Santos João Paulo Lima, Versace Amelia, Ladouceur Cecile D, Soehner Adriane M
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Magnetic Resonance Research Center, University of Pittsburgh, Pittsburgh, PA, USA.
Behav Sleep Med. 2025 Jan-Feb;23(1):31-43. doi: 10.1080/15402002.2024.2401471. Epub 2024 Sep 8.
Sleep and internalizing problems escalate during adolescence and can negatively impact long-term health. However, the directionality of this risk-relationship remains poorly understood within a developmental context. The current study aimed to determine the directionality of this relationship in adolescents with no history of psychiatric disorder and whether sex at birth played a role in this relationship.
We used data from the Adolescent Brain Cognitive Development, an ongoing multisite longitudinal US study, that covered four waves (W1:9-11 years; W2:10-12 years; W3:11-13 years; W4:12-14 years). Analyses included 3,128 youth (50.99%girls) with no past or current psychiatric disorders at W1. The Sleep Disturbance Scale for Children and the Child Behavior Checklist were used to measure sleep and internalizing problems. Cross-lagged panel models were used to evaluate the cross-lagged relationships across waves.
The sleep-internalizing cross-lagged relationship was unidirectional, with medium-large effect sizes: greater total sleep problems were associated with more severe internalizing problems at later waves (W2➔W3, coefficient = 0.052, = .021; W3➔W4, coefficient = 0.091, < .001), with problems in initiating and maintaining sleep predicting internalizing problems early on. Girls showed greater sleep-internalizing risk than boys.
Sleep-internalizing relationships change across adolescence, becoming significant and more specific from early to mid-adolescence. Sleep interventions delivered in early adolescence, to girls in particular, may have a positive short and long-term impact on internalizing outcomes.
睡眠问题和内化问题在青少年时期会加剧，并且会对长期健康产生负面影响。然而，在发育背景下，这种风险关系的方向性仍知之甚少。本研究旨在确定无精神疾病史的青少年中这种关系的方向性，以及出生时的性别是否在这种关系中起作用。
我们使用了来自美国一项正在进行的多地点纵向研究“青少年大脑认知发展”的数据，该研究涵盖四个阶段（W1：9 - 11岁；W2：10 - 12岁；W3：11 - 13岁；W4：12 - 14岁）。分析纳入了3128名在W1时无既往或当前精神疾病的青少年（50.99%为女孩）。使用儿童睡眠障碍量表和儿童行为清单来测量睡眠问题和内化问题。采用交叉滞后面板模型来评估各阶段之间的交叉滞后关系。
睡眠 - 内化交叉滞后关系是单向的，效应量为中到大：总睡眠问题越多，在后续阶段（W2→W3，系数 = 0.052，p = 0.021；W3→W4，系数 = 0.091，p < 0.001）的内化问题就越严重，入睡和维持睡眠问题在早期就能预测内化问题。女孩比男孩表现出更大的睡眠 - 内化风险。
睡眠 - 内化关系在整个青春期会发生变化，从青春期早期到中期变得显著且更具特异性。特别是在青春期早期对女孩进行睡眠干预，可能会对内化结果产生积极的短期和长期影响。
