Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Bipolar Disord. 2024 Mar;26(2):176-185. doi: 10.1111/bdi.13376. Epub 2023 Aug 9.
Disturbed sleep during early childhood predicts social-emotional problems. However, it is not known how various early childhood sleep phenotypes are associated with the development of childhood psychopathology, nor whether these relationships vary as a function of parental psychopathology. We identified sleep phenotypes among preschool youth; examined whether these phenotypes were associated with child and parent factors; and determined if early sleep phenotypes predicted later childhood psychopathology.
Using data from the Pittsburgh Bipolar Offspring study, parents with bipolar disorder (BD), non-BD psychopathology, and healthy controls reported about themselves and their offspring (n = 218) when their children were ages 2-5. Offspring and parents were interviewed directly approximately every 2 years from ages 6-18. Latent class analysis (LCA) identified latent sleep classes; we compared these classes on offspring demographics, parental sleep variables, and parental diagnoses. Kaplan-Meier survival models estimated hazard of developing any new-onset Axis-I disorders, as well as BD specifically, for each class.
The optimal LCA solution featured four sleep classes, which we characterized as (1) good sleep, (2) wake after sleep onset problems, (3) bedtime problems (e.g., trouble falling asleep, resists going to bed), and (4) poor sleep generally. Good sleepers tended to have significantly less parental psychopathology than the other three classes. Risk of developing new-onset Axis-I disorders was highest among the poor sleep class and lowest among the good sleep class.
Preschool sleep phenotypes are an important predictor of the development of psychopathology. Future work is needed to understand the biopsychosocial processes underlying these trajectories.
儿童早期睡眠紊乱可预测社会情绪问题。然而,目前尚不清楚各种儿童早期睡眠表型与儿童精神病理学的发展有何关联,也不知道这些关联是否因父母精神病理学而异。我们在学龄前儿童中确定了睡眠表型;研究了这些表型是否与儿童和父母因素有关;并确定早期睡眠表型是否预测后期儿童精神病理学。
使用匹兹堡双相障碍后代研究的数据,双相障碍(BD)、非 BD 精神病理学和健康对照组的父母报告了他们自己和他们的孩子(n=218)在孩子 2-5 岁时的情况。孩子在 6-18 岁时大约每两年接受一次直接访谈。潜在类别分析(LCA)确定了潜在的睡眠类别;我们比较了这些类别的儿童人口统计学、父母睡眠变量和父母诊断。Kaplan-Meier 生存模型估计了每个类别发生任何新出现的轴 I 障碍的风险,以及特定的 BD。
最佳 LCA 解决方案具有四个睡眠类别,我们将其特征描述为(1)良好的睡眠,(2)睡眠后觉醒问题,(3)就寝时间问题(例如入睡困难,抗拒上床睡觉),和(4)总体睡眠不佳。良好的睡眠者的父母精神病理学明显少于其他三个类别。新出现的轴 I 障碍的风险在睡眠不佳的类别中最高,在良好的睡眠类别中最低。
学龄前睡眠表型是精神病理学发展的重要预测指标。需要进一步研究这些轨迹背后的生物心理社会过程。