Lack of sleep in children increases risk of later emotional disorders

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Inadequate sleep impacts children’s emotional health not only by creating more negative emotions, but also by altering positive emotional experiences, found a University of Houston research review.

When asked how lack of sleep affects emotions, common responses are usually grumpy, foggy and short-tempered. While many jokes are made about how sleep deprivation turns the nicest of people into a Jekyll and Hyde, not getting enough shut-eye can lead to far more serious consequences than irritability, difficulty concentrating and impatience.

Candice Alfano, a clinical psychologist and associate psychology professor at the Sleep and Anxiety Centre of Houston, department of psychology, University of Houston, says children who experience inadequate or disrupted sleep are more likely to develop depression and anxiety disorders later in life. Funded by a grant from the NIH’s National Institute of Mental Health (NIMH), the study seeks to determine the precise ways inadequate sleep in childhood produces elevated risk for emotional disorders in later years.

“In particular, we are interested in understanding how children appraise, express, regulate and later recall emotional experiences, both when sleep is adequate and when it is inadequate,” said Alfano, who is the principal investigator of the study and director of the Sleep and Anxiety Centre of Houston (SACH). “We focus on childhood, because similar to problems with anxiety and depression, sleep habits and patterns develop early in life and can be enduring.”

Alfano and co-investigator Cara Palmer, who is a postdoctoral fellow at SACH, are identifying distinct emotional processes that, when disrupted by poor sleep, make children vulnerable to developing anxiety and depression. To pinpoint these cognitive, behavioural and physiological patterns of emotional risk, they are temporarily restricting sleep in 50 pre-adolescent children between the ages of 7 to 11.

Their findings reveal that inadequate sleep impacts children’s emotional health not only by creating more negative emotions, but also by altering positive emotional experiences. For example, after just two nights of poor sleep, children derive less pleasure from positive things, are less reactive to them and less likely to recall details about these positive experiences later. When their normal nightly sleep habits are adequate in duration, however, they’re finding these emotional effects are less apparent.

“Healthy sleep is critical for children’s psychological well-being,” Alfano said. “Continually experiencing inadequate sleep can eventually lead to depression, anxiety and other types of emotional problems. Parents, therefore, need to think about sleep as an essential component of overall health in the same way they do nutrition, dental hygiene and physical activity. If your child has problems waking up in the morning or is sleepy during the day, then their night-time sleep is probably inadequate. This can result for several reasons, such as a bedtime that is too late, non-restful sleep during the night or an inconsistent sleep schedule.”

Alfano says studying the link between sleep disruption and maladaptive emotional processing in childhood is essential, because that’s when sleep and emotion regulatory systems are developing. The increased need for sleep and greater brain plasticity during childhood suggests this to be a critical window of opportunity for early intervention. The combined societal costs of anxiety and depressive disorders are estimated to be more than $120bn annually, underscoring the need for early identification of risk factors and effective intervention methods.

Research by Palmer and Alfano reviewed the scientific literature on sleep and emotion regulation, partly to inform the methods of their NIH study. Their article provides evidence that without adequate sleep, people are less likely to seek out positive or rewarding experiences if they require effort, such as social or leisure activities. Over time, they say, these behavioural changes can elevate risk for depression and an overall poorer quality of life.

“There are multiple emotional processes that seem to be disrupted by poor sleep,” Alfano said. “For example, our ability to self-monitor, pick up on others’ non-verbal cues and accurately identify others’ emotions diminishes when sleep is inadequate. Combine this with less impulse control, a hallmark feature of the teenage years, and sleep deprivation can create a ‘perfect storm’ for experiencing negative emotions and consequences.”

Abstract
A growing body of research suggests that disrupted sleep is a robust risk and maintenance factor for a range of psychiatric conditions. One explanatory mechanism linking sleep and psychological health is emotion regulation. However, numerous components embedded within this construct create both conceptual and empirical challenges to the study of emotion regulation. These challenges are reflected in most sleep–emotion research by way of poor delineation of constructs and insufficient distinction among emotional processes. Most notably, a majority of research has focused on emotions generated as a consequence of inadequate sleep rather than underlying regulatory processes that may alter these experiences. The current review utilizes the process model of emotion regulation as an organizing framework for examining the impact of sleep upon various aspects of emotional experiences. Evidence is provided for maladaptive changes in emotion at multiple stages of the emotion generation and regulation process. We conclude with a call for experimental research designed to clearly explicate which points in the emotion regulation process appear most vulnerable to sleep loss as well as longitudinal studies to follow these processes in relation to the development of psychopathological conditions.

Authors
Cara A Palmer, Candice A Alfano

University of Houston material
Sleep Medicine Reviews abstract


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