Sleep Problems In Adolescents Research Articles

Childhood lead exposure and sleep problems in adolescents: a longitudinal cohort study.

Childhood lead exposure is linked to poorer neurobehavioral function in adolescence, but the relationship between lead and adolescent sleep health remains inconsistent. This study aimed to investigate concurrent and longitudinal associations between lead exposure and multiple sleep health domains in adolescents. A total of 972 adolescents from China Jintan Child Cohort were included in analyses. The Blood lead levels (BLLs) were assessed in two Waves, at ages 3-5years (mean 6.50 ± 2.76μg/dL) and 11-13years (mean 3.12 ± 1.17μg/dL). Sleep problems at age 11-13 were parent-reported via the Child Sleep Health Questionnaire (CSHQ) and self-reported by adolescents using the Pittsburgh Sleep Quality Index (PSQI). Both early and later BLLs were associated positively with parental reported sleep problems, including sleep onset delay, night waking, short duration, parasomnias, and disordered breathing. Sex-stratified analyzes showed that most adjusted associations between two-Wave BLLs and sleep outcomes (CSHQ and PSQI) remained statistically significant in males, with a minor increase in the magnitude of these associations. The association between Wave II BLLs and shorter self-reported sleep duration was only statistically significant in female adolescents. Compared to children with consistently low BLLs at both ages, those with persistently high BLLs at both ages had significantly shorter parental-reported sleep duration and worse sleep onset delay. Findings suggest that both early and later childhood lead exposures link to more adolescent sleep problems, with recent BLLs showing stronger associations with poor adolescent sleep health reported by their parents.

Machine learning approach to investigate pregnancy and childbirth risk factors of sleep problems in early adolescence: Evidence from two cohort studies

BackgroundThis study aimed to predict early adolescent sleep problems using pregnancy and childbirth risk factors through machine learning algorithms, and to evaluate model performance internally and externally. MethodsData from the China Jintan Child Cohort study (CJCC; n=848) for model development and the US Healthy Brain and Behavior Study (HBBS; n=454) for external validation were employed. Maternal pregnancy histories, obstetric data, and adolescent sleep problems were collected. Several machine learning techniques were employed, including least absolute shrinkage and selection operator, logistic regression, random forest, naïve bayes, extreme gradient boosting, decision tree, and neural network. The area under the receiver operating characteristic curve, sensitivity, specificity, accuracy, and root mean square of residuals were used to evaluate model performance. ResultsKey predictors for CJCC adolescents’ sleep problems include gestational age, birthweight, duration of delivery, and maternal happiness during pregnancy. In HBBS adolescents, the duration of postnatal depressive emotions was the primary perinatal predictor. The prediction models developed in the CJCC had good-to-excellent internal validation performance but poor performance in predicting the sleep problems in HBBS adolescents. ConclusionThe identification of specific perinatal risk factors associated with adolescent sleep problems can inform targeted interventions during and after pregnancy to mitigate these risks. Health providers should consider integrating these predictive factors into routine pre- and postnatal assessments to identify at-risk populations. The variability in model performance across different cohorts highlights the need for context-specific models and the cautious application of predictive analytics across diverse populations. Future research should focus on refining predictive models to account for such variations, potentially through the incorporation of additional socio-cultural factors and genetic markers. This study emphasizes the importance of personalized and culturally sensitive approaches in the prediction and management of adolescent sleep problems, leveraging advanced computational methods to enhance maternal and child health outcomes.

Associations between capacity of cognitive control and sleep quality: a two-wave longitudinal study.

This longitudinal study explored the impact of the upper limit of cognitive control on the sleep quality of high school students. We collected data in two waves to examine four main variables: capacity of cognitive control (CCC), trait mindfulness, emotional distress and sleep quality. At the first time point (T1), trait mindfulness and emotional distress were measured by rating scales, and the CCC was evaluated by revised backward masking majority function task. Sleep quality was rated 5 months later (T2). The results indicated that: (1) the CCC was negatively correlated with trait mindfulness, and trait mindfulness was negatively correlated with emotional stress; (2) there was no simple mediation of either trait mindfulness or emotional distress in the relationship between CCC and sleep quality; (3) instead, the CCC was associated with poor sleep quality in a sequential mediation through trait mindfulness and then emotional stress. The research highlights the importance of trait mindfulness and emotional distress for addressing sleep problems in adolescents.

