The interplay of sleep disturbance, anxiety, and depression in children.

OBJECTIVE To review and critically evaluate the association between sleep, anxiety, and depression in children and provide recommendations for future research. METHODS A literature search was conducted using MEDLINE and PsychINFO computerized databases and bibliographies of relevant articles. RESULTS A surprisingly small but growing research base exists on the relation between sleep disturbance, anxiety, and depression in pediatric populations. Existing research indicates a significant symptom overlap between anxiety, depression, and sleep. This overlap may complicate proper assessment and treatment of children with these disorders. CONCLUSIONS Future research should ensure adequate assessment for symptoms of anxiety and depression when examining sleep disturbance in children. Likewise, research on anxiety and depression should include assessment for symptoms of disturbed sleep. Bridging the gap between these literatures should provide further insights into the etiologies of these disorders, increase symptom detection, and improve the clinical care of children and their families.