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. 2017 Jun;48(3):455-467.
doi: 10.1007/s10578-016-0672-1.

Self-Reported Time in Bed and Sleep Quality in Association with Internalizing and Externalizing Symptoms in School-Age Youth

Sonia L Rubens  1 , Spencer C Evans  2 , Stephen P Becker  3 , Paula J Fite  2 , Andrea M Tountas  4
Affiliations

Self-Reported Time in Bed and Sleep Quality in Association with Internalizing and Externalizing Symptoms in School-Age Youth

Sonia L Rubens et al. Child Psychiatry Hum Dev. 2017 Jun.

Abstract

This study investigated the relationship between self-reported time in bed and sleep quality in association with self-reported internalizing and externalizing symptoms in a sample of 285 elementary school students (52 % female) recruited from a rural Midwestern elementary school. Path models were used to estimate proposed associations, controlling for grade level and gender. Curvilinear associations were found between time in bed and anxiety, depressive symptoms, and irritability. Marginal curvilinear trends were found between time in bed and emotion dysregulation, reactive aggression, and proactive aggression. Sleep quality was negatively associated with anxiety, depressive symptoms, irritability, reactive aggression, and delinquency engagement. Gender and grade differences were found across models. Findings suggest that examining self-reported time in bed (both linear and quadratic) and sleep quality is important for understanding internalizing and externalizing symptoms associated with sleep in school-age youth. Incorporating self-reported sleep assessments into clinical practice and school-based evaluations may have implications for a child's adjustment.

Keywords: Children; Externalizing problems; Internalizing problems; Sleep quality; Time in bed.

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Figures

Figure 1.
Figure 1.
Significantly and marginally significant curvilinear relations between time in bed and internalizing problems controlling for grade, gender, and sleep quality. Solid line and circular markers represent the model-estimated values at the mean level of time in bed, 9.78 hours (center marker) ± 3 hours (outer markers). Dotted line represents the sample mean of the y-axis variable. Panel A (anxiety), quadratic trend p = .039; Panel B (depressive symptoms), quadratic trend p = .004; Panel C (emotion dysregulation), quadratic trend p = .086; Panel D (irritability), quadratic trend p < .001.
Figure 2.
Figure 2.
Marginally significant curvilinear relations between time in bed and externalizing problems controlling for grade, gender, and sleep quality. Solid line and circular markers represent the model-estimated values at the mean level of time in bed, 9.78 hours (center marker) ± 3 hours (outer markers). Dotted line represents the sample mean of the y-axis variable. Panel A (reactive aggression), quadratic trend p = .073; Panel B (proactive aggression), quadratic trend p = .088.
See this image and copyright information in PMC

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