Sleep Problems and Health Outcomes Among Urban American Indian and Alaska Native Adolescents

Adolescent sleep problems are prevalent, particularly among racial and ethnic minority groups, and can increase morbidity. Despite the numerous strengths of their racial and ethnic group, urban American Indian and Alaska Native adolescents face significant health disparities but are rarely included in health research. Understanding how sleep problems are associated with health outcomes among American Indian and Alaska Native adolescents may elucidate novel targets for interventions to promote health equity. To assess whether baseline sleep problems are associated with changes in behavioral and cardiometabolic health outcomes among urban American Indian and Alaska Native adolescents 2 years later. American Indian and Alaska Native adolescents were recruited via flyers and community events for an observational cohort study in California. Baseline assessments were conducted among 142 adolescents from March 1, 2018, to March 31, 2020, and follow-ups were conducted among 114 adolescents from December 1, 2020, to June 30, 2022. Baseline actigraphy-assessed sleep duration and efficiency and self-reported sleep disturbances and social jet lag (absolute value of the difference in sleep midpoint on weekends vs weekdays; indicator of circadian misalignment). Main outcome measures included self-reported depression (measured using the Patient Health Questionnaire), anxiety (measured using the Generalized Anxiety Disorder 7-item scale), past year alcohol and cannabis use, body mass index, systolic blood pressure (SBP) and diastolic blood pressure (DBP), waist circumference, and glycosylated hemoglobin (HbA1c). Analyses examined whether baseline sleep was associated with health outcomes at follow-up, controlling for age, sex, and baseline outcome measures. The baseline sample included 142 urban American Indian and Alaska Native adolescents (mean [SD] age, 14.0 [1.4] years; 84 girls [59%]), 80% of whom (n = 114; mean [SD] age, 14.1 [1.3] years; 71 girls [62%]) completed follow-ups. Linear or logistic regressions showed significant negative associations between shorter sleep duration and depression (β = -1.21 [95% CI, -2.19 to -0.24]), anxiety (β = -0.89 [95% CI, -1.76 to -0.03]), DBP (β = -2.03 [95% CI, -3.79 to -0.28]), and HbA1c level (β = -0.15 [95% CI, -0.26 to -0.04]) and likelihood of alcohol (odds ratio [OR], 0.57 [95% CI, 0.36-0.91]) and cannabis use (full week: OR, 0.59 [95% CI, 0.35-0.99]) at follow-up. Greater social jet lag was associated with significantly higher SBP (β = 0.06 [95% CI, 0.01-0.11]) at follow-up. This cohort study found significant associations between poor sleep and adverse changes in health outcomes. Findings highlight the importance of developing culturally responsive interventions that target sleep as a key modifiable risk factor to improve the health of American Indian and Alaska Native adolescents.

Demographic, lifestyle, social, and psychological factors associated with worry-related sleep problems among school-going adolescents in Timor-Leste.

Adolescent sleep problems are a worldwide public health issue. The present study examines factors associated with worry-related sleep problems among school-going adolescents. The country of interest is Timor-Leste, a low-income country, where studies pertaining to adolescent sleep problems are lacking. Data were analysed from the Global School-Based Student Health Survey Timor-Leste (n = 3455). An ordered probit model was used to assess the effects of demographic, lifestyle, social, and psychological factors on different levels of worry-related sleep problems (i.e., no, mild and severe sleep problems). School-going adolescents were more likely to face mild or severe worry-related sleep problems if they were older, passive smokers, alcohol drinkers and moderately active. School-going adolescents who sometimes or always went hungry were more likely to experience worry-related sleep problems than those who did not. Involvement in physical fights, being bullied, and loneliness were positively associated with the probability of having modest or severe worry-related sleep problems. Age, exposure to second-hand smoke, alcohol consumption, physical activity, going hungry, physical fights, being bullied and loneliness are the important determining factors of adolescent worry-related sleep problems. Policymakers should pay special attention to these factors when formulating intervention measures.

Changes to sleep patterns and insomnia symptoms following cognitive behavioural therapy for anxiety disorders in adolescents.

