title: Behavioral Profiles Associated with Objective Sleep Duration in Young Children with Insomnia Symptoms.
abstract: Based on previous studies reporting on the association of objective sleep duration and physiologic changes (i.e., increased cortisol) in children, we examined the role of objective sleep duration on differentiating behavioral profiles in children with insomnia symptoms. Seven hundred children (ages 5-12, 47.8% male) from the Penn State Child Cohort underwent a nine-hour polysomnography and parent completed Pediatric Behavior Scale. Insomnia symptoms were defined as parent report of difficulty falling and/or staying asleep, sleep disordered breathing as an AHI of ≥1, and objective short sleep duration as a total sleep time < 7.7 h. Children with insomnia symptoms demonstrated more overall behavioral problems than controls. Significant interactions between insomnia symptoms and objective sleep duration on scores of externalizing behaviors, mood variability and school problems were found. Profile analyses showed that children with insomnia symptoms and normal sleep duration were associated with clinically elevated externalizing behaviors, inattention, mood variability, and school problems, while children with insomnia and short sleep duration were associated with an overall elevated profile in which internalizing behaviors were more prominent. Childhood insomnia symptoms are associated with a wide array of behavioral problems, for which objective sleep duration is useful in differentiating behavioral profiles. Children with insomnia symptoms and normal sleep duration had a behavioral profile consistent with limit-setting and rule-breaking behaviors, while children with insomnia symptoms and short sleep duration had a behavioral profile more consistent with internalizing behaviors resembling that of psychophysiological disorders.
authors.affiliation: Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA, USA. scalhoun@psu.edu.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Calhoun
authors.affiliation: Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA, USA.
authors.forename: Julio
authors.initials: J
authors.lastname: Fernandez-Mendoza
authors.affiliation: Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA, USA.
authors.forename: Alexandros N
authors.initials: AN
authors.lastname: Vgontzas
authors.affiliation: Department of Psychiatry H073, Milton S. Hershey Medical Center, P.O. Box 850, Hershey, PA, 17033, USA.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Mayes
authors.affiliation: Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.
authors.forename: Duanping
authors.initials: D
authors.lastname: Liao
authors.affiliation: Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA, USA.
authors.forename: Edward O
authors.initials: EO
authors.lastname: Bixler
mesh_terms: D002648:Child; D002652:Child Behavior / Q000145:classification / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D000066553:Problem Behavior / Q000523:psychology*; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology*
keywords: Anxiety and depression; Behavior problems; Childhood insomnia; Objective sleep duration