Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1124-1132 (doi:10.1542/peds.2005-3118)
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ARTICLE

Associations Between Sleep Problems, Anxiety, and Depression in Twins at 8 Years of Age

Alice M. Gregory, PhDa,b, Frühling V. Rijsdijk, PhDa, Ronald E. Dahl, MDc, Peter McGuffin, PhDa and Thalia C. Eley, PhDa

a Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
b Psychology Department, Goldsmiths College, University of London, London, United Kingdom
c Deparment of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

OBJECTIVES. Associations between sleep and internalizing problems are complex and poorly understood. To better understand these covarying difficulties, genetic and environmental influences were estimated by using a twin design.

METHODS. Three hundred 8-year-old twin pairs reported on their anxiety and depression by completing the Screen for Childhood Anxiety Related Emotional Disorders and the Children's Depression Inventory. Parents reported on their children's sleep problems by completing the Child Sleep Habits Questionnaire.

RESULTS. Children reported by their parents to have different types of sleep problems self-reported more depression symptoms than those without. The correlation between total sleep-problem score and depression was moderate. That between sleep problems and anxiety was smaller and was not examined further. The association between sleep problems and depression was mainly explained by genes, and there was substantial overlap between the genes influencing sleep problems and those influencing depression. There was smaller influence from environmental factors making family members alike, and environmental factors making family members different decreased the association between sleep problems and depression.

CONCLUSIONS. A range of sleep difficulties are associated with depression in school-aged children, and the overall association between the 2 difficulties may be largely influenced by genes.

Key Words: sleep problems • anxiety • depression • twins

Abbreviations: ECHO—Emotions, Cognitions, Heredity and Outcome • TEDS—Twins Early Development Study • SES—socioeconomic status • CSHQ—Child Sleep Habits Questionnaire • CDI—Children's Depression Inventory • A—genetic influence • C—shared environmental influence • E—nonshared environmental influence • AIC—Akaike information criterion • CI—confidence interval

Accepted Apr 13, 2006.




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