title: Caffeine consumption, sleep, and affect in the natural environments of depressed youth and healthy controls.
abstract: OBJECTIVE
  Sleep problems are a cardinal symptom of depression in children and adolescents and caffeine use is a prevalent and problematic issue in youth; yet little is known about caffeine use and its effects on sleep in youth with depression. We examined caffeine use and its relation to sleep and affect in youth's natural environments.
  
  
  METHODS
  Thirty youth with major depressive disorder (MDD) and 23 control youth reported on caffeine use, sleep, and affect in their natural environment using ecological momentary assessment at baseline and over 8 weeks, while MDD youth received treatment.
  
  
  RESULTS
  Youth with MDD reported more caffeine use and sleep problems relative to healthy youth. Youth with MDD reported more anxiety on days they consumed caffeine. Caffeine use among youth with MDD decreased across treatment, but sleep complaints remained elevated.
  
  
  CONCLUSIONS
  Findings suggest that both sleep quality and caffeine use are altered in pediatric depression; that caffeine use, but not sleep problems, improves with treatment; and that caffeine may exacerbate daily anxiety among youth with depression.
authors.affiliation: Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Whalen
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Silk
authors.forename: Mara
authors.initials: M
authors.lastname: Semel
authors.forename: Erika E
authors.initials: EE
authors.lastname: Forbes
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
authors.forename: David A
authors.initials: DA
authors.lastname: Axelson
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
mesh_terms: D000293:Adolescent; D000339:Affect; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D001628:Beverages; D002110:Caffeine; D000697:Central Nervous System Stimulants; D002648:Child; D015283:Citalopram / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004569:Electroencephalography; D004777:Environment; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D002110:Caffeine; D000697:Central Nervous System Stimulants; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors