Sleep profile in a sample of Egyptian school-aged children with depression

Abstract

Background Children with major depressive disorder often complain of subjective sleep disturbances. Studies that assessed the prevalence and nature of subjective sleep complaints in children and adolescents with depression showed controversial findings. Many polysomnographic (PSG) studies have failed to find objective evidence of these disturbances. Aim The aim of this study was to find out the following: (i) differences in sleep profile between children with depression and healthy control; (ii) the relationship between sleep profile disturbance and the severity of depression; (iii) the role of sex in sleep profile disturbance of depressed children; (iv) the relationship between family history of psychiatric disorders and sleep profile disturbance of depressed children. Patients and methods Participants were randomly selected according to certain inclusion and exclusion criteria from the Child Psychiatry Clinic in the Institute of Psychiatry, Ain Shams University Hospitals. Cases and controls were subjected to psychiatric institute sheet, MINI Kid (Arabic version), IQ test, Children’s Sleep Habits Questionnaire (CSHQ) (Arabic version), Children’s Depression Inventory Questionnaire and PSG. Results The study sample consisted of 30 children: 20 cases and 10 controls. A total of 60% were boys and 40% were girls (for both cases and controls), with an age range of 8–12 years (mean 9.95 years) for cases and 8–10 years (mean 10.3 years) for controls. There were significant differences in many sleep parameters in cases compared with controls including increased sleep latency, decreased sleep efficiency, increased stages NI and NII, decreased stage NIII (deep sleep), decreased rapid eye movement (REM) latency, increased bedtime resistance, increased time to sleep, decreased sleep period and marked increase in sleep-related anxiety, with relevant increased disorders of excessive somnolence (with no significance to age, sex, REM sleep or REM density). Children’s Depression Inventory Questionnaire severity scores were correlated with most of the CSHQ and PSG parameters. Conclusion Depressed children showed a significant distinct profile of sleep disturbance compared with healthy normal controls. This profile is apparent both in clinical parameters such as CSHQ and in PSG parameters. Specifically, bedtime resistance and sleep period are strongly related to the severity of depression.