Bidirectional associations between accelerometer-based sleep metrics and mental health symptoms from childhood to late adolescence: data from a Brazilian birth cohort
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: A bidirectional relationship between sleep and emotional/behavioral problems has been suggested in the literature; however, no study has examined this association longitudinally across multiple developmental stages using objective sleep metrics. This study investigated the reciprocal relationship between sleep and emotional/behavioral symptoms and explored the potential existence of critical or sensitive periods within a Brazilian birth cohort. METHODS: The 2004 Pelotas Birth Cohort Study recruited 4231 children (2196 boys) born in 2004 in Pelotas, Brazil. Emotional/behavioral problems were evaluated using the Strengths and Difficulties Questionnaire (SDQ) at 6, 11, 15, and 18 years of age and analyzed as externalizing and internalizing symptoms. Sleep duration and efficiency were evaluated using actigraphs during the mentioned follow-ups. Cross-lagged panel models were used to assess bidirectionality and critical/sensitive periods. RESULTS: = 0.061, p > 0.001), and higher internalizing scores at age 15 were significantly associated with reduced sleep efficiency at age 18 (β = - 0.034, p = 0.022). CONCLUSIONS: Higher externalizing symptoms predicted poorer sleep efficiency and longer sleep duration, whereas a bidirectional association with an opposite relationship to internalizing symptoms was found. These results highlight that adolescence is a critical point for both associations.
Source: BMC Medicine
Language: English
Topic: Sleep and related disorders
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $4,190
Funders: L'Oreal USA, Wellcome Trust, Universidade Federal de Pelotas, Fundação de Amparo à Pesquisa do Estado de São Paulo, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul, Ministério da Saúde, Associação Brasileira de Saúde Coletiva, Economic and Social Research Council
Awards: G1035275698, Implications of early life and contemporary exposures on body composition, human capital, mental health, and precursors of complex chronic diseases in three Brazilian cohorts (1982, 1993 and 2004)., Sleep and mental health: exploring the life course association and biosocial mechanisms in a Brazilian birth Cohort, G247810146, Impact of social distancing measures in the COVID-19 pandemic on the mental health of adolescents belonging to a birth cohort, G3059863438, G3572101131, Sleep and mental health: exploring the life course association and biosocial mechanisms in a Brazilian birth Cohort, G541389482, G570024232, G6028232586, G7488163499, Mental disorders, substance use and executive functions in early adolescence in a birth cohort
OpenAlex ID: W4413258477