It is unclear whether treatment for an anxiety disorder improves sleep. This study examined baseline sleep characteristics of adolescents with an anxiety disorder, comparing weekdays and weekends, and whether there were significant improvements in sleep following cognitive behaviour therapy (CBT). To improve our understanding of sleep problems in adolescents with an anxiety disorder and examine whether CBT for the treatment of the anxiety disorder improves sleep. Data was gathered from 179 participants with an anxiety disorder (11-17 years old) who had previously engaged with the out-patient child and adolescent mental health service. Baseline self-report measures of anxiety and depression symptoms, sleep patterns and experiences of insomnia were examined. Of this group, 135 participants had baseline data. A subset (n=73) had outcome data, which was used to examine changes in sleep following CBT. At baseline, adolescents reported significantly less total sleep and more night-time waking on weekdays than weekends. Following treatment for their anxiety disorder, adolescents' weekday sleep patterns significantly improved for sleep onset latency and total sleep time, whereas weekend sleep patterns only showed improvements for sleep onset latency. No significant improvements were reported for symptoms of insomnia. The study relied upon subjective measurement of sleep and there was no control group; however, the findings provide promising results that CBT for adolescent anxiety disorders can improve some sleep problems. Further research is needed to understand discrepancies between subjective and objective sleep, and to explore avenues for the delivery of support for sleep problems.

Secular trends in sleep and circadian problems among adolescents in Hong Kong: From 2011-2012 to 2017-2019

ObjectiveThe study aimed to investigate secular trends in sleep and circadian problems in Hong Kong Chinese adolescents. MethodsThis study analyzed cross-sectional data from two large-scale school-based sleep surveys conducted in 2011-2012 and 2017-2019. Sleep and circadian problems, including sleep-wake pattern, insomnia, chronotype, social jetlag, daytime sleepiness, and other sleep-related factors, were compared between two survey years. ResultsA total of 8082 adolescents (5639 students in 2011-2012 [Mean age: 14.4 years, 50.9% boys] and 2443 students in 2017-2019 [Mean age: 14.7 years, 54.0% boys]) were included in this 7-year study. The average time in bed of Hong Kong adolescents decreased from 8.38 hours to 8.08 hours from 2011-2012 to 2017-2019. There was a 0.28-hour delay in weekday bedtime, 0.54-hour advance in weekend wake-up time, and a 0.36-hour decline in average time in bed, resulting in increased trends of sleep loss (Time in bed <8h: OR = 2.06, 95%CI: 1.44–2.93, p < 0.01; Time in bed <7h: OR = 2.73, 95%CI: 1.92–3.89, p < 0.01), daytime sleepiness (OR = 1.70, 95%CI: 1.34–2.16, p < 0.01), and evening chronotype (OR = 1.26, 95%CI: 1.08–1.48, p < 0.01). The increased trend in insomnia disorder, however, was insignificant when covariates were adjusted. ConclusionA secular trend of reduced time in bed, delay in weekday bedtime, advance in weekend wake-up time, increase in evening chronotype and daytime sleepiness from 2011-2012 to 2017-2019 were observed. There is a timely need for systematic intervention to promote sleep health in adolescents.

A Review of Turkish Self-Reporting Instruments for Sleep Problems in Children, Adolescents, and Adults.

Many self-reported sleep instruments have been developed and adapted into many languages, including Turkish, and their psychometric properties have been examined. This study aims to present a literature review on self-report instruments adapted into Turkish and used to assess diferent aspects of sleep in child, adolescent, and adult populations. Terms related to sleep self-report instruments were applied to 4 search engines: PubMed, EMBASE, Scopus, and Google Scholar. The search engines were searched for articles published until October 2023. Assessment instruments whose psychometric properties were not evaluated in Turkish language were excluded from the study. This study defined 27 sleep instruments, including 9 child and adolescent and 18 adult sleep instruments. Increasing the availability of Turkish sleep tools for children and adult will improve the chance of intervention by increasing the identification of sleep disorders.

Childhood maltreatment, emotion regulation difficulties/externalizing problems, and sleep problems in adolescents: Direct and indirect associations among developmental trajectories

BackgroundThe deleterious effects of childhood maltreatment, emotion regulation difficulties (ERD), and externalizing problems (EP) on sleep problems has been established. Nevertheless, there is still a need to gain a deeper understanding of the potential direct and indirect mechanisms through which these crucial risk factors influence adolescents’ sleep problems, particularly with a developmental perspective. This study thus aimed to examine the direct and indirect associations among developmental trajectories of the focal variables in adolescents. MethodsA total of 1648 Chinese adolescents (48.12% boys; Mage = 13.69 years, SD = 0.82) completed self-report measures on 3 time points across 1 years. Latent growth curve modeling was used to examine the hypothesized models. ResultsBoth the developmental trajectory of childhood maltreatment and the developmental trajectory of ERD/EP were positively and directly related to the developmental trajectory of sleep problems; and the developmental trajectory of childhood maltreatment was indirectly related to the developmental trajectory of sleep problems through the mediating effect of the developmental trajectory of ERD/EP. ConclusionsThe findings elucidated the direct and indirect longitudinal associations among the focal variables, highlighting that interventions should target childhood maltreatment and ERD/EP to decrease sleep problems in adolescents with a developmental perspective.

