To Örebro University

Introduction: Sleep problems in children and adolescents are common, with a significant majority having less than the recommended 8 h of sleep and/or experiencing suboptimal sleep quality. This issue, worsening with age and more prevalent in females, has been identified as a potentially critical health epidemic. Recent studies challenge the traditional view that sleep problems are merely consequences of mental disorders, suggesting a bidirectional relationship where sleep issues can also predict and exacerbate psychopathology, possibly even more so than the reverse relationship. Growing evidence underlines the urgent need for early interventions aimed at sleep disturbance to prevent future mental illness, highlighting a gap in research and the importance of a systematic review to guide future efforts in addressing this critical issue among children and adolescents.

Method: Prospective, longitudinal studies, where sleep problems were measured during childhood or adolescence, and mental illness either not present at baseline, or controlled for, were eligible for inclusion. Searches from Medline, Embase, Web of science and PsychInfo resulted in a total of 25825 hits, which were screened using ASReview.

Results: Preliminary search results identified approximately 85 studies eligible for inclusion. Of these, nine included infants and pre-school children (age 0–6 years), with eight of these studies focusing on symptoms of depression and anxiety, and one on symptoms of borderline personality disorder or psychotic symptoms. Children (age 7 to 12 years) were the focus in 26 of the studies, 20 of which had depression and/or anxiety as the outcome, two ADHD, two bipolar disorder, and three psychotic experiences. In 39 of the studies, participants were adolescents (age 13–18 years) at baseline. Some 40 of these focused on depression and/or anxiety, four on PTSD, five on bipolar disorder, four on psychosis, three on ADHD, and three on substance use disorder. Apart from a few exceptions, sleep problems in children and adolescents were found to be associated with future mental illness.

Conclusion: Sleep problems during childhood and adolescence are consistently associated with a range of later mental illnesses. This systematic review constitutes a foundation highlighting the need to prioritize sleep problems in youth in prevention efforts.