title: Subjective sleep complaints in pediatric depression: a controlled study and comparison with EEG measures of sleep and waking.
abstract: 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.
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
authors.forename: Michele A
authors.initials: MA
authors.lastname: Bertocci
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Williamson
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Iosif
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: David
authors.initials: D
authors.lastname: Axelson
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
mesh_terms: 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*