, 0.00-0.10; P = .05), and opposition (β=0.08; 95% CI, 0.02-0.13; P = .01) in adolescence.
Conversely, symptoms of opposition at 15 years of age were significantly less likely among those who had short sleep duration (β= -0.08; 95% CI, -0.14 to -0.03; P = .003) and long wakefulness after sleep onset (β= -0.06; 95% CI, -0.11 to -0.03; P = .04) during childhood. Further, long wakefulness after sleep onset during childhood was associated with fewer conduct problems (β= -0.06; 95% CI, -0.11 to -0.01; P = .03) during adolescence.
These findings indicate that a long childhood sleep latency is associated with an increased risk for mental health problems during adolescence. “This could lead to better promote preventive sleep interventions during childhood in order to reduce the risk of developing mental health problems in adolescence,” the investigators concluded.
Study limitations include the potential overestimation of nighttime sleep duration due to reliance on maternal reports, a lack of assessment of pubertal status, and the reliance on self-reported mental health data.
Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
This article originally appeared on Psychiatry Advisor