Sleep complaints and psychiatric symptoms in children evaluated at a pediatric mental health clinic.
OBJECTIVE
To examine the association of sleep problems with psychiatric symptoms in children evaluated at a university-based outpatient child psychiatry clinic.


METHODS
Parents of 174 children attending psychiatric services completed a 47-item Childhood Sleep Questionnaire and the Behavioral Assessment System for Children. Psychiatric diagnosis was obtained through retrospective chart review. Sleep characteristics were compared among 4 diagnostic subcategories: attention-deficit/hyperactivity disorder (ADHD) alone (n=29), ADHD with comorbid mood and anxiety disorders (ADHD+; n=50), mood and anxiety disorders alone (n=67), and other psychiatric disorders (n= 28). Data from sleep habits survey of 174 community children without reported psychiatric history served as controls.


RESULTS
Children with psychiatric disorders had a significantly higher prevalence of sleep complaints compared with nonpsychiatric controls. Children with ADHD had frequent nocturnal awakenings, bad dreams, and bedtime struggles. In addition, the presence of leg jerks during sleep was particularly frequent in patients with ADHD compared with any other psychiatric disorder. More frequent nighttime awakenings were present in children with mood and anxiety disorders. Sleep duration and sleep latency strongly correlated with aggression, hyperactivity, and depression. Restless sleep scores highly correlated with all psychiatric symptoms.


CONCLUSIONS
Sleep problems are highly prevalent among children with psychiatric disorders. Children with ADHD and comorbid anxiety or mood disorders are more likely to report sleep disturbances. Restless sleep, long sleep latency, short sleep duration, and frequent nocturnal awakenings correlate with the severity of psychiatric symptoms.
Ivanenko
Anna
A
Department of Psychiatry and Behavioral Neurosciences, Loyola University of Chicago, 2160 S. First Avenue Building 105 Room 1942, Maywood, IL 60153, USA. aivanenko@lumc.edu
Crabtree
Valerie McLaughlin
VM
Obrien
Louise Margaret
LM
Gozal
David
D
D000275:Adjustment Disorders / Q000453:epidemiology*; D000554:Ambulatory Care Facilities; D001008:Anxiety Disorders / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012913:Snoring / Q000453:epidemiology; D011795:Surveys and Questionnaires