title: Developmental Trajectories of Sleep Problems from Childhood to Adolescence Both Predict and Are Predicted by Emotional and Behavioral Problems.
abstract: Although the prevalence rates of sleep disorders at different stages of childhood and adolescence have been well established, little is known about the developmental course of general sleep problems. This also holds true for the bidirectional relationship between sleep problems and emotional as well as behavioral difficulties. This longitudinal study investigated the general pattern and the latent trajectory classes of general sleep problems from a large community sample aged 5-14 years. In addition, this study examined the predictive value of emotional/behavioral difficulties (i.e., anxiety/depression, attention problems, and aggressive behavior) on sleep problems latent trajectory classes, and vice-versa. Participants (N= 1993) were drawn from a birth cohort of Western Australian children born between 1989 and 1991 who were followed until 14 years of age. Sleep problems were assessed at ages 5, 8, 10, and 14, respectively, whereas anxiety/depression, attention problems, and aggressive behavior were assessed at ages 5 and 17 years. Latent growth curve modeling revealed a decline in an overall pattern of sleep problems during the observed 10-year period. Anxiety/depression was the only baseline factor that predicted the longitudinal course of sleep problems from ages 5 to 14 years, with anxious and depressed participants showing faster decreasing patterns of sleep problems over time than those without anxiety or depression. Growth mixture modeling identified two classes of sleep problem trajectories:Normal Sleepers(89.4%) andTroubled Sleepers(10.6%). Gender was randomly distributed between these groups. Childhood attention problems, aggressive behavior, and the interaction between gender and anxiety/depression were significantly predictive of membership in the group ofTroubled Sleepers. Group membership inTroubled Sleeperswas associated with higher probability of having attention problems and aggressive behavior in mid-adolescence. Boys and girls with behavioral difficulties, and girls with emotional difficulties were at increased risk of having sleep problems during later childhood and adolescence. Developmental trajectories of sleep problems were also predictive of behavioral difficulties in later life. Findings from this study provide empirical evidence for the heterogeneity of sleep problems and their development, and emphasize the importance of understanding sleep problems and their relationship to children and adolescents' mental health.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Goettingen Goettingen, Germany.
authors.forename: Biyao
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Goettingen Goettingen, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Isensee
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Goettingen Goettingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Becker
authors.affiliation: Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, The University of Western Australia, Perth WA, Australia.
authors.forename: Janice
authors.initials: J
authors.lastname: Wong
authors.affiliation: Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, The University of Western Australia, Perth WA, Australia.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Eastwood
authors.affiliation: Telethon Kids Institute, Perth WA, Australia.
authors.forename: Rae-Chi
authors.initials: RC
authors.lastname: Huang
authors.affiliation: Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, The University of Western Australia, Perth WA, Australia.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Runions
authors.affiliation: Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, The University of Western Australia, Perth WA, Australia.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Stewart
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, German Centre for Cardiovascular Research, University of Goettingen Goettingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Meyer
authors.affiliation: Child and Adolescent Psychiatry, Psychiatry Services Thurgau Frauenfeld, Switzerland.
authors.forename: L G
authors.initials: LG
authors.lastname: Brüni
authors.affiliation: Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, The University of Western Australia, PerthWA, Australia; Specialised Child and Adolescent Mental Health Services, Department of Health, PerthWA, Australia.
authors.forename: Florian D
authors.initials: FD
authors.lastname: Zepf
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Goettingen Goettingen, Germany.
authors.forename: Aribert
authors.initials: A
authors.lastname: Rothenberger
keywords: CBCL; Raine study; aggressive behavior; anxiety/depression; attention problems; childhood and adolescence; latent trajectory classes; sleep problems