title: Polysomnographic sleep patterns of non-depressed, non-medicated children with generalized anxiety disorder.
abstract: BACKGROUND
  Polysomnographic (PSG) studies of children with psychiatric illness have primarily focused on depressed samples. Children with generalized anxiety disorder (GAD) report high rates of sleep problems yet investigation of objective sleep patterns in non-depressed children with GAD are unavailable. Identification of unique clinical features linking early GAD with sleep disturbance, including possible HPA activation during the pre-sleep period, is needed to inform effective treatments.
  
  
  METHODS
  Thirty non-medicated, pre-pubescent children (ages 7-11 years) were assessed including 15 children with GAD and 15 matched healthy controls. Anxious children had GAD as their primary diagnosis and did not meet criteria for secondary mood disorders. All participants underwent structured diagnostic assessment and laboratory-based polysomnography (PSG). State anxiety and salivary cortisol were assessed prior to light out on the PSG night.
  
  
  RESULTS
  Children with GAD showed significantly increased sleep onset latency and reduced latency to rapid eye movement (REM) sleep compared to controls. Marginal differences in the form of reduced sleep efficiency and increased total REM sleep also were found in the GAD group. Pre-sleep anxiety and cortisol levels did not differ between the two groups.
  
  
  CONCLUSIONS
  A small sample size, time-limited assessment of cortisol, and possible first night effects should be considered.
  
  
  CONCLUSIONS
  Results of this study provide initial evidence of PSG-based differences in children with GAD compared to controls. Follow-up studies are needed to explore the course of sleep alterations and whether targeting sleep problems early in the course of GAD might improve clinical outcomes.
authors.affiliation: Department of Psychology, University of Houston, Houston, TX 77204, USA. caalfano@uh.edu
authors.forename: Candice A
authors.initials: CA
authors.lastname: Alfano
authors.forename: Katharine
authors.initials: K
authors.lastname: Reynolds
authors.forename: Nikia
authors.initials: N
authors.lastname: Scott
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Mellman
mesh_terms: D001008:Anxiety Disorders / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D008297:Male; D017286:Polysomnography; D012463:Saliva / Q000737:chemistry; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis*
chemical_list: D006854:Hydrocortisone