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Abstract
Sleep problems are prevalent in youth with behavioral and emotional problems which is concerning considering the associated negative consequences found in nonclinical populations, including a decline in behavioral and emotional functioning. Despite research suggesting a dynamic relationship between sleep, mood, and behavior in nonclinical youth, there has been relatively little examination of these relationships, particularly at the daily level, in clinical samples. Thus, the primary aim of the present study was to examine the daily, sequential relationship between sleep and psychopathology in a clinical sample of youth. Youth aged 6 to 11 (36% female, 44% European American) presenting to outpatient behavioral health treatment (N = 25) were recruited to participate in the study. Baseline measures of sleep and emotional and behavioral functioning were collected. Additionally, children and parents completed daily questionnaires regarding the child's sleep, mood, and behavior for a 14 day period while youth wore an actigraph watch to objectively measure sleep.
Multilevel models were estimated to deconstruct the between and within person variance in the relationship between sleep and mental health. Overall, results indicate that these youth had poor sleep duration and quality and that sleep and psychopathology were highly related at baseline and at the daily-level. Between-person effects were found to be most important and significant sequential relationships between average daily mental health and sleep were found. Further, baseline moderators of this relationship were explored.
Results indicate that identifying and addressing sleep problems in the context of mental health treatment is important as sleep is associated with worse psychopathology and may contribute to exacerbated mental health symptoms. Beyond treatment implications, results provide a stepping stone for future research to examine mechanisms and intervention strategies for this relationship.
