Sleep and psychiatric disorders in children: A complex reciprocal relationship

During the past decade and since the publication of the first edition of this volume, there has been an exponential increase in published reports of comorbid sleep and psychiatric disorders. As a result, there is now compelling evidence for linkages between the regulation of sleep, emotion, attention, and behavior in both children and adults. The majority of published reports on children have focused on sleep problems associated with specific psychiatric disorders. In particular, many early reports focused on depression (1,2), while subsequent focus shifted to sleep in children with attention deficit hyperactivity disorder (ADHD) (3). More recently, there has been an increasing interest in examining sleep among children with anxiety disorders, pervasive developmental disorders (PDD), and other developmental disorders associated with genetic syndromes. Collectively, however, few studies have addressed the neurobehavioral and psychiatric sequelae of sleep disturbance during childhood, including the shared pathophysiology of sleep and psychiatric disorders. In this chapter, we will review the pediatric literature that has addressed the relationship between sleep, anxiety disorders, depression, ADHD, and developmental disorders, with a particular focus on assessment and treatment. When relevant, we will also dis- cuss findings from the adult literature, which is significantly better developed, particularly for the affective disorders.