Sleep quality, insomnia, and internalizing difficulties in adolescents: insights from a twin study

Abstract

Study Objectives There is a well-established association between poor sleep quality and internalizing traits. This relationship has previously been studied using a twin design. However, when it comes to adolescence, there is a paucity of twin studies that have investigated this relationship, despite the importance of this developmental stage for both the development of poor sleep quality and internalizing symptoms. Additionally, anxiety sensitivity, which is commonly associated with poor sleep quality, has not been studied in this context. Our objective was to estimate genetic and environmental influences on the relationships between insomnia, poor sleep quality, and internalizing symptoms in adolescence. Methods Insomnia, poor sleep quality, depression, anxiety, and anxiety sensitivity traits were measured in a sample of 5111 twin pairs from the Twins Early Development Study, born between 1994 and 1996 (mean age 16.32 years [SD = 0.68]). Results A moderate proportion of the variance for the different variables (.29–.42) was explained by genetic factors. Associations between sleep and internalizing variables were moderate (r = .34–.46) and there was a large genetic overlap between these variables (rA= .51–.73). Conclusion This study adds novel information by showing that there are large genetic correlations between sleep disturbances and internalizing symptoms in adolescence.

Are adversities and worries during the COVID-19 pandemic related to sleep quality? Longitudinal analyses of 46,000 UK adults

“…Inadequate sleep may also reinforce the impact of stressors by reducing individual's ability to respond effectively, leading to a maladaptive psychophysiological cycle [38][39][40][41]. Impaired sleep is in turn related to worsened physical health outcomes, such as cardiovascular disease, weight gain, and mortality [42,43], and poorer mental health outcomes, such as anxiety and depression [44]. It is therefore essential to understand whether experience of worries about adversities during the COVID-19 are leading to sleep problems.…”

Smartphone-Based Interventions and Internalizing Disorders in Youth: Systematic Review and Meta-analysis

“…Anxiety is one of the most common disorders in young people and is estimated to affect 4% to 20% of children and adolescents [ 7 ], whereas depression is said to affect 2% to 8% of children and adolescents [ 8 ] and is a leading cause of disability globally [ 9 ]. Similarly, stress is often internalized and can significantly impact an individual’s coping abilities, self-esteem, and social relations [ 10 ], whereas insomnia (ie, sleep problems) has a robust relationship with depression [ 11 ] and other internalizing symptoms including anxiety [ 12 ]. Disorders can begin early in childhood and can develop into chronic conditions that negatively impact an individual’s relationships, development, and daily functioning in the near future [ 13 ].…”

Are adversities and worries during the COVID-19 pandemic related to sleep quality? Longitudinal analyses of 48,000 UK adults

“…Numerous biological studies have focused on the pathways underlying these effects, including disruption of HPA axis activity and increased cortisol production, and bidirectional changes between hormonal variation and circadian rhythm 36,37 A. I Inadequate sleep may reinforce the impact of stressors by reducing individual's ability to respond effectively, leading to a maladaptive psychophysiological cycle [38][39][40][41] . Impaired sleep is in turn related to worsened physical health outcomes, such as cardiovascular disease, weight gain, and mortality 42,43 , and mental health outcomes, such as anxiety and depression 44 . It is therefore essential to understand whether experience of worries about adversities during the COVID-19 are leading to sleep problems.…”