Behavioral Sleep-Related Problems in Clinically Anxious Children: A Parent-Report Diary Study

Area of Science:

• Child Psychology
• Sleep Medicine
• Behavioral Science

Background:

• Anxiety disorders and behavioral sleep-related problems (SRPs) frequently co-occur in childhood.
• Few studies have utilized sleep diaries to investigate these co-occurrences.
• Parental perception is a key factor in identifying childhood behavioral issues.

Purpose of the Study:

• To examine parental perceptions of behavioral SRPs in clinically anxious versus non-anxious children.
• To utilize a 7-day sleep diary for detailed assessment of behavioral SRPs.
• To compare the frequency and nature of SRPs between anxious and control groups.

Main Methods:

• A 7-day sleep diary was completed by parents of 22 clinically anxious children and 29 healthy controls (aged 6-13 years).
• Parents recorded their child's behavioral SRPs, including mood, bedtime, night awakenings, and morning routines.
• Data were analyzed to compare parental ratings of SRPs between the anxious and control groups.

Main Results:

• Parents rated anxious children as more frequently exhibiting negative pre-sleep mood, bedtime delay, and needing nighttime parental assistance.
• Anxious children were also reported to have more difficulty waking, falling back asleep after morning waking, and waking in a negative mood.
• No significant differences were found in sleep onset latency or duration; reported SRPs did not impact next-day functioning.

Conclusions:

• Parents of anxious children are more likely to perceive and report behavioral sleep-related problems compared to parents of non-anxious children.
• Parental perception of behavioral SRPs is heightened in anxious youth, particularly concerning mood and bedtime routines.
• While behavioral SRPs are perceived more in anxious children, objective sleep parameters and daily functioning were not significantly affected based on parent reports.