Scientists are discovering that children with chronic sleep problems are at increased risk for developing a mental illness later in life.
Recent studies show that children who have persistent sleep problems, such as difficulty falling asleep or staying asleep, or not getting enough night-time shut-eye, are more likely later to suffer from depression and anxiety disorders and to abuse alcohol and drugs than kids without sleep problems. The findings add to previous research that has linked children’s sleep problems to a host of issues, including aggressive behavior, learning and memory problems and obesity.
A 2010 study of 392 boys and girls published online in the Journal of Psychiatric Research found that those who had trouble sleeping at 12 to 14 years old were more than two times as likely to have suicidal thoughts at ages 15 to 17 as those who didn’t have sleep problems at the younger age. In a study published last year in Alcoholism: Clinical and Experimental Research, involving 386 participants, children whose mothers reported that they were overtired when 3 to 8 years old were 2.8 times as likely to binge drink when they were 18 to 20 years old. And a study of 1,037 children revealed that 46% of those who were considered to have a persistent sleep difficulty at age 9 had an anxiety disorder at age 21 or 26. By comparison, of the children who didn’t have sleep problems at age 9, 33% had an anxiety disorder as young adults, according to the research, which was published in 2005 in the Journal of Abnormal Child Psychology. Scientists caution that some study-sample sizes are small and research is still in its early stages.
Psychiatrists and psychologists say they hope that by addressing sleep problems in childhood, some of the instances of later mental illness can be prevented. Clinicians also have developed effective treatments for poor sleep and are experimenting with some new approaches that teach kids how to reduce the frequency and strength of anxious thoughts that can crop up at night. In general, doctors do not recommend using medication to help kids sleep.
“We think that healthy, optimal sleep may be a buffer against developing anxiety and depression in kids,” says Ronald E. Dahl, a professor at the University of California, Berkeley and a leading researcher on pediatric sleep.
Anxiety disorders and depression are the most common mental illnesses: 28.8% of the general population will have an anxiety disorder in their lifetime and 20.8% will have a mood disorder, according to a 2005 study published in the Archives of General Psychiatry. Anxiety disorders emerge early in life: The median age of onset is 11, according to the study. Rates of depression spike in adolescence, too. And those who develop depression young tend to have a more serious disease, with a higher risk of relapse.
Scientists aren’t certain as to why poor sleep in childhood increases the risk of anxiety disorders and depression. It could be that sleep problems lead to changes in the brain, which, in turn, contribute to the psychiatric illnesses, they say. Or some underlying issue, partly explained by genetics and early childhood experiences, could be a precursor to both poor sleep and the mental disorders.
Researchers say that before puberty—between the ages of about 9 and 13—is a key time to tackle poor sleep. That’s before the spike in rates of depression and the upheavals of adolescence and while the brain is still very responsive. “The brains of children are far more plastic and amenable to change,” says Candice Alfano, assistant professor of psychology and pediatrics at Children’s National Medical Center in Washington, D.C. Sleep changes dramatically after puberty: Circadian rhythms shift so kids naturally stay up later. With schools starting early, kids often don’t get enough sleep. Academic and social pressures surge, too.
A small study suggested healthy sleep may be able to help protect kids from depression—even those at high-risk because of genetics. (Both anxiety disorders and depression are believed to be partly inherited.) The study, published in 2007 in the journal Development and Psychopathology, found that children who fell asleep quicker and spent more time in the deepest stage of sleep were less likely to develop depression as young adults. A larger body of research shows that improving sleep in kids and adults who already have mental-health problems also leads to a stronger recovery.
A Good Night
Most parents underestimate the amount of sleep children should get a day. They need:
Infants: 14 to 15 hours
Toddlers: 12 to 14 hours
Preschoolers: 11 to 13 hours
School-age kids: 10 to 11 hours
Teenagers: 9 to 10 hours
Strategies to encourage healthy sleep in kids
Set a regular bedtime and wake time, even on weekends.
Make the bedroom a dark and quiet oasis for sleep. No homework in bed.
Create a calming bedtime routine. For younger kids: a bath and story. For older kids: Reading or listening to mellow music.
Limit caffeine consumption, especially after 4 p.m.
Ban technology (TV, Web surfing, texting) in the half hour before bed. The activities are stimulating. The light from a computer can interfere with the production of the sleep-promoting hormone, melatonin.
Don’t send kids to bed as punishment or allow them to stay up late as a reward for good behavior. This delivers a negative message about sleep.
Help kids review happy moments from the day. Have them imagine a TV with a ’savoring channel.’ Relegate anxious thoughts to ‘a worry channel.’