title: The bidirectional association between daytime affect and nighttime sleep in youth with anxiety and depression.
abstract: OBJECTIVE
  This study examines relationships between affect and sleep in youth with affective disorders using ecological momentary assessment (EMA).
  
  
  METHODS
  Participants included 94 youth, ages 8-16 (M = 11.73, 53% female) years with an anxiety disorder only (n = 23), primary major depressive disorder (with and without a secondary anxiety diagnoses; n = 42), and healthy controls (n = 29). A cell phone EMA protocol assessed affect and actigraphy measured sleep.
  
  
  RESULTS
  The patterns of bidirectional relationships between affect and sleep differed across diagnostic groups. Higher daytime positive affect and positive to negative affect ratios were associated with more time in bed during the subsequent night for youth with primary depression and less time in bed for youth with anxiety only. More time asleep was associated with more positive affect for both diagnostic groups the following day.
  
  
  CONCLUSIONS
  This relationship may be important to consider in the treatment of youth affective disorders.
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh PA 15213, USA. cousinsjc2@upmc.edu
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Cousins
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Whalen
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
authors.forename: Erika E
authors.initials: EE
authors.lastname: Forbes
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Olino
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Silk
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D000339:Affect / Q000502:physiology*; D001007:Anxiety / Q000503:physiopathology; D001008:Anxiety Disorders / Q000503:physiopathology*; D002648:Child; D003863:Depression / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012890:Sleep / Q000502:physiology*