Prospective Longitudinal Associations Between Persistent Sleep Problems in Childhood and Anxiety and Depression Disorders in Adulthood

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.

Prior sleep problems predict internalising problems later in life

“…As in many epidemiological studies, our measure of sleep was based on a single CBCL sleep item, which is well correlated with sleep latency assessed by diary and actigraphic measures (Gregory et al, 2011). As others (Gregory et al, 2005;Gregory et al, 2008), we used parental perceptions of sleep problems, which could be different from polysomnographic sleep problems. In addition, we used ASEBA scores to assess psychological difficulties, which are less specific than psychiatric diagnoses.…”

“…Although sleep problems are sometimes considered a sign of anxiety and depression (Ostberg & Hagelin, 2011), research shows that they often precede the occurrence of other manifestations of psychological difficulties (such as excessive worry, unexplained somatic symptoms, sadness or social withdrawal). Sleep problems are associated with increased risk of internalising symptoms (particularly anxiety) in toddlers (Jansen et al, 2011), children (Pesonen et al, 2010), adolescents (Gregory & O'Connor, 2002), and adults (Gregory et al, 2005). For instance, a longitudinal study which followed 4-19 year olds over a period of 14 years, found that various types of sleep problems, as reported by the parents using the Child Behavioural Checklist (CBCL) (e.g., "decreased sleep", "overtiredness", and "trouble sleeping") predicted later depression and anxiety (Gregory et al, 2008).…”

Advancing a Biopsychosocial and Contextual Model of Sleep in Adolescence: A Review and Introduction to the Special Issue

“…In contrast, a reciprocal association was found between generalized anxiety and sleep problems: generalized anxiety predicted later sleep problems and sleep problems likewise predicted later generalized anxiety, leading the authors to conclude that ''generalized anxiety appeared to be the 'necessary ingredient' for longitudinal associations between internalizing distress disorders and sleep disturbance'' (Shanahan et al 2014, p. 555). Likewise, after controlling for internalizing symptoms in childhood, Gregory et al (2005) found persistent sleep problems in childhood to predict a diagnosis of anxiety but not depression in young adulthood. Armstrong et al (2014) similarly found in a 14-year prospective study that persistent parent-reported insomnia in childhood predicted selfreported anxiety symptoms but not depression in adolescence.…”

Sleep in Childhood and Adolescence: Age-Specific Sleep Characteristics, Common Sleep Disturbances and Associated Difficulties

“…although not all studies are consistent (Johnson et al 2000;Gregory et al 2005a). One study which demonstrated that sleep disturbances predicted later depressive symptoms at one year follow--up in a sample of adolescents, and that this association was partially mediated by catastrophic worry (Danielsson et al 2012).…”