Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder

J Am Acad Child Adolesc Psychiatry. 2014 May;53(5):550-8. doi: 10.1016/j.jaac.2013.12.029. Epub 2014 Feb 20.

Abstract

Objective: We tested whether sleep problems co-occur with, precede, and/or follow common psychiatric disorders during childhood and adolescence. We also clarified the role of comorbidity and tested for specificity of associations among sleep problems and psychiatric disorders.

Method: Data came from the Great Smoky Mountains Study, a representative population sample of 1,420 children, assessed 4 to 7 times per person between ages 9 and 16 years for major Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) disorders and sleep problems. Sleep-related symptoms were removed from diagnostic criteria when applicable.

Results: Sleep problems during childhood and adolescence were common, with restless sleep and difficulty falling asleep being the most common symptoms. Cross-sectional analyses showed that sleep problems co-occurred with many psychiatric disorders. Longitudinal analyses revealed that sleep problems predicted increases in the prevalence of later generalized anxiety disorder (GAD) and high GAD/depression symptoms, and oppositional defiant disorder (ODD). In turn, GAD and/or depression and ODD predicted increases in sleep problems over time.

Conclusions: Sleep problems both predict and are predicted by a diagnostic cluster that includes ODD, GAD, and depression. Screening children for sleep problems could offer promising opportunities for reducing the burden of mental illness during the early life course.

Keywords: GAD; ODD; adolescence; depression; sleep problems.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Attention Deficit and Disruptive Behavior Disorders / diagnosis*
  • Attention Deficit and Disruptive Behavior Disorders / epidemiology*
  • Attention Deficit and Disruptive Behavior Disorders / psychology
  • Checklist / statistics & numerical data
  • Child
  • Comorbidity
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Female
  • Health Surveys
  • Humans
  • Longitudinal Studies
  • Male
  • Psychometrics
  • Sleep Wake Disorders / diagnosis*
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / psychology
  • Statistics as Topic
  • United States