Getting enough sleep is especially important for children, as it promotes growth and development. Children who suffer from chronic sleep deprivation from an early age may be more likely to suffer health problems and may even be at increased risk of developing psychosis in early adulthood, new research shows. Researchers at the University of Birmingham examined the information on nighttime sleep duration from a large cohort study of children aged 6 months to 7 years. They found that children who consistently slept fewer hours during this period were more than twice as likely to develop a psychotic disorder and almost four times as likely to have a psychotic episode in early adulthood.

Childhood Sleep and Psyche

While previous research has shown links between sleep problems and psychosis at specific points in time, this is the first study to show that persistent lack of sleep is a strong predictor of psychosis. While it is normal for children to experience sleep problems at different points in their childhood, it is also important to know when it is time to seek help. Sometimes, sleep can become a persistent and chronic problem, and this is where we see links to psychiatric illness in adulthood.

The good news is that we know it is possible to improve our sleep patterns and sleep behavior. While persistent sleep loss is not the only cause of psychosis in early adulthood, research suggests that it is a contributing factor and something that parents can address. The findings, published in JAMA Psychiatry, were based on data from the Avon Longitudinal Study of Parents and Children (ALSPAC), which includes records from 12,394 children aged 6 months to 7 years and 3,889 at 24 years of age. Although the study found an association between a lack of sleep in childhood and psychosis in early adulthood, the team was unable to prove a causal link, and further factors associated with both sleep in childhood and psychosis need to be investigated.

For example, Dr. Isabel Morales-Muño’s team examined the general health of the immune system in children to determine whether immune system impairments could also be responsible for some of the links between a lack of sleep and psychosis. This was tested in nine-year-olds by measuring the level of inflammation in blood samples. The results showed that a weakened immune system could partially explain the links between a lack of sleep and psychosis, but other unknown factors are likely to be important as well. The aim is to test and validate treatments for early psychosis and depression in children and adolescents.

Childhood Sleep and Drug Use

It is no secret that a good night’s sleep is essential for children’s health and development, but in fact, sleep patterns in childhood may also be linked to future substance use, such as drugs and alcohol. A study conducted by a team of researchers from Penn State University found that adolescents who went to bed later and slept fewer hours as children and adolescents were more likely to have consumed alcohol or tried marijuana by the age of 15. The team published their findings in Annals of Epidemiology.

“The study suggests that there may be critical ages when sleep can be an intervention target,” said Anne-Marie Chang, associate professor of biobehavioral health at Penn State and senior author of the study. “Improving sleep among the school-age population could lead not only to improved sleep health, but also to improved decision-making around engaging in risky behaviors, such as alcohol and other substance use.”

The research team examined sleep in children at different stages of development within the same sample of children to see if there was an influence on later substance use, something that has only been examined in a few studies to date. They focused on two different aspects of sleep health – total sleep duration and bedtime. The researchers explained that going to bed later may affect children’s ability to get good sleep, especially at school age.

“The brain is more plastic at younger ages and you want healthy sleep to support neural development,” said David Reichenberger, co-lead author and a PhD in Biobehavioral Health at Penn State University at the time of the research. “Poor sleep health could be detrimental to their physical health as well as their decision-making, which in turn could be related to their decision to use drugs.”

The Findings

The study relied on data from 1,514 children from the Future of Families and Child Wellbeing Study, a diverse birth cohort of children from 20 cities across the United States. Parents reported their child’s regular bedtime on weekdays at ages three, five, and nine years. They also reported their child’s sleep duration at ages five and nine years. When the research team examined the association between childhood bedtime and sleep duration with future teenage alcohol and marijuana use, they found an association in the longitudinal section. Adolescents were 45% more likely to have tried alcohol by the age of 15 if they had a later bedtime at age nine compared to other children with earlier bedtimes at the same age. However, bedtime at age five was not associated with future alcohol use, nor was sleep duration at either age five or nine. As for marijuana use, a later bedtime at age five was associated with a 26% higher odds of trying marijuana by age 15, while sleeping one hour less at age nine was associated with a 19% higher odds of trying marijuana by age 15.

The research team also examined data from adolescents at age 15 who self-reported their bedtime, sleep duration, and alcohol and marijuana use. The experts found that adolescents who went to bed later were 39% more likely to have drunk alcohol and 34% more likely to have tried marijuana. Losing an hour of sleep was associated with a 28% higher likelihood of ever using alcohol, but not marijuana use.

According to Reichenberger, sleep in the years just before adolescence is the most important factor in relation to the future risk of drug use. During this developmental phase, children change rapidly and their brains mature. The researchers point out that earlier studies by other groups suggest that shorter sleep duration and later bedtimes can increase impulsivity and impair decision-making, which could affect the choice of substance use. These findings underscore the crucial role of sleep for various aspects of long-term health and well-being, according to the researchers.