The Impact of Sleep Profiles on Psychopathology Symptoms in Adolescents


Results reveal changes in sleep problems across adolescence are associated with internalizing and externalizing symptoms, highlighting the need to address this early.

The Impact of Sleep Profiles on Psychopathology Symptoms in Adolescents

Rebecca Cooper, MPO

As children grow into adolescents, their sleep problems can change a lot, leading to mental health issues like anxiety or feeling compelled to act out. A new study shows that by understanding an individual’s specific sleep problems, they can learn to better cope with these mental health issues.1

According to the results, children with more severe sleep issues were at a much higher risk for internalizing the symptoms that accompany insomnia and other sleep conditions. Sleep problems and psychopathology symptoms are known to be closely related, but it is unclear whether specific profiles of sleep problems are associated with particular internalizing and externalizing symptoms.

Early detection and management of sleep problems can potentially help avoid the development of psychopathology symptoms later in life, the study noted. Identifying and addressing sleep issues in this population early on might guide prevention, or effective management, of the occurrence of mental health problems in the future.

From Problems with Sleep to Psychopathy

The data included a total of 10,313 individuals (47.6% female) that were categorized into 4 latent profiles of sleep problems at both baseline and follow-up:

  • low disturbance profile
  • sleep onset/maintenance problems profile
  • moderate and nonspecific disturbance profile (termed mixed disturbance)
  • high disturbance profile

Individuals in the 3 more severe problem profiles displayed a greater risk of concurrent internalizing symptoms and externalizing symptoms. The study stated that transitions between sleep profiles over time were associated with prospective internalizing and externalizing symptoms but not vice versa.

Investigating the Internalization of Symptoms in Adolescents

Rebecca Cooper, MPO, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, and a team of investigators performed an observational cohort study aiming to determine individual changes in sleep problem profiles and their prospective associations with psychopathology symptoms during the transition from childhood to adolescence.

The study used baseline data from individuals aged between 9-11 years and 2-year follow-up data of individuals aged between 11-13 years from the community-setting, multicenter Adolescent Brain Cognitive Development (ABCD) study. The participants were evaluated for a range of sleep problems at both waves and grouped into profiles using latent profile analysis.

The stability and change in these profiles over time were evaluated using latent transition analysis. Logistic regression models were used to examine whether psychopathology symptoms were cross-sectionally associated with profile membership and whether transitions between profiles were associated with changes in psychopathology symptoms over time.

Sleep problems were assessed at both baseline and follow-up using the parent-reported Sleep Disturbance Scale for Children (SDSC), while psychopathology symptoms were assessed using the internalizing and externalizing dimension scores derived from the parent-reported Child Behavior Checklist.

Further Research for Adolescent Sleep Interventions

Investigators found substantial changes in sleep problems across the transition to adolescence that are associated with later internalizing and externalizing symptoms. These findings suggest that sleep profiles could be targeted in future intervention and treatment programs to improve sleep-related and mental health-related outcomes across development.

They further emphasized the importance of early detection and management of sleep problems in children and adolescents to prevent the development of psychopathology symptoms later in life.

“The 4 sleep profiles identified in this study demonstrate that developmental sleep problems are diverse, highly comorbid, and follow individualized trajectories across development,” the team wrote. “These sleep profiles were further associated with the development of psychopathology symptoms in early adolescence.”


  1. Cooper R, Di Biase MA, Bei B, Quach J, Cropley V. Associations of Changes in Sleep and Emotional and Behavioral Problems From Late Childhood to Early Adolescence. JAMA Psychiatry. Published online April 05, 2023. doi:10.1001/jamapsychiatry.2023.0379
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