Sleep Edition

Dr Mark Lovell


Dr Mark Lovell is a Consultant Child and Adolescent Intellectual Disability Psychiatrist, Tees, Esk and Wear Valleys NHS Foundation Trust. He is an ACAMH Board Member and the Lead for CPD and Training.

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This edition of The Bridge concentrates on sleep, a poignant reminder that I am editing this on a 6am train to London having shortened my own sleep cycle and feeling rather sleep deprived on this dark winter morning. Having looked at the original research and summaries, I can now thankfully say I am now wide awake and feel invigorated for the rest of the day (with a little help from the contents of my coffee mug).

Clinically, sleep is often presented to Paediatric and Child and Adolescent Mental Health settings, either as the primary issue or as a symptom or sign of another condition. Often where it is presented can be luck of the draw, and has no logic. It is therefore important that clinically we understand the interrelationships between sleep from a biological, psychological and social perspective. It can be affected within neurodevelopmental disorders such as ASD and ADHD, in Cerebral Palsy and cortical blindness, as part of ear, nose and throat conditions, epilepsy may alter it, as may pain and discomfort, it may be a symptom or sign of either low or high mood and may be affected in children that have been affected by traumatic experiences or even be genetically pre-programmed with differences in sleep patterns eg in Smith Magenis Syndrome. As the scientific literature expands, we are learning more and more about the reason we sleep and what happens when we don’t sleep enough. Also, we are learning what interventions work and for whom.

In today’s society where data is literally being fed into our lives 24 hours a day and we are accessing stimulating electronic devices with backlights that reduce our naturally produced melatonin that helps us sleep, the importance of sufficient quality and quantity of sleep couldn’t be more pertinent, particularly as we are understanding more about its effects.

There have been some fascinating research articles in ACAMH’s journals CAMH and JCPP covering a diverse range of sleep-related topics. From neurological predictors of poor sleep in the future, sleep and links to behavioural problems, cognitive and language development, links to depression, adverse childhood experiences and a summary of the evidence base for pharmacological treatments for sleep disturbance. This edition of The Bridge contains some summaries by the original authors as well as commissioned summaries by our science writer.

I hope that you enjoy reading this issue of The Bridge and perhaps you’ll be interested in attending one of ACAMH’s periodic events on sleep either in person or online.

If you have any ideas for content or feedback on the bridge whilst I am acting as Guest Editor, please email me.

I hope you enjoy reading this edition of The Bridge please share it with colleagues, and a pdf version is available, plus look out for our Tourette Syndrome edition out next month.

Articles from this edition

Sleep partially mediates the link between adverse childhood experiences and delinquency

Sleepiness in adolescence is associated with criminal behaviour in adulthood

Sleep problems in preschoolers predict depression and anxiety severity

Day-time naps promote vocabulary growth in early childhood

Cortical hyperarousal in children may predict insomnia in adolescence

Prescribing in the dark: off-label drug treatments for children with insomnia

Time spent awake during the night in infancy is a marker for cognitive trajectories

Improvements of adolescent psychopathology after insomnia treatment results from a randomized controlled trial over one year

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