Associations of sleep with psychological problems and well-being in adolescence: causality or common genetic predispositions?

M Vermeulen, KB van der Heijden, Desi Kocevska, JL Treur, C Huppertz, CEM Beijsterveldt, DI Boomsma, H Swaab, EJW Someren, M Bartels

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19 Citations (Scopus)
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Abstract

Background: Whereas short and problematic sleep are associated with psychological problems in adolescence, causality remains to be elucidated. This study therefore utilized the discordant monozygotic cotwin design and cross-lagged models to investigate how short and problematic sleep affect psychological functioning. Methods: Adolescent twins (N = 12,803, 13–20 years, 42% male) completed questionnaires on sleep and psychological functioning repeatedly over a two-year interval. Monozygotic twin pairs were classified as concordant or discordant for sleep duration and trouble sleeping. Resulting subgroups were compared regarding internalizing problems, externalizing problems, and subjective well-being. Results: Cross-sectional analyses indicated associations of worse psychological functioning with both short sleep and problematic sleep, and cross-lagged models indicate bidirectional associations. Longitudinal analyses showed that an increase in sleep problems experienced selectively by one individual of an identical twin pair was accompanied by an increase of 52% in internalizing problem scores and 25% in externalizing problem scores. These changes were significantly different from the within-subject changes in cotwins with unchanged sleep quality (respectively, 3% increase and 5% decrease). Psychological functioning did, however, not worsen with decreasing sleep duration. Conclusions: The findings suggest that sleep quality, rather than sleep duration, should be the primary target for prevention and intervention, with possible effect on psychological functioning in adolescents.

Original languageEnglish
Pages (from-to)28-39
Number of pages12
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Volume62
Issue number1
DOIs
Publication statusPublished - Jan 2021

Bibliographical note

Funding Information:
The authors warmly thank all NTR participants, who participated in this study. This work was supported by the following grants: Database Twin register (NWO 575‐25‐006); Spinozapremie (NWO/SPI 56‐464‐14192); Twin‐family Database for Behavior Genetics and Genomics Studies (NWO 480‐04‐004); BBMRI–NL: Biobanking and Biomolecular Resources Research Infrastructure (NWO 184.021.007); Genetics of Mental Illness: European Research Council (ERC‐230374); Genetic and Family Influences on Adolescent Psychopathology and Wellness (NWO 463‐06‐001); A Twin‐Sib Study of Adolescent Wellness (NWO‐VENI 451‐04‐034); Netherlands Twin Registry Repository: researching the interplay between genome and environment (NWO‐large investment 480‐15‐001/674). M.B. is supported by a University Research Chair position and an ERC Consolidator grant (WELL‐BEING 771057). J.L.T. was supported by a Rubicon grant from the Netherlands Organization for Scientific Research (NWO; grant 446‐16‐009). The work was further supported by NWO National Initiative Brain & Cognition Research Program ‘Innovative Learning Materials and Methods’ Grant 056‐32‐013 and VICI Innovation Grant 453‐07‐001 and by the European Research Council Advanced Grant 671084. D. Kocevska was funded by NWA Startimpuls Royal Netherlands Academy of Arts and Sciences 2017 Grant (AZ/3137). The authors have declared that they have no competing or potential conflicts of interest. Key points

Funding Information:
The authors warmly thank all NTR participants, who participated in this study. This work was supported by the following grants: Database Twin register (NWO 575-25-006); Spinozapremie (NWO/SPI 56-464-14192); Twin-family Database for Behavior Genetics and Genomics Studies (NWO 480-04-004); BBMRI?NL: Biobanking and Biomolecular Resources Research Infrastructure (NWO 184.021.007); Genetics of Mental Illness: European Research Council (ERC-230374); Genetic and Family Influences on Adolescent Psychopathology and Wellness (NWO 463-06-001); A Twin-Sib Study of Adolescent Wellness (NWO-VENI 451-04-034); Netherlands Twin Registry Repository: researching the interplay between genome and environment (NWO-large investment 480-15-001/674). M.B. is supported by a University Research Chair position and an ERC Consolidator grant (WELL-BEING 771057). J.L.T. was supported by a Rubicon grant from the Netherlands Organization for Scientific Research (NWO; grant 446-16-009). The work was further supported by NWO National Initiative Brain & Cognition Research Program ?Innovative Learning Materials and Methods? Grant 056-32-013 and VICI Innovation Grant 453-07-001 and by the European Research Council Advanced Grant 671084. D.K. was funded by NWA Startimpuls Royal Netherlands Academy of Arts and Sciences 2017 Grant (AZ/3137). The authors have declared that they have no competing or potential conflicts of interest. Key points Whereas short and problematic sleep are associated with psychological problems in adolescence, causality remains to be elucidated. The present study included, for the first time, the powerful longitudinal discordant monozygotic co-twin design and cross-lagged models in a large cohort of 12,803 twins. Results indicate a causal contribution of problematic sleep, but not short sleep, to the development of psychological problems in adolescence. Sleep quality, rather than sleep duration, should be the primary target for prevention and intervention, with possible effect on psychological functioning in adolescents. Whereas short and problematic sleep are associated with psychological problems in adolescence, causality remains to be elucidated. The present study included, for the first time, the powerful longitudinal discordant monozygotic co-twin design and cross-lagged models in a large cohort of 12,803 twins. Results indicate a causal contribution of problematic sleep, but not short sleep, to the development of psychological problems in adolescence. Sleep quality, rather than sleep duration, should be the primary target for prevention and intervention, with possible effect on psychological functioning in adolescents.

Publisher Copyright:
© 2020 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health

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