How to survive the long night? Longitudinal relationship between sleep problems and suicidal behavior among adolescents: The serial mediating roles of negative emotion, self-control, and nonsuicidal self-injury.

Sleep problems are a significant risk factor for identifying and preventing suicidal involvement among adolescents. However, there is limited evidence to assess the underlying mechanisms between them. This study investigated the longitudinal relationship between sleep problems and suicidal behavior and examined whether this relationship was moderated by negative emotions, low self-control, and nonsuicidal self-injury (NSSI). From December 2020 onward, we assessed 1214 Chinese secondary school adolescents (60.7% were boys, aged 13-19 years) three times, 6 months apart. In the direct effects model, sleep problems were found to have a positive impact on adolescent suicidal behavior. In the indirect effects model, we observed that sleep problems were associated with an elevated risk of suicidal behavior through several pathways: one-mediator path of negative emotions, low self-control, and NSSI, respectively; two-mediator path of negative emotions via low self-control, negative emotions via NSSI, and low self-control via NSSI, and three-mediator path from negative emotions to NSSI via low self-control. This longitudinal study provides evidence that sleep problems in adolescents may increase suicidal behavior by exacerbating negative emotions, weakening self-control, and promoting NSSI. The findings suggest sleep problems should be addressed in suicide prevention and intervention efforts for adolescents.

Improving adolescent sleep in long-term Juvenile correctional settings: case examples with clinical, research, and policy implications.

Poor sleep during adolescence is a public health concern that may be especially important to address among youth in juvenile correctional facilities, who tend to experience greater mental health challenges, substance use disorders, and traumatic stress exposure. However, evidence for addressing sleep in correctional settings is limited. Using de-identified composite clinical cases, this paper describes challenges and opportunities for addressing sleep disorders (i.e. insomnia) and promoting sleep health (i.e. improving duration, regularity, and behaviors) among adolescents in long-term juvenile correctional facilities. These clinical cases highlight common presenting problems and underscore the need for integrated sleep and mental health interventions as well as adaptations to enhance feasibility and efficacy of behavioral sleep treatment and sleep health promotion in juvenile correctional contexts. We conclude by summarizing clinical, research, and policy implications for addressing adolescent sleep problems and promoting sleep health and well-being in these contexts.

Effects of the COVID-19 pandemic on emotional and behavioral problems and sleep problems in adolescents

Background The asynchrony rapid phase of cognitive, physical and emotional development occurring in adolescence may result in various issues such as risk-taking behavior, psychosocial and emotional problems. School closure during the COVID-19 pandemic has caused a tremendous change in adolescent lifestyle and habits, including sleep patterns. causing added challenges to adolescents’ emotional and behavioral problems.&#x0D; Objective To identify the association between sleep disorders with emotional and behavioral problems during the COVID-19 pandemic in urban and rural adolescents.&#x0D; Methods We conducted a cross-sectional study among adolescents aged 12-18 years from November to December 2021 in two provinces, DKI Jakarta and Riau Islands. We recruited students consecutively from randomly selected junior and senior high schools. We used the Strengths and Difficulties Questionnaire (SDQ) and the Pittsburgh Sleep Quality Index (PSQI) to screen for emotional and behavioral problems and for sleep disorders, respectively. The questionnaires were sent electronically to each subject after obtaining parental consent.&#x0D; Results There were 400 subjects included in our study, of which 64% were female. The prevalences of COVID-19 amongst subjects in urban and rural areas were COVID-19 12.5% and 5.5%, respectively. Emotional and behavioral disorders as well as sleep disorders were more common in rural than urban areas (13 vs. 11.5% and 50.5% vs. 38%; P=0.012, respectively). Sleep disorders were associated with the SDQ subscales of emotional symptoms [PR 4.88 (95%CI 2.97 to 8.03); P&lt;0.01), conduct problems [PR 3.71 (95%CI 1.53 to 9.04); P=0.02), hyperactivity/inattention [PR 6.05 (95%CI 2.58 to 16.17); P&lt;0.01], and peer relationship problems [PR 3.28 (95%CI 1.33 to 8.09); P&lt;0.01).&#x0D; Conclusion Sleep disorders among adolescents during COVID-19 pandemic were associated with emotional and behavioral problems. Adolescents who live in rural areas were more likely to have sleep disorders, emotional and behavioral problems.

