Associations of sleep with psychological problems and well-being in adolescence: causality or common genetic predispositions?

BACKGROUND: Whereas short and problematic sleep are associated with psychological problems in adolescence, causality remains to be elucidated. This study therefore utilized the discordant monozygotic cotwin design and cross-lagged models to investigate how short and problematic sleep affect psychological functioning. METHODS: Adolescent twins (N = 12,803, 13-20 years, 42% male) completed questionnaires on sleep and psychological functioning repeatedly over a two-year interval. Monozygotic twin pairs were classified as concordant or discordant for sleep duration and trouble sleeping. Resulting subgroups were compared regarding internalizing problems, externalizing problems, and subjective well-being. RESULTS: Cross-sectional analyses indicated associations of worse psychological functioning with both short sleep and problematic sleep, and cross-lagged models indicate bidirectional associations. Longitudinal analyses showed that an increase in sleep problems experienced selectively by one individual of an identical twin pair was accompanied by an increase of 52% in internalizing problem scores and 25% in externalizing problem scores. These changes were significantly different from the within-subject changes in cotwins with unchanged sleep quality (respectively, 3% increase and 5% decrease). Psychological functioning did, however, not worsen with decreasing sleep duration. CONCLUSIONS: The findings suggest that sleep quality, rather than sleep duration, should be the primary target for prevention and intervention, with possible effect on psychological functioning in adolescents.

Sleep spindle characteristics and sleep architecture are associated with learning of executive functions in school-age children.

The macro- and microstructural characteristics of sleep electroencephalography have been associated with several aspects of executive functioning. However, only a few studies have addressed the association of sleep characteristics with the learning involved in the acquisition of executive functions, and no study has investigated this for planning and problem-solving skills in the developing brain of children. The present study examined whether children's sleep stages and microstructural sleep characteristics are associated with performance improvement over repeated assessments of the Tower of Hanoi task, which requires integrated planning and problem-solving skills. Thirty children (11 boys, mean age 10.7 years, SD = 0.8) performed computerized parallel versions of the Tower of Hanoi three times across 2 days, including a night with polysomnographically assessed sleep. Pearson correlations were used to evaluate the associations of Tower of Hanoi solution time improvements across repeated assessments with sleep stages (% of total sleep time), slow-wave activity, and fast and slow spindle features. The results indicated a stronger performance improvement across wake in children with more Stage N2 sleep and less slow-wave sleep. Stronger improvements across sleep were present in children in whom slow spindles were more dense, and in children in whom fast spindles were less dense, of shorter duration and had less power. The findings indicate that specific sleep electroencephalography signatures reflect the ability of the developing brain to acquire and improve on integrated planning and problem-solving skills.

Chronic sleep reduction is associated with academic achievement and study concentration in higher education students.

Inadequate sleep impairs cognitive function and has been associated with worse academic achievement in higher education students; however, studies that control for relevant background factors and include knowledge on sleep hygiene are scarce. This study examined the association of chronic sleep reduction (i.e. symptoms of chronic sleep reduction such as shortness of sleep, sleepiness and irritation), subjective sleep quality and sleep hygiene knowledge with academic achievement (grades and study credits) and study concentration among 1378 higher education students (71% female, mean age 21.73 years, SD = 3.22) in the Netherlands. Demographic, health, lifestyle and study behaviour characteristics were included as covariates in hierarchical regression analyses. After controlling for significant covariates, only chronic sleep reduction remained a significant predictor of lower grades (last exam, average in current academic year). Better sleep quality and sleep hygiene knowledge were associated with better academic achievement, but significance was lost after controlling for covariates, except for a remaining positive association between sleep hygiene beliefs and grades in the current academic year. Moreover, better sleep quality and lower scores on chronic sleep reduction were associated with better study concentration after controlling for significant covariates. To conclude, chronic sleep reduction is associated with academic achievement and study concentration in higher education students. Inadequate sleep hygiene knowledge is moderately associated with worse academic achievement. Future research should investigate whether sleep hygiene interventions improve academic achievement in students of higher education.

Memory effects of sleep, emotional valence, arousal and novelty in children.

Effectiveness of memory consolidation is determined by multiple factors, including sleep after learning, emotional valence, arousal and novelty. Few studies investigated how the effect of sleep compares with (and interacts with) these other factors, of which virtually none are in children. The present study did so by repeated assessment of declarative memory in 386 children (45% boys) aged 9-11 years through an online word-pair task. Children were randomly assigned to either a morning or evening learning session of 30 unrelated word-pairs with positive, neutral or negative valenced cues and neutral targets. After immediately assessing baseline recognition, delayed recognition was recorded either 12 or 24 h later, resulting in four different assessment schedules. One week later, the procedure was repeated with exactly the same word-pairs to evaluate whether effects differed for relearning versus original novel learning. Mixed-effect logistic regression models were used to evaluate how the probability of correct recognition was affected by sleep, valence, arousal, novelty and their interactions. Both immediate and delayed recognition were worse for pairs with negatively valenced or less arousing cue words. Relearning improved immediate and delayed word-pair recognition. In contrast to these effects, sleep did not affect recognition, nor did sleep moderate the effects of arousal, valence and novelty. The findings suggest a robust inclination of children to specifically forget the pairing of words to negatively valenced cue words. In agreement with a recent meta-analysis, children seem to depend less on sleep for the consolidation of information than has been reported for adults, irrespective of the emotional valence, arousal and novelty of word-pairs.

Temperament moderates the association between sleep duration and cognitive performance in children.

The importance of sufficient sleep for cognitive performance has been increasingly recognized. Individual differences in susceptibility to effects of sleep restriction have hardly been investigated in children. We investigated whether individual differences in temperament moderate the association of sleep duration with sustained attention, inhibition, and working memory in 123 children (42% boys) aged 9 to 11 years. Sleep duration was assessed using parental diaries, and temperament traits of extraversion and negative affectivity were assessed by child self-report (Early Adolescent Temperament Questionnaire-Revised). Computerized assessment of sustained attention (short-form Psychomotor Vigilance Task, PVT), inhibition (PVT Go/No-Go adaptation), and working memory (visual Digit Span) were performed at school. Our findings demonstrate that long-sleeping introverted and negatively affective children show worse sustained attention and working memory than short-sleeping children with these temperaments.