Sleep duration, brain structure, and psychiatric and cognitive problems in children

Abstract

Low sleep duration in adults is correlated with psychiatric and cognitive problems. We performed for the first time a large-scale analysis of sleep duration in children, and how this relates to psychiatric problems including depression, to cognition, and to brain structure. Structural MRI was analyzed in relation to sleep duration, and psychiatric and cognitive measures in 11,067 9-11-year-old children from the Adolescent Brain Cognitive Development (ABCD) Study, using a linear mixed model, mediation analysis, and structural equation methods in a longitudinal analysis. Dimensional psychopathology (including depression, anxiety, impulsive behavior) in the children was negatively correlated with sleep duration. Dimensional psychopathology in the parents was also correlated with short sleep duration in their children. The brain areas in which higher volume was correlated with longer sleep duration included the orbitofrontal cortex, prefrontal and temporal cortex, precuneus, and supramarginal gyrus. Longitudinal data analysis showed that the psychiatric problems, especially the depressive problems, were significantly associated with short sleep duration 1 year later. Further, mediation analysis showed that depressive problems significantly mediate the effect of these brain regions on sleep. Higher cognitive scores were associated with higher volume of the prefrontal cortex, temporal cortex, and medial orbitofrontal cortex. Public health implications are that psychopathology in the parents should be considered in relation to sleep problems in children. Moreover, we show that brain structure is associated with sleep problems in children, and that this is related to whether or not the child has depressive problems.

Figure 1.

A) The correlation between sleep duration and a wide variety of measurements including physical and mental health, neuro-cognition, substance use, culture, environment and mobile technology, etc. Here we highlight the 17 measurements that are significantly correlated with sleep duration. For example, the positive r value for the cognition scores indicates that long sleep duration is positively correlated with good cognition. The full names for these measurements are shown below and the details for each item are provided in Table S1. B) A histogram showing the relation between the number of hours of sleep and cognitive measures. The Y axis is the cognitive score and the error bar is the SEM. There was a significant correlation between the cognitive score and the number of hours of sleep (Bonferroni corrected, p<0.05). The children with long sleep duration tended to have good cognitive performance. C) A histogram showing the relation between the number of hours of sleep and the psychiatric problems scores. The Y axis is the psychiatric problems score and the error bar is the SEM. There was a significant negative correlation between the psychiatric problems scores and the number of hours of sleep (Bonferroni corrected, p<0.05). The children with short sleep duration tended to have high psychiatric problems scores. Note: abcd_saiq02: ABCD Parent Sports and Activities Involvement Questionnaire (SAIQ); abcd_sds01: ABCD Parent Sleep Disturbance Scale for Children; abcd_ssphp01: ABCD Sum Scores Physical Health Parent; abcd_tbss01: ABCD Youth NIH TB Summary Scores; abcd_asrs01: Adult Self Report summary scores; abcd_cbcl01: ABCD Parent Child Behavior Checklist Raw Scores Aseba (CBCL); abcd_cbcls01: Child Behavior Check List summary scores; abcd_ksad01: ABCD Parent Diagnostic Interview for DSM-5 Full; abcd_ksad01: ABCD Parent Diagnostic Interview for DSM-5 Full (KSADS-5); abcd_ksad501: ABCD Youth Diagnostic Interview for DSM-5 (KSADS-5); abcd_pgbi01: ABCD Parent Parent General Behavior Inventory-Mania; abcd_ssbpmtf01: ABCD Summary Scores Brief Problem Monitor-Teacher Form for Ages 6-18; dibf01: ABCD Parent Diagnostic Interview for DSM-5 Background Items Full; pasr01: ABCD Parent Adult Self Report Raw Scores Aseba; abcd_rhds01: Residential History Derived Scores; fes02: ABCD Parent Family Environment Scale-Family Conflict Subscale Modified from PhenX; macv01: ABCD Parent Mexican American Cultural Values Scale Modified; abcd_stq01: ABCD Youth Screen Time Survey.

Figure 2.

A) Brain regions with their cortical area significantly associated with sleep duration (FDR corrected, p<0.005). The red color indicates brain regions with high area positively associated with longer sleep duration. B) Brain regions with their area significantly associated with the cognitive total score (FDR corrected, p<0.005). The red color indicates brain regions where high area is positively correlated with a higher cognitive score. Here, we only show the regions with Cohen’s d larger than 0.15. C) Brain regions with their area significantly associated with the depressive problems score (FDR corrected, p<0.005). Blue indicates brain regions with a negative correlation between area and the depressive problems score (i.e. a low cortical area is associated with depressive problems). The brain regions shown here were confirmed using a non-parametric approach that utilized a permutation test (with 5,000 random samplings). D) Brain regions with their area associated with both sleep duration and the cognitive total score. The regions shown are the overlap of what is shown in A and B. E) Brain regions with their area associated with both sleep duration and the depressive problems score. The regions shown are the overlap of what is shown in A and C.

Figure 3.

A) The longitudinal association between the depressive problems score and the sleep duration revealed by structural equation modelling (using a two-wave cross-lagged panel model). The depressive problems score was significantly associated with lower sleep duration measured one year later (β = −0.081, SE = 0.016, p < 1×10⁻⁴); and the reverse (dashed line) was not true (β = −0.018, SE = 0.013, p = 0.174). B) Mediation analysis: the mediation implemented by depressive problems from the cortical area on sleep duration was significant (β = 0.015, p = 2.5×10⁻¹⁰). The indirect path (A, AB and B) shows that the depressive problems score mediates part of the effect of cortical area on sleep duration. Path A: Effect of the independent variable, the mean cortical area of the brain regions shown in Fig. 2E which are associated with both sleep duration and the depressive score, on the mediator, the depressive problems score; Path B: the effect of the mediator (depressive problems score) on the outcome (sleep duration); Path C shows that the regression coefficient (beta value) of the cortical area on the sleep duration was high when the sleep duration was not taken into account. The beta values show the regression coefficient of the effect of the independent variable (cortical area) on the dependent variable (sleep duration). Path C’ indicates the direct effect of the cortical area on the outcome (sleep duration) controlling for the mediator (the depressive problems score). Path C’ shows some reduction in the regression coefficient when the effect of the depressive problems score was taken into account. Path AB indicates the extent to which taking the depressive problems score into account can explain the 25.9% effect of the cortical area on sleep duration, which is significant as noted above at p = 2.5×10⁻¹⁰. C) Mediation analysis: the mediation implemented by sleep duration from the cortical area on cognition was significant (β = 0.032, p=1.5×10⁻⁴). SE, standard error.