Addressing Sleep in Children with Anxiety Disorders

Cowie, Jennifer; Alfano, Candice A.; Patriquin, Michelle A.; Reynolds, Katharine C.; Talavera, David C.; Clementi, Michelle A.

doi:10.1016/j.jsmc.2014.02.001

Cited by 17 publications

(14 citation statements)

References 93 publications

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“…A number of studies document robust and consistent subjective sleep complaints in as many as 90% of youth with anxiety, particularly as reported by parents [for recent reviews, 6+, 7]. These complaints include bedtime resistance, problems initiating/maintaining sleep, and feeling rested upon waking.…”

Section: Characterizing the Nature Of Sleep Disturbance In Youth Withmentioning

confidence: 99%

“…Accordingly, although several recent studies have taken care to examine sleep among youth falling into different diagnostic categories[7, 21–23], it may be even more critical to focus on discrete dimensions of anxiety that relate to particular forms of sleep disruption. There were several examples in the literature this year [24–26].…”

Section: Characterizing the Nature Of Sleep Disturbance In Youth Withmentioning

confidence: 99%

“…In general, recent reviews suggest that evidence is mixed for a bidirectional association between sleep and anxiety, with more robust evidence supporting early sleep problems as a precursor to anxiety in childhood and adolescence [6+, 7, 28++, 29++]. Key issues that may ultimately resolve inconsistencies are reflected in recent studies.…”

Section: Prospective Associations Between Sleep and Anxiety In Youthmentioning

confidence: 99%

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Sleep and anxiety in late childhood and early adolescence

McMakin

Alfano

2015

Current Opinion in Psychiatry

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181

118

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Purpose of review Adolescence is a period of dynamic change in both sleep and emotional systems, with related increases in problems controlling emotion and behavior. Youth with anxiety enter adolescence with pre-existing vulnerabilities in systems of sleep and emotion that may place them at heightened risk. This review summarizes recent research on sleep and anxiety during the transition to adolescence, and highlights emerging themes. Recent findings Prospective studies support that sleep predicts anxiety symptoms in early adolescence. Notably, robust evidence for subjective sleep problems in anxious youth is not well-corroborated by objective assessments. Longitudinal designs and methodology that carefully examine dimensions of anxiety and sleep may clarify inconsistencies. Preliminary evidence suggests that late childhood to early adolescence may be a sensitive period for escalating problems with sleep and anxiety. Recent advances in the neuroscience of sleep can further refine integrative mechanistic models of developmental psychopathology—the role of sleep in emotional learning and memory is provided as an example. Summary Sleep problems are common and prospectively predict escalating anxiety symptoms. Precision is needed regarding the nature of sleep disruption, and how and when sleep impacts various aspects of developmental trajectories. This precision, along with advances in the neuroscience of sleep, may lead to developmentally-informed translational interventions.

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Section: Characterizing the Nature Of Sleep Disturbance In Youth Withmentioning

confidence: 99%

Section: Characterizing the Nature Of Sleep Disturbance In Youth Withmentioning

confidence: 99%

Section: Prospective Associations Between Sleep and Anxiety In Youthmentioning

confidence: 99%

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Sleep and anxiety in late childhood and early adolescence

McMakin

Alfano

2015

Current Opinion in Psychiatry

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181

118

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“…Despite high rates of sleep complaints, little is known about the actual sleep patterns of anxiety-disordered children (Cowie et al 2014), even though such data might directly inform sleep intervention approaches. In the only study to examine sleep diary data collected over 1 week, children with anxiety disorders had later bedtimes (by approximately 20 min) and shorter sleep duration (by 30 min) on weekdays than healthy controls (Hudson et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Subjective – Objective Sleep Comparisons and Discrepancies Among Clinically-Anxious and Healthy Children

Alfano

Patriquin

Reyes

2015

J Abnorm Child Psychol

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We compared subjective and objective sleep patterns and problems, and examined cross-method correspondence across parent reports, child reports, and actigraphy-derived sleep variables in clinically-anxious children and healthy controls. In a multi-site, cross-sectional study, 75 pre-adolescent children (6 to 11 years; M = 8.7 years; SD = 1.4; n = 39/52 % female) were examined including 39 with a diagnosis of primary generalized anxiety disorder (GAD) and 36 controls recruited from university-based clinics in Houston, TX and Washington, DC. Structured interviews, validated sleep questionnaires, and 1 week of actigraphy data were utilized. Despite subjective reports of significantly greater sleep problems among anxious children, actigraphy data revealed no significant differences between the groups. All parents estimated earlier bedtimes and greater total sleep duration relative to actigraphy, and all children endorsed more sleep problems than parents. With few exceptions, subjective reports exhibited low and non-significant correspondence with actigraphy-based sleep patterns and problems. Our findings suggest that high rates of sleep complaints found among children with GAD (and their parents) are not corroborated by objective sleep abnormalities, with the exception of marginally prolonged sleep onset latency compared to controls. Objective-subjective sleep discrepancies were observed in both groups but more apparent overall in the GAD group. Frequent complaints of sleep problems and daytime tiredness among anxious youth might more accurately reflect difficulties prior to the actual sleep period, cognitive-affective biases associated with sleep, and/or poor sleep quality. Findings highlight the importance of considering sleep from multiple perspectives.

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“…The composite relationship between sleep and psychological disorder, such as anxiety and depression in adolescents, has attracted much attention over time [10,35]. Although there has been mixed evidence regarding the bidirectional relationship between sleep and anxiety disorder [10], evidence supporting early sleep problems as a precursor to anxiety in adolescence is receiving a lot of attention [36][37][38]. Regulation of mood and emotion is contingent on adequate sleep.…”

Section: Discussionmentioning

confidence: 99%

Psychological distress, drug use, and internet use: the association with poor sleep quality in a sample of secondary school students

Olashore

Akanni

Ayilara

2020

Preprint

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BackgroundSleep problems are common among children and adolescents. Sleep quality plays a significant role in adolescents’ mental health. The study aimed to determine the prevalence of poor sleep quality (PSQ) among secondary school students, identify sociodemographic factors associated with PSQ in this group, and to examine the independent associations of psychological distress, stimulant use and internet use with PSQ.MethodsData were collected from 420 secondary school students from four different schools who were selected using a mixture of convenience and random sampling. A set of questionnaires was administered to collect data, and it consisted of 5 sections measuring: the sociodemographic, drug use, psychological distress, internet use, and sleep qualityResultsA total of 378 questionnaires were analyzed. The prevalence of those with PSQ was 12.2%. A logistic regression model showed that anxiety (AOR=1.20, 95%CI:1.10-1.32), depression (AOR=1.12, 95%CI:1.00-1.25), and internet use (AOR=1.02, 95%CI:1.00-1.03) were significantly associated with PSQ.ConclusionsPSQ commonly exists among students and has a relationship with their psychological state and potentially addictive behavior, such as internet use. A bi-directional evaluation of PSQ as a cause and, or effect of psychological and addictive problems, was further recommended.

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Addressing Sleep in Children with Anxiety Disorders

Cited by 17 publications

References 93 publications

Sleep and anxiety in late childhood and early adolescence

Sleep and anxiety in late childhood and early adolescence

Subjective – Objective Sleep Comparisons and Discrepancies Among Clinically-Anxious and Healthy Children

Psychological distress, drug use, and internet use: the association with poor sleep quality in a sample of secondary school students

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