Higher Rates of Sleep Disturbance Among Offspring of Parents With Recurrent Depression Compared to Offspring of Nondepressed Parents

Jessica L. Hamilton, PHD; Cecile D. Ladouceur, PHD; Jennifer S. Silk, PHD; Peter L. Franzen, PHD; Lauren M. Bylsma, PHD

Disclosures

J Pediatr Psychol. 2020;45(1):1-11. 

In This Article

Results

Table I presents descriptive statistics of primary study variables for the overall sample and by risk status, as well as percentage of youth above clinical cutoffs for sleep disturbance and internalizing symptoms. Bivariate correlations are provided in Supplementary Table 1. Both parent and child reports of sleep disturbance were correlated, signifying convergence of reports. On average, participants reported 9.08 (SD = .10; range: 6.9–12.56) hours of sleep per night. However, 37% of youth under 13 reported less than the recommended 9 hrs of sleep on weekdays, 64% of all youth reported at least one night less than 8 hrs, and 35% reported at least one night less than 7 hrs. The average sleep midpoint was 3: 38 a.m., with youth ranging from 1: 58 a.m. to 8: 11 a.m. Sleep midpoint was later on weekends than weekdays (t(81) = 8.87, p < .001) and sleep duration was longer (t(81) = 2.55, p < .001). Youth who completed the study during a school-break had later sleep midpoints (B = 1.56; SE = .26; p < .001), but there was no effect on sleep duration or disturbance. Most youth (66%) completed the study during the school year; high-risk youth were more likely to complete the study during the school-break. Ten youth reported that they set their own bedtimes (7 low-risk youth and 3 high-risk). There were no significant differences by sex on primary demographic variables (age, puberty, sleep, or internalizing symptoms, sleep; p's > .05); however, high-risk youth had lower SES.

Child Risk Status Predicting Sleep Disturbance, Duration, and Midpoint

Our model fit for path analysis was saturated. Consistent with hypotheses, we found a significant main effect of risk status for sleep disturbance as reported by both high-risk youth and their parents (Table II). Of note, these results simultaneously examined parent- and child-reported sleep disturbance, and covaried for youth age, sex, SES, puberty, parent-set bedtimes and internalizing symptoms. Our model accounted for 24.5% of the total variance in parent-reported sleep disturbance and 44.9% of child-reported sleep disturbance; risk status accounted for 6.5% and 5.3%, respectively. Several covariates (age, depression) predicted youth sleep disturbance, with younger youth and those with elevated symptoms reporting more sleep disturbance, whereas SES (receipt of public assistance) predicted parent-reported sleep disturbance.

For the daily sleep variables, sleep duration and sleep midpoint were significantly correlated at the within-person level (B = −.28; SE = .07; p < .001) and at the between-person level (B = −.44; SE = .14; p = .002). There were no main effects of risk status on the intercept of sleep midpoint or duration over the 9-day study period (Table III), controlling for age, sex, pubertal status, SES, school break, and youth internalizing symptoms. Similarly, there were no significant effects when separately examined by weekday or weekend days (Supplementary Table 2 and Supplementary Table 3). This finding is in contrast to our hypothesis that high-risk youth would have shorter sleep duration and later sleep timing. Several covariates, school break and SES, significantly predicted later sleep midpoint. There was significant variability observed within-individual (level 1) and between-individual (level 2) in sleep duration and midpoint (Table III), indicating that other factors may explain individual variability in sleep duration and midpoint.

Sex Differences in Risk Status Predicting Sleep Domains

For exploratory analyses examining whether high and low risk youth demonstrated distinct sleep disturbances by sex, we only found significant interactions of sex and risk status for parent-reported sleep disturbance (Table II). Probing this interaction (Figure 1), high-risk girls had more parent-reported sleep disturbance than low-risk girls (B = .36; B/SE = 3.35; p = .001) and high-risk boys (B = .40; B/SE = 2. 57; p = .01). There were no significant interactions for sleep duration or midpoint (Table III). There were still significant individual variability and fluctuations from sleep midpoint and sleep duration (i.e., random intercept).

Figure 1.

Average amount of parent-reported sleep disturbance by risk status and sex.
Note. Means depicted are the average amount of sleep disturbance reported on the Children's Sleep Habits Questionnaire (CSHQ).

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