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Alice M. Gregory, PhD; Jan Van der Ende, MS; Thomas A. Willis, PhD; Frank C. Verhulst, MD

Arch Pediatr Adolesc Med. 2008;162(4):330-335.

Objective  To examine associations between sleep problems during development and subsequent emotional and behavioral difficulties.

Design  Prospective longitudinal study.

Setting  The Dutch province of Zuid-Holland.

Participants  At time 1 of data collection, a representative sample of 2076 children aged 4 to 16 years participated in the study.

Outcome Measures  Parents rated their children's (4-19 years old) sleep at 5 assessments by completing the Child Behavior Checklist. Participants reported on their own emotional and behavioral symptoms at a later assessment (when aged 18-32 years) by completing the Young Adult Self-Report.

Results  After adjusting for sex, age, socioeconomic status, and parent-rated scores through development for the difficulty being predicted, having any parental reports of sleeping less than others was a risk indicator of high scores on the Anxious/Depressed scale (odds ratio, 1.43; 95% confidence interval, 1.07-1.90; P = .01) and the Aggressive Behavior scale (odds ratio, 1.51; 95% confidence interval, 1.13-2.02; P = .005). There was some (albeit less robust) support for links between other reported sleep difficulties and later problems. Parental reports of sleeping more than others and nightmares were not associated with later difficulties.

Conclusions  Physicians should inquire about sleep problems during child development and should be aware that some, but perhaps not others, may constitute risk indicators of later difficulties.

Author Affiliations: Department of Psychology, Goldsmiths College, University of London, London, England (Drs Gregory and Willis); and Erasmus University Medical Centre–Sophia, Rotterdam, the Netherlands (Mr Van der Ende and Dr Verhulst).

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