Anxiety Disorders and Comorbid Sleep Problems in School-Aged Youth: Review and Future Research Directions

Abstract

This review examines the relationship between anxiety disorders and sleep related problems (SRPs) in school-aged youth. Following an overview of normative sleep patterns and maturational sleep changes, the review addresses issues related to sleep measurement. SRPs are reviewed in relation to executive functions (e.g. affect regulation) as is the shared role of neurological regions in the regulation of anxiety and sleep. Studies of the association between SRPs and anxiety in anxiety-disordered samples are reviewed with explicit consideration of the potential mechanisms underlying the sleep-anxiety relationship (e.g., arousal, sleep hygiene, parental accommodation). Specific cognitive-behavioral treatments for SRPs and anxiety are reviewed with regard to their impact on comorbid anxiety or SRPs. Methodological limitations are noted and recommendations for future research are proposed.

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Fig. 1

Notes

  1. 1.

    Youth parasomnias include nightmares, night terrors, sleep walking, sleep paralysis, and confusional arousals.

  2. 2.

    With the exception of the few objective measurement studies above, and a study by Alfano et al. that used the CSHQ, finding 85 % of youth diagnosed with anxiety having SRPs in the clinical range.

  3. 3.

    The type and severity of SRP varies by several factors, including: type of stimulant drug, length of drug trial, when drug was administered, dose, and flexibility of dosing [86].

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Acknowledgments

We would like to thank Nicole DiCrecchio for her assistance with this project.

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Correspondence to Jeremy S. Peterman.

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Peterman, J.S., Carper, M.M. & Kendall, P.C. Anxiety Disorders and Comorbid Sleep Problems in School-Aged Youth: Review and Future Research Directions. Child Psychiatry Hum Dev 46, 376–392 (2015). https://doi.org/10.1007/s10578-014-0478-y

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Keywords

  • Anxiety
  • Sleep
  • Youth
  • Children
  • Adolescents
  • CBT