title: Stability of sleep disorders from preschool to first grade and their bidirectional relationship with psychiatric symptoms.
abstract: OBJECTIVE
  To examine the prevalence and stability of DSM-4-defined sleep disorders from preschool to first grade and to explore the bidirectional relationship between sleep disorders and symptoms of psychiatric disorders.
  
  
  METHODS
  All children born in 2003 or 2004 in Trondheim, Norway, who attended regular community health checkups for 4-year-olds, were invited to participate (97.2% attendance; 82.0% consent rate, n = 2475) in this study. The authors recruited a screen-stratified subsample of 1250 children and interviewed 994 parents (79.6%) using a structured diagnostic interview (the Preschool Age Psychiatric Assessment). Two years later, 795 of the parents completed the interview.
  
  
  RESULTS
  There was stability in insomnia (adjusted odds ratio [OR] = 4.03, confidence interval [CI] = 2.83-5.75) and sleepwalking (adjusted OR = 19.28, CI = 4.53-82.10), whereas none of the children with hypersomnia or nightmare disorder at age 4 had the same disorder 2 years later. Insomnia increased the risk for developing symptoms of conduct disorder, major depressive disorder (MDD), and social phobia when the initial levels of insomnia were adjusted for. Symptoms of attention-deficit hyperactivity disorder, oppositional defiant disorder, and MDD at age 4 were statistically linked to insomnia at age 6. Sleepwalking predicted later separation anxiety disorder, whereas hypersomnia was unrelated to symptoms of psychiatric disorders.
  
  
  CONCLUSIONS
  Insomnia is a prevalent and stable disorder in children and is bidirectionally related to psychiatric symptoms.
authors: *Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; †Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway; ‡NTNU Social Science, Trondheim, Norway.
authors: Silje
authors: S
authors: Steinsbekk
authors: Lars
authors: L
authors: Wichstrøm
mesh_terms: D001010:Anxiety, Separation / Q000453:epidemiology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D004325:Dreams; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009664:Norway / Q000453:epidemiology; D010698:Phobic Disorders / Q000453:epidemiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*; D013009:Somnambulism / Q000453:epidemiology*