Citation

Soehner AM, Bertocci MA, Levenson JC, Goldstein TR, Rooks B, Merranko J, Hafeman D, Diler R, Axelson D, Goldstein BI, Hickey MB, Monk K, Phillips ML, Birmaher B. J. Am. Acad. Child Adolesc. Psychiatry 2019; 58(6): 608-617.

Affiliation

University of Pittsburgh, PA.

Copyright

(Copyright © 2019, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2018.09.448

PMID

30851396

Abstract

OBJECTIVE: Sleep disturbance may be involved in symptom progression across multiple domains of psychopathology and could represent a target for treatment development in youth. Our objective was to identify sleep patterns that longitudinally change in conjunction with psychiatric symptom severity in at-risk youth.

METHOD: The study included 484 Pittsburgh Bipolar Offspring Study youth with at least two sleep assessments occurring between 10 and 18 years-old: 267 offspring of parents with bipolar I or II disorder and 217 community comparison offspring. Assessments occurred approximately every 2 years (mean number of assessments=2.8±0.8, mean follow-up duration= 3.8±1.6 years). Offspring had a range of psychiatric diagnoses at baseline. Multivariate lasso regression was implemented to select offspring-reported sleep patterns associated with changes in five psychiatric symptom measures from baseline through last follow-up (mania, depression, mood lability, anxiety, inattention/externalizing). Analyses accounted for parent psychiatric diagnoses and offspring demographics, psychiatric diagnoses, and medications.

RESULTS: Follow-up duration, baseline socioeconomic status, parental history of bipolar disorder, offspring attention deficit hyperactivity disorder and disruptive behavior disorder, and five sleep patterns were identified as predictors of change in all five psychiatric symptom measures. Decreasing sleep duration, later sleep timing preference, longer sleep latency, increasing nighttime awakenings, and greater sleepiness over follow-up were associated with increasing severity the five psychiatric symptom outcomes over follow-up. These ten predictors explained 16% of the variance in longitudinal psychiatric symptom change, 33% of which was accounted for by sleep predictors.

CONCLUSION: A constellation of sleep features were associated with psychiatric symptom changes in youth, and may represent viable targets for future interventions.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

circadian; longitudinal; psychiatric symptoms; sleep; youth