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Updated: Jun 27, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents
Candice A Alfano1, Alan H Zakem, Natalie M Costa
1Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, The George Washington University School of Medicine, 111 Michigan Avenue NW, Washington, DC 20010, USA. calfano@cnmc.org
Background:
Existing research indicates sleep problems to be prevalent in youth with internalizing disorders. However, childhood sleep problems are common in the general population and few data are available examining unique relationships between sleep, specific types of anxiety and depressive symptoms among non-clinical samples of children and adolescents.
Methods:
The presence of sleep problems was examined among a community sample of children and adolescents (N=175) in association with anxiety and depressive symptoms, age, and gender. Based on emerging findings from the adult literature we also examined associations between cognitive biases and sleep problems.
Results:
Overall findings revealed significant associations between sleep problems and both anxiety and depressive symptoms, though results varied by age. Depressive symptoms showed a greater association with sleep problems among adolescents, while anxiety symptoms were generally associated with sleep problems in all youth. Cognitive factors (cognitive errors and control beliefs) linked with anxiety and depression also were associated with sleep problems among adolescents, though these correlations were no longer significant after controlling for internalizing symptoms.
Conclusions:
Results are discussed in terms of their implications for research and treatment of sleep and internalizing disorders in youth.
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