Longitudinal Relationship Between Mental Health Symptoms and Sleep Disturbances and Duration in Maltreated and Comparison Adolescents

Purpose: To examine the longitudinal relationships between mental health symptoms and sleep for male and female maltreated and comparison adolescents.

Methods: Participants were from a longitudinal study of child maltreatment (maltreated n = 247; comparison n = 138). The current analyses used data from Time 3 (T3; average age 13.7 years) and Time 4 (T4; average age 18.2 years). Path models tested cross-lagged effects between mental health symptoms (depression and Post Traumatic Stress Disorder [PTSD]) and sleep (disturbances and duration) and main effects of maltreatment on Time 4 variables, stratified by sex.

Results: Reciprocal relationships between depressive and PTSD symptoms and sleep disturbances were found only for females. Specifically, depressive and PTSD symptoms at T3 predicted sleep disturbances at T4 and sleep disturbances at T3 also predicted depressive and PTSD symptoms at T4. Regarding sleep duration, PTSD symptoms at T3 predicted shorter sleep duration at T4 among females but not for males. There was no effect of maltreatment status on mental health symptoms or sleep disturbance, but maltreated adolescents reported longer sleep duration at T4 than comparison adolescents.

Conclusions: The reciprocal nature of the relationship between mental health symptoms and sleep disturbances in females highlights the need to treat both mental health symptoms as well as sleep problems in female adolescents to improve mental and physical health. The absence of a negative effect of maltreatment on sleep may be due to the fact that the maltreated youth and comparison youth lived in the same low-income urban communities and were exposed to the same nocturnal environmental irritants.