Early life adversity and adolescent sleep problems during the COVID-19 pandemic.

The COVID-19 pandemic resulted in a reorganization of adolescents' routines, especially their sleep schedules. Utilising 175 caregiver-adolescent dyads, the current study examined associations of biological (e.g., prenatal substance use), environmental (e.g., poverty), and relational (e.g., child maltreatment) subtypes of early life adversity (ELA) with various components of adolescents' sleep across the first year of the COVID-19 pandemic. Relational ELA explained unique variance in adolescents' sleep disturbances, but not other sleep components, following short- and longer-term exposure to the COVID-19 pandemic. However, the direction of this association switched such that relational ELA predicted decreased sleep disturbances during the initial phase of the U.S. COVID-19 pandemic in spring 2020 beyond pre-pandemic levels, but, over time, contributed to increased sleep disturbances beyond early-pandemic levels as the pandemic extended into the winter of 2020.

Investigation of the relationship between disasters and sleep problems in adolescents

ABSTRACT This study was conducted to determine relationship between disasters and sleep problems in adolescents. In this descriptive and cross-sectional study, 407 adolescents aged 10–18 years were included. The data were collected with Descriptive Characteristics Form, Disaster Fear Form, and Bergen Insomnia Scale. 86.5% of the adolescents had experienced at least one disaster. It was found that 67.3% of adolescents experienced sleep problems after disasters. A positive correlation was found between the mean scores of Fear Disaster Form and Bergen Insomnia Scale. In addition, mean Bergen Insomnia Scale scores of adolescents who experienced earthquakes, pandemic disease, traffic accidents, and floods were statistically higher than those who did not (p < 0.05). By screening for sleep problems in adolescents who have experienced disasters and planning and implementing appropriate interventions, adolescents who are already at risk for sleep problems can develop healthy sleep habits and prevent physiological, mental, and cognitive problems due to sleep problems.

Sleep problems in children and adolescents in an attention deficit hyperactivity disorder service.

Sleep problems are common amongst children and adolescents with attention deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate sleep problems in children and adolescents attending a specialist ADHD service. This was a cross-sectional online survey combined with a retrospective chart review, conducted in the ADHD Assessment, Diagnosis, Management, initiation, Research and Education (ADMiRE) service, the first public specialist ADHD service for young people in Ireland. Participants were caregivers of children and adolescents with ADHD attending ADMiRE. Sleep was assessed using The Children's Sleep Habits Questionnaire (CSHQ) and ADHD symptoms were assessed using an abbreviated version of the Swanson, Nolan and Pelham Teacher and Parent Rating Scale (SNAP-IV). Details regarding patient demographics, co-morbidities and medication were collected from patient records. Eighty-four percent of young people scored above the clinical cut-off for a sleep disorder. The most frequently reported sleep problems were related to sleep onset and sleep duration, and 64% of respondents met the criteria for two or more sleep problems. ADHD severity was associated with greater sleep problems. Co-morbid physical, neurodevelopmental, and mental health disorders as well as stimulant use were not associated with greater sleep problems. Sleep problems are very common amongst children and adolescents with ADHD. This study has demonstrated an association between more sleep problems and ADHD severity. These findings highlight the need for both effective ADHD treatment to ensure optional sleep in young people as well as effective interventions for sleep problems to prevent worsening of ADHD symptoms.

Sex difference in the association between pyrethroids exposure and sleep problems among adolescents: NHANES 2007–2014

BackgroundPyrethroids have been widely used in the United States and worldwide. Few studies examined the effect of pyrethroids exposure on sleep problems among adolescents.ObjectivesThis study investigated the associations between pyrethroids exposure and sleep problems in male and female adolescents.MethodsThe data were used from the National Health and Nutrition Examination Survey 2007–2014. In this study, 3-Phenoxybenzoic Acid (3-PBA) was used as a validated biomarker for pyrethroids exposure. The association between urinary 3-PBA and sleep problems was analyzed using logistic regression models.ResultsA total of 805 adolescents aged 16–20 years old were included in this study. The proportion of sleep problems was higher in females than in males (10.18% vs.7.35%, P = 0.154). A significant interaction was found between sex and 3-PBA (P interaction = 0.021) in the risk of sleep problems. A positive association of 3-PBA exposure with sleep problems was observed in male adolescents after adjusting for all the other covariates (OR = 4.04, 95% CI 1.31, 12.42). No statistically significant association was observed in female adolescents.ConclusionsA positive association was observed between pyrethroids exposure and sleep problems in male adolescents, but not in female adolescents. More studies are required to confirm our findings.

