Children's Sleeping Habits Linked to Mental Health?

In the spirit of Mental Health Awareness Month, new interesting research shows that children's sleeping habits may be linked to their mental health status.

Tired parents are often told that night waking is part of toddlerhood, and that it will soon pass on its own, but this may not the case for everyone. A new comprehensive survey of nearly 1,000 toddlers shows that serious sleep disorders in young children can have long-term consequences.

In fact, 4-year-olds with sleep disorders have a higher risk of developing symptoms of psychiatric problems as 6-year-olds, compared with children who sleep soundly.

At the same time, 4-year-olds with psychiatric symptoms have a greater risk of developing a sleep disorder as 6-year-olds, compared with children who do not have these kinds of symptoms.

"It is common for children to have periods when they sleep poorly, but for some children, the problems are so extensive that they constitute a sleep disorder. Our research shows that it is important to identify children with sleep disorders, so that remedial measures can be taken. Sleeping badly or too little affects a child's day-to-day functioning, but we are seeing that there are also long term repercussions," researcher Silje Steinsbekk, from The Norwegian University of Science and Technology (NTNU), said in a statement.

While previous research in children has shown that 4-year-olds with sleep disorders often also show symptoms of psychiatric problems, this latest study indicates that the relationship works both ways, and persists over time.

It is known that 20-40 percent of young children struggle with sleep in one way or another, but scientists don't know how many of them actually suffer from a diagnosable sleep disorder. So NTNU researchers conducted interviews with the parents of the children participating in the study, basing their questions on the DSM-IV diagnostic manual - which contains the official diagnostic criteria for mental disorders.

"Previous studies of sleep problems in children have mainly used a questionnaire format, with questions like, 'Does your child have trouble sleeping?' But what parents define as sleep problems will vary. In the diagnostic interview we ask parents questions until we are confident that we have enough information to assess whether a symptom is present or not. The information we've collected is more reliable than information obtained from the questionnaire," Steinsbekk explained.

Based on the results, it seems that poor sleep causes psychiatric problems, and at the same time psychiatric problems cause poor sleep.

One possible explanation for this reciprocity may be that both conditions are biologically determined, by common underlying genetics, for example. (Scroll to read on...)

Another explanation may be that insufficient sleep creates general functional impairment, and that the risk of other problems therefore increases - in the same way that psychiatric symptoms often result in poorer everyday functioning, which in turn may negatively affect sleep.

Researchers also suggest that sleep disorders and mental health issues share the same risk factors. A child who shows signs of anxiety or a behavioral disorder may easily end up in a vicious cycle, where conflict with adults triggers anxiety and in turn leads to trouble falling asleep.

It may also be that difficult and negative thoughts steal both energy and sleep and make us restless and depressed if we fail to gain control over them.

"Given that so many children suffer from insomnia, and only just over half 'outgrow it,' it is critical for us to be able to provide thorough identification and good treatment. Perhaps early treatment of mental health problems can also prevent the development of sleep disorders, since psychiatric symptoms increase the risk of developing insomnia," said Steinsbekk.

According to the study, insomnia is the most prevalent sleep disorder, resulting in an inability to fall asleep and frequent waking. Insomnia was diagnosed in 16.6 percent of the 4-year-olds surveyed, and 43 percent of these still had insomnia as 6-year-olds.

Insomnia in 4-year olds increases the risk for symptoms of anxiety, depression, ADHD and behavioral problems as 6-year-olds.

Examples of other types of sleep disorders are hypersomnia (i.e. an extreme urge to sleep), and various cases of parasomnia, such as nightmares, night terrors and sleepwalking - though these conditions are all uncommon. Researchers hope to conduct future studied to better understand the relationship between mental health and sleeping habits.

The results were published in the Journal of Developmental & Behavioral Pediatrics.

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