Subjective sleep complaints in pediatric depression: a controlled study and comparison with EEG measures of sleep and waking.
OBJECTIVE
Children with major depressive disorder (MDD) often complain of sleep disturbances; however, polysomnographic studies have failed to find objective evidence of these disturbances. This article examines subjective sleep reports of children with MDD and healthy controls focusing on comparing subjective and objective sleep measures.


METHODS
Fifty-one subjects with MDD and 42 healthy subjects, 8-17 years old, participated in a comprehensive psychobiologic study including three nights of EEG sleep recording. Each morning, subjects completed a post-sleep form subjectively rating their sleep, which was then compared with their polysomnographic studies.


RESULTS
Depressed subjects reported significantly worse sleep on four scales: subjective sleep quality, perceived number of awakenings, estimated minutes awake, and perceived ease of waking. In contrast to these subjective complaints, objective EEG measures indicated no evidence of disturbed sleep in the depressed sample compared to controls. Furthermore, exploratory analyses focusing on the subset of depressed subjects with the greatest subjective sleep disturbance showed, paradoxically, significantly better sleep in terms of the number of EEG awakenings and objective disturbances.


CONCLUSIONS
Despite clinical evidence of subjective sleep complaints in depressed children, our EEG measures showed little evidence to indicate an objective basis for these perceptions. These findings raise provocative questions regarding the nature of sleep complaints associated with early-onset depression.
Bertocci
Michele A
MA
University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Dahl
Ronald E
RE
Williamson
Douglas E
DE
Iosif
Ana-Maria
AM
Birmaher
Boris
B
Axelson
David
D
Ryan
Neal D
ND
D000293:Adolescent; D002540:Cerebral Cortex / Q000503:physiopathology; D002648:Child; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D004569:Electroencephalography; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D017286:Polysomnography; D012016:Reference Values; D012803:Sick Role; D012815:Signal Processing, Computer-Assisted; D012894:Sleep Stages / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D014851:Wakefulness / Q000502:physiology*