Does a child's sleep quality help predict how anxious or low they feel a little later? Researchers in China set out to answer this, publishing in Frontiers in Public Health.
They followed 1,529 children (782 boys and 747 girls) in grades 1 to 3 at three primary schools in an urban district of Chongqing. The average age was 8.00 years. Each child completed two surveys, with questionnaires measuring sleep problems, anxiety and depressive symptoms.
Children with poorer sleep at the start were more likely to be anxious or low later
The sleep questionnaire (called the PSQI-5) gives a score, and a higher score means more sleep problems. The researchers then checked how the children scored on anxiety and depression questionnaires at the second survey.
After adjusting for other factors, including how anxious or low the children already felt at the start, a higher baseline sleep-problem score predicted later:
- anxiety (odds ratio 1.144)
- depression (odds ratio 1.097)
- anxiety and depression together (odds ratio 1.146)
An odds ratio above 1 means a greater likelihood of the outcome. So in this study, more sleep problems went with higher odds of each emotional difficulty. Taking the children's starting moods into account matters, because it makes it less likely that low mood was simply causing the poor sleep.
When sleep got worse, feelings tended to get worse too
The team also looked at how each child's sleep score changed between the two surveys. Children whose sleep worsened were more likely to show worsening anxiety and depressive symptoms (all p < 0.001, meaning the pattern was very unlikely to be chance).
Here is a reassuring detail. On average, sleep, anxiety and depression scores were all lower at the second survey than at the first. So the group as a whole did not get worse over time. The concern is for individual children whose sleep slipped or stayed poor.
There are limits to bear in mind:
- The study shows an association, not proof that poor sleep causes anxiety or low mood. The authors say poor sleep "may increase the risk".
- It took place in one city in China. It did not include children in Singapore, so we cannot say the same figures apply here.
- The measures were questionnaires, not clinical diagnoses.
- The follow-up was short-term, so it says little about longer-term outcomes.
Putting the sleep findings to use at home
- Treat lasting sleep trouble as worth noticing, since the study linked long-term poor sleep to a higher risk of anxiety and low mood.
- Notice if your child's sleep gets worse over time, because worsening sleep went with worsening emotional symptoms.
- If poor sleep and persistent worry or low mood appear together, consider raising both with your child's doctor, since the study found them linked.