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PubMed2006

Characterizing sleep problems in persons with Alzheimer's disease and normal elderly.

We retrospectively analyzed sleep disturbance symptoms and estimated time in bed from the intake interviews of 399 healthy, non-demented elderly (NDE) and 263 persons with a diagnosis of possible (n = 53) or probable (n = 210) Alzheimer's disease (AD). Our primary objective was to identify what symptoms might underlie an individual's perception of 'sleep problems' and to determine if these were consistent within, and across, our two cohorts. We stratified each cohort according to whether or not they (or their caregiver) indicated that they had a 'sleep problem', and compared the frequency and endorsement rates of each of 21 sleep disturbance symptoms across those who did or did not endorse 'sleep problem'. For less than half of the symptoms in persons with AD, and a quarter of those in NDE, endorsement rates were significantly different depending on whether the reporter (or their sleep partner) did or did not report a sleep problem. Differences in mean frequency ratings between individuals reporting sleep problems relative to those not reporting were observed on 10 symptoms in both cohorts; six of these were the same symptom for both cohorts. When persons with subjective sleep problems in the AD and NDE cohorts were compared, only four of 21 symptoms were endorsed in one and not the other; two symptoms were significantly more frequent in one cohort than the other. Thus, within cohorts, the differences between persons with and without 'sleep problems' were relatively pronounced while the main differences in specific sleep-related symptoms between AD and NDE were not. Observed between-cohort differences appear to be driven by who is reporting, and the high prevalence of daytime sleeping in AD. Within-cohort differences reflect a clear distinction between persons with and without sleep problems, regardless of the reporter.

Aged↗

PubMed2002

Sleep problems in a very old population: drug use and clinical correlates.

BACKGROUND: Complaints of disturbed or dissatisfied sleep are common among older people. This study aimed to evaluate the prevalence of sleep problems in very old persons and its relation to physical and mental health and drug use. METHODS: This is a cross-sectional analysis of sleep problems in a population of old persons living in Stockholm, Sweden. There were 641 subjects aged 81+ years; 77.8% were women, 91.4% were noninstitutionalized, and 68.6% lived alone. All persons underwent a comprehensive medical and psychiatric interview and examination. Sleep problems were assessed using the Clinical Psychopathological Rating Scale (CPRS). Covariates included chronic medical conditions, depression, dementia, pain, self-rated health, activities of daily living, use of hypnotics-sedatives, use of other psychotropic drugs, and use of nonpsychotropic drugs. RESULTS: More than one third of subjects were identified with sleep problems. They were more common among women and persons using a higher number of drugs. Poor self-rated health, depression, and pain were related to the presence of sleep problems. Among persons with sleep problems and depression, only 19.2% used antidepressants, and 46.2% used hypnotics-sedatives. Among persons with sleep problems and pain, 63.2% used analgesics, and 47.0% used hypnotics-sedatives. One or more chronic diseases, use of hypnotics-sedatives, use of other psychotropic drugs, and use of nonpsychotropic drugs were also related to sleep problems. After multivariate analysis, factors significantly related to sleep problems were female gender, depression, pain, and hypnotic-sedative use. CONCLUSIONS: Sleep problems were common in this very old population. These results suggest the importance of carefully assessing an older person's complaints to accurately diagnose and effectively treat sleep problems.

Aged↗

PubMed2006

Prevalence, stability, and outcomes of cry-fuss and sleep problems in the first 2 years of life: prospective community-based study.

OBJECTIVE: To report the prevalence and stability of cry-fuss problems during the first 4 months of life and sleep problems from 2 to 24 months and relationships between the persistence of cry-fuss and sleep problems and outcomes at 24 months. METHODS: The study was a prospective cohort study in maternal and child health centers in 3 local government areas in Melbourne, Australia. A total of 483 first-born infants were monitored prospectively from 2 weeks through 2, 4, 8, 12, 18, and 24 months. Child behavior, maternal depression, parenting stress, and marital quality were assessed. Predictor variables were parent reports of moderate or greater cry-fuss problems (2 and 4 months) and sleep problems (8, 12, 18, and 24 months) and parent-reported, 24-hour, sleep/cry-fuss diaries (2, 4, and 12 months). RESULTS: The response rate was 68% (483 of 710 infants); the attrition rate was <6%. The prevalence of cry-fuss problems decreased from 19.1% at 2 months to 12.8% at 4 months, with 5.6% of mothers reporting cry-fuss problems at both ages. Prevalence rates of sleep problems were 21.2%, 16.2%, 10.0%, and 12.1% at 8, 12, 18, and 24 months, respectively; 6.4% had a problem at > or =3 of these ages. In multivariate analyses, cry-fuss/sleep problems at > or =3 previous time points (but not 1 or 2 time points) contributed significantly to depression (2.8% of variance), total behavior (1.4% of variance), and total stress (4.6% of variance) scores. Repeated problems had a greater impact than a concurrent sleep problem on depression and stress scores, whereas the reverse was true for behavior scores. CONCLUSIONS: Most cry-fuss and sleep problems in the first 2 years of life are transient. Persistent, rather than transient, problems contribute to maternal depression, parenting stress, and subsequent child behavior problems.

Adult↗

PubMed2000

Prevalence and correlates of sleep problems in Chinese schoolchildren.

STUDY OBJECTIVES: This study examined the prevalence and correlates of sleep problems in Chinese schoolchildren. DESIGN AND SETTING: A cross-sectional questionnaire survey was undertaken in Shandong Province, People's Republic of China. PARTICIPANTS: A total of 2004 elementary school children (998 boys and 1006 girls) participated in the survey. MEASUREMENTS AND INTERVENTIONS: The parents completed a questionnaire that asked about sleep problems, and characteristics of the family and child. Teachers completed a questionnaire that included the Modified Conners Hyperkinesis Index (MCHI), whether the child slept in class, and school achievement. RESULTS: Parent-reported sleep problems that occurred "sometimes" or "often" were sleep walking/talking, 14.2%; too little sleep, 14.0%; too much sleep, 12.5%; nightmares, 12.0%; trouble sleeping, 6.1%; and nocturnal enuresis, 4.5%. Teachers reported that 9.4% of children slept in class "sometimes" or "often". Approximately 11% of children were reported to have any sleep problem "often". Children with sleep problems were more frequently reported to be hyperactive, and to have poorer child-parent relations, poorer peer relations, and poorer social competency and school achievement. Multivariate logistic regression analysis indicated that sleep problems were significantly correlated with following factors: poor parental relations, crowded homes, bedwetting cessation after age 4, chronic physical diseases, reported hyperactivity and poor peer relations. CONCLUSIONS: Parent-reported sleep problems in Chinese children were less prevalent than those reported in Western countries, and associated with multiple family, prenatal, and child developmental factors. Children with sleep problems were reported to be more hyperactive, and to have social and academic problems more frequently. <=

Child↗

PubMed2003

[An epidemiological study of sleep problems among the Japanese pregnant women].

OBJECTIVE: The objective of the study was to identify: 1) what kinds of sleep problems that pregnant women experience in Japan; and 2) the relationships between sleep problems and month of pregnancy, sleep problems and the number of pregnancies, and sleeping hours, by means of a questionnaire given to pregnant women in Japan. Conditions to assure good quality sleep were studied. METHODS: Of 500 obstetric facilities which were randomly selected from areas surveyed by the Japan Association of Obstetricians and Gynecologists, 260 finally agreed to participate in this study. Women who had their pregnancy confirmed and were on a revisit to the 260 obstetric facilities were enrolled. These pregnant women completed anonymous self-administered questionnaires during the waiting time for treatment and submitted them to the obstetric facilities in sealed envelopes. The questionnaire covered personal attributes such as age and highest level of education, pregnancy status, working status, and patterns of smoking and alcohol drinking. Sleep-related items such as 1) subjective sleep quality, 2) difficulty in getting to sleep, 3) frequent awakenings, 4) waking up too early, 5) sleeping hours and 6) daytime drowsiness were also included. RESULTS: The month of pregnancy was significantly related to four sleep-related items, including difficulty in getting to sleep and waking up too early. With respect to the relationship between the number of pregnancies and sleep problems, significance was found for five sleep-related items, including subjective sleep quality and waking up too early. Poor subjective sleep quality was significantly related to sleeping less than seven hours and whether or not pregnant women had a regular job. It was also suggested that the greater the number of pregnancies, the shorter the sleeping hours. When responses to each sleep-related item were compared between pregnant women and the general population, the former were more likely to have sleep problems. CONCLUSION: These findings suggest that as well as the number of pregnancies and month of pregnancy with sleeping hours may be factor intimately related to sleep problems during pregnancy. A good quality sleep during pregnancy is vital for normal maternal health and fetal growth and sufficient sleeping hours are therefore needed. Attention should therefore be paid to the finding that pregnant women were more likely to have sleep problems than the general population.

Adolescent↗

PubMed2006

Sleep problems, comorbid mental disorders, and role functioning in the national comorbidity survey replication.

BACKGROUND: Little is known about the population prevalence of sleep problems or whether the associations of sleep problems with role impairment are due to comorbid mental disorders. METHODS: The associations of four 12-month sleep problems (difficulty initiating or maintaining sleep, early morning awakening, nonrestorative sleep) with role impairment were analyzed in the National Comorbidity Survey Replication controlling 12-month DSM-IV anxiety, mood, impulse-control, and substance disorders. The WHO Composite International Diagnostic Interview was used to assess sleep problems and DSM-IV disorders. The WHO Disability Schedule-II (WHO-DAS) was used to assess role impairment. RESULTS: Prevalence estimates of the separate sleep problems were in the range 16.4-25.0%, with 36.3% reporting at least one of the four. Mean 12-month duration was 24.4 weeks. All four problems were significantly comorbid with all the 12-month DMS-IV disorders assessed in the survey (median OR: 3.4; 25(th)-75(th) percentile: 2.8-3.9) and significantly related to role impairment. Relationships with role impairment generally remained significant after controlling comorbid mental disorders. Nonrestorative sleep was more strongly and consistently related to role impairment than were the other sleep problems. CONCLUSIONS: The four sleep problems considered here are of public health significance because of their high prevalence and significant associations with role impairment.

Activities of Daily Living↗

PubMed2001

Sleep problems, health-related quality of life, work functioning and health care utilization among the chronically ill.

OBJECTIVES: To provide a comprehensive assessment of whether sleep problems among the chronically ill are associated with decrements in functional health and well-being, decreases in work functioning and increases in the use of health care services. DESIGN: Cross-sectional survey of patients from the Medical Outcomes Study (MOS), an observational study of functional health and well-being. Chronically ill patients (n = 3484) were sampled from health maintenance organizations, large multi-specialty groups, and solo or single-specialty group practices in Boston, Los Angeles, and Chicago. Chronic illness subgroups include: clinical depression (n = 527), congestive heart failure (229), diabetes (n = 577), recent myocardial infarction (n = 170), hypertension (n = 2206), asthma (n = 84), back problems (n = 771), and arthritis (n = 672). ANCOVA analyses of the relationship between sleep problems and SF-36 scales and summaries were performed. In addition, a 'relative impact' analysis determined what scales or summaries were most associated with sleep problems. MAIN OUTCOME MEASURES: Eight scales and two summary measures from the SF-36 Health Survey, work productivity and work quality measures and self-reports of health care utilization. RESULTS: Comparing chronically ill patients with no sleep problems to those with mild, moderate, or severe sleep problems revealed a direct association between sleep problems and decrements in health-related quality of life (HRQOL) as measured by SF-36 scales and summaries (MANOVA F 24.1; d.f. 24; p < or = 0.0001). In addition, significant differences in HRQOL were found when comparing patients with and without sleep problems within most of the disease groups studied. The relative impact analysis revealed that measures of mental health and the mental health summary were most associated with sleep problem severity in the total sample and chronic disease subsets, in comparison with measures of physical health. In addition, monotonic relationships were found between severity of sleep problems and decreases in work productivity and increases in health care utilization, as expected. CONCLUSIONS: The analyses revealed that sleep problems go hand in hand with poorer mental health, diminished work productivity and work quality and greater use of health care services. Sleep problems, therefore, may be a significant confounding factor in the interpretation of health outcomes among patients with chronic diseases.

Adult↗

PubMed2004

Sleep problems in children with autism.

Autism is a developmental disability characterized by severe deficits in social interaction and communication, and the presence of repetitive-ritualistic behaviors. Sleep problems are frequently reported by parents of children with autism with prevalence estimates of 44-83% for sleep disorders in this population. To better understand sleep in autism, we surveyed sleep problems in 210 children with autism using a Likert-based questionnaire for parent report. The most frequently reported sleep problems included difficulty in falling asleep, restless sleep, not falling asleep in own bed, and frequent wakenings. Least frequently reported sleep problems were sleep walking, morning headaches, crying during sleep, apnea, and nightmares. When surveys were divided into mental retardation (MR)/not MR categories, no significant differences were identified in frequencies of reported sleep problems except for waking at night which occurred much more frequently in the MR group. There was also no difference in sleep problems related to age of the child other than nocturnal enuresis. An association was noted between certain medical problems and sleep problems. Vision problems, upper respiratory problems, and runny nose were associated with decreased nighttime sleep. Vision problems, poor appetite, and poor growth were associated with increased nighttime waking. Poor appetite and poor growth were associated with decreased willingness to fall asleep. This study confirms a high prevalence of sleep problems reported by parents of children with autism and points to the need for more systematic research as an initial step in developing treatment strategies.

Adolescent↗

PubMed1995

Sleep problems and their correlates in a working population.

OBJECTIVE: To measure the prevalence of sleep problems in a working population and examine their association with health problems, health-related quality-of-life measures, work-related problems, and medical expenditures. Also, to explore the usefulness of a sleep-problems screen for mental health conditions and underlying sleep disorders. DESIGN: Cross-sectional survey administered via voice mail and telephone interview. SETTING: A San Francisco Bay Area telecommunications firm. PARTICIPANTS: Volunteer sample of 588 employees who worked for a minimum of six months at the company and were enrolled in its fee-for-service health plan. MEASUREMENTS AND MAIN RESULTS: Thirty percent of respondents reported currently experiencing sleep problems and were found to have worse functioning and well-being (general health, cognitive functioning, energy), more work-related problems (decreased job performance and lower satisfaction, increased absenteeism), and a greater likelihood of comorbid physical and mental health conditions than were the respondents who did not have sleep problems. They also demonstrated a trend toward higher medical expenditures. CONCLUSIONS: Self-perceived sleep problems were common among the respondents and were associated with poorer health and health-related quality of life. A single question about sleep problems may serve as an effective screen for identifying primary care patients with mental health problems, as well as underlying sleep disorders.

Absenteeism↗

PubMedDate not supplied

Prevalence of sleep problems and habits in a sample of Saudi primary school children.

BACKGROUND: Sleep problems in children vary not only with age, but also with ethnic and sociocultural background. No research has been conducted to assess sleep problems in Saudi elementary school children. This study surveyed parents (or guardians) abouttheir elementary school children's sleep to assess the prevalence of certain sleep problems. METHODS: The study population comprised boys and girls attending regular public elementary schools in all grades and was conducted during springtime of the year 1999. A questionnaire inquiring about demographic data, specific sleep problems and habits and home environment was distributed and completed bythe parents or guardians. RESULTS: A total of 1012 complete questionnaires were included in the analysis. The sample comprised 511 boys (50.5%) and 501 girls (49.5%). The mean age was 9.5+/-1.9 years, ranging from 5 to 13 years. Daytime fatigue was the most prevalent sleep problem (37.5%) followed by bedtime resistance (26.2%), difficulty rising in the morning during weekdays (20.7%), and sleep-onset delay (11.8%). Cosleeping with parents was reported in 12.4% of children. The study revealed some differences between boys and girls. Napping during the daytime was reported in 40.8% of children. CONCLUSION: The study showed that sleep problems are prevalent among Saudi elementary school children. Moreover, the study shed some light on sleep habits and practices in this age group in Saudi Arabia, like the high prevalence of daytime napping.

Adolescent↗

PubMed2004

Association between television viewing and sleep problems during adolescence and early adulthood.

BACKGROUND: Although research has suggested that extensive television viewing may be associated with sleep problems, the direction of this association has not yet been determined. OBJECTIVE: To investigate directional hypotheses regarding the association between television viewing and sleep problems during adolescence and early adulthood. DESIGN: The Children in the Community Study, a prospective longitudinal investigation. PARTICIPANTS AND SETTING: A community-based sample of 759 mothers from upstate New York and their offspring were interviewed during the early adolescence (mean age, 14 years), middle adolescence (mean age, 16 years), and early adulthood of the offspring (mean age, 22 years). MAIN OUTCOME MEASURES: Television viewing and sleep problems during adolescence and early adulthood measured using the Disorganizing Poverty Interview and the age-appropriate versions of the Diagnostic Interview Schedule for Children. RESULTS: Adolescents who watched 3 or more hours of television per day during adolescence were at a significantly elevated risk for frequent sleep problems by early adulthood. This elevation in risk remained significant after offspring age, sex, previous sleep problems, offspring psychiatric disorders, offspring neglect, parental educational level, parental annual income, and parental psychiatric symptoms were controlled statistically. Adolescents who reduced their television viewing from 1 hour or longer to less than 1 hour per day experienced a significant reduction in risk for subsequent sleep problems. Sleep problems during adolescence were not independently associated with subsequent television viewing when prior television viewing was controlled. CONCLUSION: Extensive television viewing during adolescence may contribute to the development of sleep problems by early adulthood.

Adolescent↗

PubMed1999

Sleep problems in the elderly.

Refreshing sleep requires both sufficient total sleep time as well as sleep that is in synchrony with the individual's circadian rhythm. Problems with sleep organization in elderly patients typically include difficulty falling asleep, less time spent in the deeper stages of sleep, early-morning awakening and less total sleep time. Poor sleep habits such as irregular sleep-wake times and daytime napping may contribute to insomnia. Caffeine, alcohol and some medications can also interfere with sleep. Primary sleep disorders are more common in the elderly than in younger persons. Restless legs syndrome and periodic limb movement disorder can disrupt sleep and may respond to low doses of antiparkinsonian agents as well as other drugs. Sleep apnea can lead to excessive daytime sleepiness. Evaluation of sleep problems in the elderly includes careful screening for poor sleep habits and other factors that may be contributing to the sleep problem. Formal sleep studies may be needed when a primary sleep disorder is suspected or marked daytime dysfunction is noted. Therapy with a benzodiazepine receptor agonist may be indicated after careful evaluation.

Aged↗

PubMed2005

A survey of sleep problems in autism, Asperger's disorder and typically developing children.

BACKGROUND: Sleep problems are common in typically developing (TD) children and in children with autism, however, less is known about the sleep of children with Asperger's disorder (AD). The aim of this study was to compare sleep patterns of children with autism and AD to a TD group of children. METHODS: Sixty-six parents of TD children, 53 parents of children with autism, and 52 parents of children with AD completed a survey on their child's sleep patterns, the nature and severity of any sleep problems and success of any treatment attempted. RESULTS: The results showed high prevalence of sleep problems with significantly more problems reported in the autism and AD groups (TD = 50%, autism = 73%, AD = 73%), with no significant differences between groups on severity or type of sleep problem. Children with AD were significantly more likely to be sluggish and disoriented after waking and had a higher Behavioral Evaluation of Disorders of Sleep (BEDS) total score compared to the other two groups. The autism and AD groups reported significantly better treatment success for medication compared to the TD group. The autism group reported significantly better success for behavioural treatment compared to the AD group. CONCLUSIONS: In conclusion, children with AD may have more symptoms of sleep disturbance, and different types of sleep problems than children with autism. As this is the first study to compare autism and AD and to survey treatment outcomes, further research is needed to validate these findings.

Asperger Syndrome↗

PubMed2007

Adverse associations of sleep problems in Australian preschoolers: national population study.

OBJECTIVE: In contrast to school-aged children, the impact of sleep problems in preschool-aged children is not well documented. We aimed to determine relationships between preschool-aged child sleep problems and child behavior; health-related quality of life; verbal, preliteracy, and early numeracy skills; diagnosis of attention-deficit/hyperactivity disorder; and injury. PARTICIPANTS AND METHODS: Participants included families (n = 4983) participating in the first wave of the Longitudinal Study of Australian Children, a nationally representative study of Australian children aged 4 to 5 years surveyed from March to November 2004. Measures consisted of a primary caregiver's report of whether their child had a sleep problem (none versus mild versus moderate/severe); specific sleep patterns occurring > or = 4 nights per week; health-related quality of life (by using the Pediatric Quality of Life Inventory 4.0); behavior (by using the Strengths and Difficulties Questionnaire) and parent-reported diagnosis of attention-deficit/hyperactivity disorder; and injury requiring medical attention in the past 12 months. Tests of receptive vocabulary and preliteracy/numeracy skills (by using the Who Am I? developmental assessment and the adapted Peabody Picture Vocabulary Test, 3rd Edition) were directly administered to each child. RESULTS: Sleep problems were common, and compared with children without sleep problems, children with sleep problems had poorer child health-related quality of life, more behavior problems, and higher rates of attention-deficit/hyperactivity disorder. Difficulty going to sleep and morning tiredness had greater adverse associations than snoring or night waking. CONCLUSIONS: Given that sleep problems are very common, the adverse outcomes shown here could affect the transition to school for a very large number of preschoolers.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

Evaluating a family-centred intervention for infant sleep problems.

AIM: This paper reports a study to describe changes in parents' distress after a family-centred intervention for sleep problems of infants. BACKGROUND: Infant sleep problems are common and are related to depressive symptoms in mothers, but their impact on fathers has rarely been studied. Because childhood sleep problems and parental distress are associated, their interdependence should be recognized in research and in paediatric sleep practice. METHODS: All children hospitalized for sleep problems in a hospital in Iceland in 1997-1998 and their parents were studied using a pre- and post-test quasi-experimental design. The sample consisted of 33 infants (6-23 months of age), 33 mothers and 30 fathers. Parents' distress was assessed before and after treatment with regard to: (1) fatigue and resulting symptom distress; (2) parenting stress; (3) state-anxiety; and (4) depressive symptoms. Infants were treated for a variety of sleep problems by a paediatric nurse. The parents were simultaneously treated for distress by either the paediatric nurse or a specialist, depending on the nature of their problems. RESULTS: Mothers and fathers experienced a high degree of distress before the intervention, with no significant difference between them. Two months after the intervention both parents' distress had significantly improved. Parents' degree of distress was at a psychopathological level before the intervention but was reduced to population norms 2 months after the intervention. The paediatric nurse intervention was sufficient to reduce distress for 83% of parents. CONCLUSIONS: Health care professionals who care for infants with sleep problems should pay attention to the distressed responses of parents and support their recovery. An intervention such as that described here could be used by nurses for this purpose.

Adult↗

PubMed1998

Functional assessment and treatment of sleeping problems with developmentally disabled children: six case studies.

Sleeping problems are common among developmentally disabled children of young age and they may have adverse effects on the well-being of both child and parents. In the present study, results from functional assessment with four children suggested that sleeping problems were reinforced by parental attention whilst an undiagnosed seizure disorder was associated with nighttime crying with one child. Conditioned anxiety resulted in problems in settling to sleep with a sixth child. Behavioral (i.e., extinction, desensitization) and pharmacological (i.e., anticonvulsant) treatment resulted in a substantial reduction in sleeping problems with all children. Follow-up data indicate that effects were maintained.

Anticonvulsants↗

PubMed1997

Sleeping problems at 78 degrees north: the Svalbard Study.

The aim of this study, was to compare the prevalence of sleeping problems in two ethnically different populations living under the same extreme arctic climate. A total of 453 Norwegians (319 males and 134 females) were compared with 450 Russians (317 males and 133 females), all aged 18 years or older, living on Svalbard, the northernmost regular settlement in the world. Among Russians, 81% of the male subjects and 77% of the female subjects reported sleeping problems lasting for at least 2 weeks. The corresponding figures for the Norwegians were 22% (for males) and 25% (for females). Among Russians, sleeping problems decreased with increasing age, but no such age trend was found in Norwegians. Whereas sleeping problems among Norwegians were approximately equally frequent throughout the year, the Russians reported more problems during the polar night. 'Problems falling asleep', 'not feeling rested in the morning' and 'walking up several times during the night' were the most frequent types of sleeping problems in both groups. Depression, shift work, loneliness, ability to concentrate, alcohol consumption and quality of life were associated with sleeping problems in Norwegian subjects, whereas depression, shift work, ability to concentrate, and worry were associated with sleeping problems in Russians. The prevalence of sleeping problems was nearly fourfold higher among Russian subjects than among Norwegians living on Svalbard. As the Russians were recruited from a lower latitude than the Norwegians, we postulate that their problems should be interpreted in terms of inadequate acclimatization after migration to the north.

Adult↗

PubMed2004

Sleep problems in early childhood and early onset of alcohol and other drug use in adolescence.

BACKGROUND: No prospective studies exist on the relationship between sleep problems early in life and subsequent alcohol use. Stimulated by the adult literature linking sleep problems to the subsequent onset of alcohol use disorders in some adults, we examined whether sleep problems in early childhood predicted the onset of alcohol and other drug use in adolescence and whether such a relationship was mediated by other known predictors of this relationship, namely, attention problems, anxiety/depression, and aggression in late childhood. METHODS: This study is part of an ongoing longitudinal study of the development of risk for alcohol and other substance use disorders. Study participants were 257 boys from a community-recruited sample of high-risk families. RESULTS: Mothers' ratings of their children's sleep problems at ages 3 to 5 years significantly predicted an early onset of any use of alcohol, marijuana, and illicit drugs, as well as an early onset of occasional or regular use of cigarettes by age 12 to 14. Additionally, although sleep problems in early childhood also predicted attention problems and anxiety/depression in later childhood, these problems did not mediate the relationship between sleep problems and onset of alcohol and other drug use. CONCLUSIONS: This is, to our knowledge, the first study that prospectively examines the relationship between sleep problems and early onset of alcohol use, a marker of increased risk for later alcohol problems and alcohol use disorders. Moreover, early childhood sleep problems seem to be a robust marker for use of drugs other than alcohol. Implications for the prevention of early alcohol and other drug use are discussed.

Adolescent↗