The relationship between stressful life events, sleep, emotional regulation, and depression in freshmen college students

AbstractIn recent years, adolescent sleep problems have received increasing attention. Stressful life events have been found to be a risk factor for sleep problems, but little is known about the components that may explain or influence this association. To investigate this, the present study tested whether depressive symptoms mediated the association between stressful life events and Chinese freshmen' sleep problems, as well as whether emotional regulation skills moderated this process. A sample of 513 Chinese freshmen (32.2% males, mean age = 19.04 years, SD = 1.21) completed anonymous questionnaires regarding stressful life events, depressive symptoms, emotional regulation and sleep problems (examined using Adolescent Self‐Rating Life Events Checklist, Epidemiologic Studies Depression Scale for Children, Pittsburgh Sleep Quality Index and Response to Stress Questionnaire). The study included covariates such as gender, age, and socioeconomic level. Depressive symptoms were shown to partially mediated the association between stressful life events and sleep problems in structural equation models. Emotional regulation moderated the relationship betweenn stressful life events and depressive symptoms. The results show that promoting emotional regulation could be beneficial in preventing and intervening sleep problems related to stressful life events.

PENDIDIKAN KESEHATAN KEBUTUHAN ISTIRAHAT TIDUR PADA MASA PANDEMI BAGI REMAJA

Corona virus 19 (COVID 19) is now a word that is often heard and is a problem in Indonesia and the world. The existence of the COVID-19 pandemic has forced changes in the implementation of various activities such as Work From Home, School From Home and others. School from Home or known as Distance Learning (PJJ) makes students have to study from home and use tools such as laptops / phonecell that can have an impact on health, one of which is sleep disorders. Sleep problems in adolescence will affect the growth and development of adolescents. So it is important to be given health education about the need for sleep rest and how to regulate sleep patterns during the COVID 19 pandemic. The purpose of this activity is to increase adolescent knowledge about the need for sleep rest and how to regulate sleep patterns. The target of this activity is 40 Catholic youths in the Sakramen Mahakusus Church in Surabaya. Health education is carried out online with the Zoom application,health education methods used question and answer and assistance via group/personal Whatsapp. Adolescents are very active in health education activities and many questions are asked. The results of the evaluation before and after health education showed an increase in the knowledge of teenagers in the Sacrament Mahakudus church Surabaya parish about the need for sleep and how to regulate sleep patterns during the COVID-19 pandemic.

Sleep problems in adolescents with depression: Role of childhood trauma, alexithymia, rumination, and self-esteem

BackgroundWhile sleep problems are common in adolescents with depression, the exact prevalence has not been reported. Although previous studies have shown that childhood trauma, alexithymia, rumination, and self-esteem are related to sleep problems, the interactions between these factors remain unclear. MethodsThis study, conducted from March 1, 2021 to January 20, 2022, employed a cross-sectional design. The participants were 2192 adolescents with depression with a mean age of 15 years. The Chinese version of the Pittsburgh Sleep Quality Index, Childhood Trauma Questionnaire, Toronto Alexithymia Scale-20, Ruminative Response Scale, and Rosenberg Self-Esteem Scale were used to measure sleep problems, childhood trauma, alexithymia, rumination, and self-esteem, respectively. We used PROCESS 3.3 for SPSS to determine the chain mediating effect of alexithymia and rumination and the moderating effect of self-esteem in the relationship between childhood trauma and sleep problems. ResultsUp to 70.71 % of adolescents with depression had sleep problems. Furthermore, alexithymia and rumination played a chain mediation role in the relationship between childhood trauma and sleep problems. Finally, self-esteem moderated the relationships between alexithymia and sleep problems and rumination and sleep problems. LimitationsOwing to the study design, we cannot derive causal relationships between variables. Further, the self-reported data may have been influenced by subjective participant factors. ConclusionsThis study reveals potential ways of how childhood trauma influences sleep problems in adolescents with depression. These findings suggest that interventions targeting alexithymia, rumination, and self-esteem in adolescents with depression may be effective in reducing their sleep problems.

Sleep and Mental Health Problems in Children and Adolescents.

Previous reviews have described the links between sleep and mental health extensively. In this narrative review, we focus on literature published during the last decade investigating the links between sleep and mental health difficulties in childhood and adolescence. More specifically, we focus on the mental health disorders listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders. We also discuss possible mechanisms underlying these associations. The review ends with a discussion of possible future lines of enquiry.