Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Society for Arts and Sciences, Amsterdam, The Netherlands.
Department of Clinical Child and Adolescent Studies, Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands.
J Child Psychol Psychiatry. 2021 Jan;62(1):28-39. doi: 10.1111/jcpp.13238. Epub 2020 May 12.
Whereas short and problematic sleep are associated with psychological problems in adolescence, causality remains to be elucidated. This study therefore utilized the discordant monozygotic cotwin design and cross-lagged models to investigate how short and problematic sleep affect psychological functioning.
Adolescent twins (N = 12,803, 13-20 years, 42% male) completed questionnaires on sleep and psychological functioning repeatedly over a two-year interval. Monozygotic twin pairs were classified as concordant or discordant for sleep duration and trouble sleeping. Resulting subgroups were compared regarding internalizing problems, externalizing problems, and subjective well-being.
Cross-sectional analyses indicated associations of worse psychological functioning with both short sleep and problematic sleep, and cross-lagged models indicate bidirectional associations. Longitudinal analyses showed that an increase in sleep problems experienced selectively by one individual of an identical twin pair was accompanied by an increase of 52% in internalizing problem scores and 25% in externalizing problem scores. These changes were significantly different from the within-subject changes in cotwins with unchanged sleep quality (respectively, 3% increase and 5% decrease). Psychological functioning did, however, not worsen with decreasing sleep duration.
The findings suggest that sleep quality, rather than sleep duration, should be the primary target for prevention and intervention, with possible effect on psychological functioning in adolescents.
尽管短暂和有问题的睡眠与青少年时期的心理问题有关，但因果关系仍需阐明。因此，本研究利用不一致的同卵双胞胎设计和交叉滞后模型来研究短暂和有问题的睡眠如何影响心理功能。
青少年双胞胎（N=12803，13-20 岁，42%为男性）在两年的时间内反复完成关于睡眠和心理功能的问卷。同卵双胞胎按睡眠持续时间和睡眠问题分为一致或不一致。对结果亚组进行内部问题、外部问题和主观幸福感的比较。
横断面分析表明，较差的心理功能与睡眠不足和睡眠问题都有关，而交叉滞后模型表明存在双向关联。纵向分析表明，同卵双胞胎中一个人经历的睡眠问题增加，内部问题评分增加 52%，外部问题评分增加 25%。这些变化与睡眠质量不变的双胞胎中的个体内变化明显不同（分别增加 3%和减少 5%）。然而，睡眠持续时间的减少并不会导致心理功能恶化。
研究结果表明，睡眠质量而不是睡眠持续时间应该是预防和干预的主要目标，这可能对青少年的心理功能产生影响。
