title: Sleep-Related Problems and the Effects of Anxiety Treatment in Children and Adolescents.
abstract: This study examined (a) demographic and clinical characteristics associated with sleep-related problems (SRPs) among youth with anxiety disorders, and (b) the impact of anxiety treatment: cognitive-behavioral therapy (CBT; Coping Cat), medication (sertraline), their combination, and pill placebo on SRPs. Youth (N = 488, ages 7-17, 50% female, 79% White) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated. SRPs were reported by parents and youth. Findings differed by informant and by type of SRP, with evidence that SRPs are associated with age, anxiety severity, externalizing problems, functional impairment, and family burden at pretreatment. Anxiety treatment reduced SRPs; effect sizes were small to medium. Reductions in parent-reported separation-related sleep difficulties were significantly greater in active treatment than in the placebo condition, with the greatest reductions reported by parents of youth whose active treatment was multimodal or included sertraline. Youth whose anxiety treatment involved CBT reported significantly greater decreases in dysregulated sleep (e.g., sleeplessness). Both CBT for anxiety and sertraline appear to be somewhat effective in reducing SRPs, and multimodal treatment may be preferable depending on the symptom presentation. To inform practice, future research should examine a broad range of SRPs, incorporate objective measures of sleep, and evaluate the impact of behavioral strategies that directly target SRPs in youth with anxiety disorders.
authors.affiliation: a Department of Psychology , Georgia State University.
authors.forename: Nicole E
authors.identifier: http://orcid.org/0000-0002-8723-7443
authors.initials: NE
authors.lastname: Caporino
authors.affiliation: b Department of Psychology , Temple University.
authors.forename: Kendra L
authors.initials: KL
authors.lastname: Read
authors.affiliation: b Department of Psychology , Temple University.
authors.forename: Nina
authors.initials: N
authors.lastname: Shiffrin
authors.affiliation: b Department of Psychology , Temple University.
authors.forename: Cara
authors.initials: C
authors.lastname: Settipani
authors.affiliation: b Department of Psychology , Temple University.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
authors.affiliation: c Department of Psychiatry and Behavioral Services , Duke University Medical Center.
authors.forename: Scott N
authors.initials: SN
authors.lastname: Compton
authors.affiliation: d Division of Services and Intervention Research , National Institute of Mental Health.
authors.forename: Joel
authors.initials: J
authors.lastname: Sherrill
authors.affiliation: e Semel Institute for Neuroscience and Human Behavior , University of California Los Angeles.
authors.forename: John
authors.initials: J
authors.lastname: Piacentini
authors.affiliation: f Division of Child and Adolescent Psychiatry , Weill Cornell Medical College.
authors.forename: John
authors.initials: J
authors.lastname: Walkup
authors.affiliation: g University of Connecticut Health Center.
authors.forename: Golda
authors.initials: G
authors.lastname: Ginsburg
authors.affiliation: h Division of Child and Adolescent Psychiatry , The Johns Hopkins University School of Medicine.
authors.forename: Courtney
authors.initials: C
authors.lastname: Keeton
authors.affiliation: i Western Psychiatric Institute and Clinic , University of Pittsburgh Medical Center.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.affiliation: i Western Psychiatric Institute and Clinic , University of Pittsburgh Medical Center.
authors.forename: Dara
authors.initials: D
authors.lastname: Sakolsky
authors.affiliation: j Department of Psychology , Philadelphia College of Osteopathic Medicine.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gosch
authors.affiliation: k Department of Psychiatry , Columbia Medical Center.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Albano
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D020280:Sertraline / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000523:psychology / Q000628:therapy*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline