The Basis Of Sleep Problems
by Peter W. Welty, M.D., F.A.A.P.
September 30, 2002
Sleep problems commonly co-occur with psychiatric problems. Many people, parents and doctors alike, have noticed that sleep problems have been associated with several emotional and behavioral disorders, including anxiety and depression, autism, and Tourette’s disorder. A recent study from the Social, Genetic, and Developmental Psychiatry Research Centre in King’s College, London examined the nature and prevalence of sleep disorders in children and adolescents. This study has since been reported in the August 2002 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.
Specifically, research was studied to determine if sleep problems in childhood were associated with an increase in later psychiatric and behavioral problems. Children were studied and parental reports were obtained to look for sleep problems, and behavioral and emotional problems over an 11 year period. A sample of 490 children, ages 4 to 15 years, was studied.
There can be many different types of sleep problems. For example, a person may go to bed and have trouble falling asleep, called initial insomnia. Others may wake up several times during the night, called middle insomnia. Some people may wake up earlier than usual and not be able to go back to sleep, called terminal insomnia. There also can be nightmares, night terrors, sleepwalking, sleep talking or teeth grinding.
The relationship between sleep disorders and psychiatric problems in adults is well established. For example, it is well known that sleep problems commonly occur with depression. Similar disturbances may occur in children and adolescents with depression. ADHD children also tend to sleep poorly, and restlessly.
The research showed that those children with sleep problems generally improved with age. Children who had sleep problems at age four generally had less disturbances by adolescence. Input from the child’s parents, developmental issues, environmental stressors and issues within the family or in the child’s life, all affected a child’s sleep. This tended to improve over time.
However, some children seemed to continue with these problems across extended periods of development. There did appear to be a significant relationship between major sleep problems early on and the presence or future development of many emotional and behavioral problems in children. This included depression or anxiety, attention problems and aggression, and would affect all age groups of children.
Specifically, sleep problems seemed to correlate with significant future attention and aggression difficulties. The reason why there were these correlations between sleep and behavioral problems was less clear. Researchers wondered whether sleep disturbances and some of the features of disturbed sleep may lead to increased behavioral disturbances. Perhaps the answer will come through a yet undiscovered biologically based or cognitive mechanism.
It is interesting to note that researchers found some improvement was made in the development of behavioral problems of young children whose sleep problems were addressed and treated early on. More research will be needed to fully understand the connection between sleep problems and emotional and behavioral problems.
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