Daily Associations Between Sleep and Affect in Youth at Risk for Psychopathology: The Moderating Role of Externalizing Symptoms

Abstract

Problems with sleep, emotion regulation, and externalizing psychopathology are interrelated, but little is known about their day-to-day associations in youth. We examined self-reported daily sleep quality as a bidirectional predictor of next-day positive and negative affect (PA/NA), with externalizing symptoms as a moderator. Data were drawn from an ecological momentary assessment (EMA) study involving 82 youths (ages 9-13; 50% female; 44% White, 37% Black/African American) at high (n = 41) or low (n = 41) familial risk for psychopathology. Parents rated youths' externalizing symptoms at baseline. Youths then completed a 9-day EMA protocol, reporting sleep quality 1x/day and affect 4-8x/day. Daily means, peaks, and variability in PA and NA were computed. Multilevel models examined bidirectional associations between sleep and affect (between- and within-person), testing externalizing symptoms as a moderator and controlling for age and sex. In models of sleep predicting affect: Within-person, poorer-than-usual sleep quality predicted greater variability and higher peaks in next-day NA, but only for youth with higher levels of externalizing symptoms. Between-person, poor sleep quality and higher levels of externalizing symptoms predicted lower mean and peak PA. In models of affect predicting sleep: Within-person, lower-than-usual mean PA predicted poorer subsequent sleep quality, but only for youth with higher levels of externalizing symptoms. Between-person, youths with higher mean and peak PA had better sleep quality. These findings suggest that affective functioning is bidirectionally linked to daily self-reported sleep quality among high- and low-risk youth. Specific disturbances in daily sleep-affect cycles may be distinctly associated with externalizing psychopathology.

Keywords: Affect; Developmental psychopathology; Disruptive behavior disorders; Ecological momentary assessment; Externalizing; Sleep.

Fig. 1

Worse-than-usual perceived sleep quality predicts increases in daily NA peaks (a) and variability (b), but only among youth with higher levels of externalizing symptoms. Note. Time-varying sleep quality is person-mean-centered, and the mean within-person standard deviation was about 17. Thus, a score of 0 represents each person’s mean sleep quality from day-to-day, and scores of ± 17 represent days on which each person’s sleep quality was better or worse than their usual sleep quality by about 1 standard deviation. Externalizing symptoms are a between-person variable assessed at baseline, plotted as specified in the figure. Dependent variables are time-varying on their original scales as computed for peak NA (range: 0 to 99.13), and SD of NA (range: 0 to 53.48). See Table 1 for descriptive statistics on all variables

Fig. 2

Lower-than-usual positive affect predicts decrements in next-day’s reported sleep quality, but only among youth with higher levels of externalizing symptoms Note. Time-varying positive affect is a person-mean-centered and the mean within-person standard deviation of positive affect was about 11. Thus, a score of 0 represents each person’s mean positive affect from day-to-day, and scores of ±11 represent days on which each person’s overall positive affect was higher or lower than usual by about 1 standard deviation. Externalizing symptoms are a between-person variable assessed at baseline, plotted as specified in the figure. The sleep quality dependent variable is based on its original scale ranging from 0–100. See Table 1 for descriptive statistics on all variables