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Children May Be Especially Vulnerable to Disturbed Sleep, Depressive Symptoms Spirals
Significant bidirectional associations and cascade processes between depressive symptoms and disturbed sleep occur in children through age 12, according to a study published online in JAMA Network Open.
“To our knowledge, this cohort study is the first to report developmental cascades between disturbed sleep and depressive symptoms throughout childhood and early adolescence,” wrote lead author Cecilia Marino, MD, PhD, Centre for Addiction and Mental Health in Toronto, Canada, and coauthors. “Our finding suggests that disturbed sleep makes a significant contribution to the stability over time of depressive symptoms across childhood and early adolescence, which, in turn, is associated with ongoing disturbed sleep.”
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The study included data on 1689 children and 1113 adolescents from the Québec Longitudinal Study of Child Development. Data were collected across 8 waves from 2003 through 2015, when children were between ages 5 years and 17 years. Disturbed sleep, which included sleep duration, time awake in bed, daytime sleepiness, sleep talking, sleepwalking, night terrors, and nightmares, was parent-reported. Depressive symptoms were also parent-reported in childhood, and self-reported during adolescence.
The investigation revealed significant bidirectional associations between depressive symptoms and disturbed sleep at all time points in childhood, indicating cascade processes, researchers reported. Significant bidirectional associations were also identified in adolescents between 10 and 12 years.
At 12 and 13 years, depressive symptoms were modestly associated with disturbed sleep. The link between disturbed sleep and depressive symptoms, however, was not significant. After 13 years, cross-lagged estimates were not significant at any time point.
The authors advised caution in interpreting study findings due to the investigation’s reliance on self-reported data.
“In conclusion, bidirectional and developmental cascades linking disturbed sleep and depressive symptoms in childhood and early adolescence emphasize the importance of identifying and treating incipient disturbed sleep as early as possible to prevent spiraling effects on depression,” they wrote. “More randomized clinical trials testing interventions possibly targeting common pathways are needed to bolster depression prevention.”
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