Sleep Disturbances in Pediatric Depression

Abstract

Depressive illness beginning early in life can have serious developmental and functional consequences. Therefore, understanding its etiology and pathophysiology during this developmental stage is critical for developing effective prevention and intervention strategies. There is considerable evidence of sleep alterations in adult major depressive disorder. However, studies in children and adolescents have not found consistent changes in sleep architecture paralleling adult depression. This review article summarizes sleep polysomnography research in early-onset depression, highlighting the factors associated with variable findings across studies. In addition, potential avenues for future research will be suggested in order to develop more comprehensive theoretical models and interventions for pediatric depression.

Figure 1

Sleep profile of a medication-free depressed female patient and a healthy female control. Compared to the healthy subject, the sleep profile of this patient shows many of the typical features of sleep in depression — impaired sleep continuity, disinhibition of REM sleep and reduction of slow-wave sleep. W, Wake; REM, rapid eye movement sleep; S1–4, sleep stages 1–4; MT, Movement time; BM, body movements; EM, rapid eye movements (reprinted from Riemann et al., Biological Psychology, 2001;57:67–103).