Journal of the American Academy of Child & Adolescent Psychiatry
Volume 47, Issue 2 , Pages 148-155, February 2008

Objective Sleep in Pediatric Anxiety Disorders and Major Depressive Disorder

All of the authors are with the University of Pittsburgh, except Dr. Gregory, who is with Goldsmiths College, London University.

Accepted 26 May 2007.

ABSTRACT 

Objective:

To examine objective and subjective sleep problems in early-onset anxiety and depression.

Method:

Children and adolescents (46% female, ages 7 to 17 years) with anxiety disorders (n = 24), major depressive disorder (MDD) without comorbid anxiety disorders (n = 128), or no history of psychiatric disorder (n = 101) spent two consecutive nights in a sleep laboratory and completed self-reports of sleep quality.

Results:

On objective measures, the anxiety group exhibited more awakenings than the MDD group, less slow-wave sleep than the control or MDD group, and greater night 2 sleep latency than the MDD or control group. The anxiety group exhibited no decrease in rapid eye movement latency from the first night to the second. The MDD group exhibited less time awake than the control group and less stage 1 sleep than the anxiety or control group. On subjective measures, young people with anxiety reported greater sleep latency on the second night and no decrease in sleep latency. Age was covaried in analyses.

Conclusions:

Findings provide objective and subjective evidence of sleep disturbance in children and adolescents with anxiety disorders and replicate findings of limited objective sleep disturbance in those with MDD. Sleep problems are an important consideration when treating young people with anxiety.

Key Words::  anxiety , depression , objective sleep , sleep problems , early onset

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 This study was supported by the National Institute of Mental Health (P01 MH41712, Neal D. Ryan; K01 MH74769, Erika E. Forbes) and the National Alliance for Research on Schizophrenia and Depression (Young Investigator Award, Erika E. Forbes). The authors are grateful to Laura Trubnick for coordinating the Child and Adolescent Sleep Laboratory at Western Psychiatric Institute and Clinic, Ian Kane for assisting with data management, and the participants and their families.Disclosure: Dr. Birmaher has participated in forums sponsored by Solvay Pharmaceuticals and Abcomm and has also presented on bipolar disorders in children at a meeting sponsored by Solvay. The payment for this conference was given to the WPIC Residency Training Program. He also has received royalties for publications from Random House. The other authors report no conflicts of interest.

PII: S0890-8567(09)62285-1

doi:10.1097/chi.0b013e31815cd9bc

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 47, Issue 2 , Pages 148-155, February 2008