Sleep and Psychiatric Symptoms in School-age Children

Objective: To assess associations between the quantity and quality of children's sleep and parent- and teacher-reported psychiatric symptoms.

Method: Forty-nine physically healthy 7- to 12-year-old children from normal classes participated. They were monitored for 72 consecutive hours with belt-worn activity monitors (actigraphs) to obtain objective data on their daytime and nighttime activity and sleep. In addition, Child Behavior Checklists and Teacher's Report Forms were filled out by the parents and teachers, respectively.

Results: Quantity of sleep was significantly associated with total symptom score on the Teacher's Report Form. The highest associations were found between low true sleep time and teacher-reported externalizing symptoms such as aggressive and delinquent behavior and attention and social problems. Sleep parameters were not associated with parent-reported psychiatric symptoms, except for the association found between delayed sleep latency and aggressive, delinquent behavior.

Conclusions: The objectively measured amount of school-age children's sleep was associated with teacher-reported psychiatric symptoms. Parents may be unaware of their child's sleep deficiencies as the behavioral problems may be more evident at school than at home. Sensitive and objective measurements are needed to rule out the possibility of inadequate sleep underlying behavioral problems.