Sleepless nights, sour moods: daily sleep-irritability links in a pediatric clinical sample

BACKGROUND

Sleep, or a lack thereof, is strongly related to mood dysregulation. Although considerable research uses symptom scales to examine this relation, few studies use longitudinal, real-time methods focused on pediatric irritability. This study leveraged an ecological momentary assessment (EMA) protocol, assessing bidirectional associations between momentary irritability symptoms and daily sleep duration in a transdiagnostic pediatric sample enriched for irritability.

METHODS

A total of N = 125 youth (Mage  = 12.58 years, SD = 2.56 years; 74% male; 68.8% White) completed digital, in vivo surveys three times a day for 7 days. For a subset of youth, their parents also completed the EMA protocol. Trait irritability was measured using youth-, parent-, and clinician-report to test its potential moderating effect on the association between sleep duration and momentary irritability.

RESULTS

Results from multilevel modeling dynamically linked sleep to irritability. Specifically, according to youth- and parent-report, decreased sleep duration was associated with increased morning irritability (bs ≤ -.09, ps < .049). A bidirectional association between parent-reported nightly sleep duration and anger was found-increased evening anger related to decreased nightly sleep duration, and decreased sleep duration related to increased morning anger (bs ≤ -.17, ps < .019). Trait irritability moderated this association, which was stronger for more irritable youth (b = -.03, p < .027).

CONCLUSIONS

This study adds to the literature and suggests sleep-irritability dynamics as a potential treatment target.

Methodological review of caffeine assessment strategies with a focus on adolescents

Adolescent caffeine use and its implications for developmental changes in sleep and circadian rhythms is under-researched. A majority of adolescents report consuming caffeine and yet the United States has not established federal guidelines for this age group. This widely used stimulant is primarily studied using self-report methodologies; however, there is no standardized method for collecting self-report caffeine data and past studies' findings have limited generalizability and comparability, making it challenging to examine the effects of caffeine use on adolescents' sleep. This review discusses methods and measures used for assessing caffeine in the field with adolescents: questionnaires, interviews, and diaries. Based on the review, recommendations for future methodologies and approaches are discussed.