SLEEP–WAKE RHYTHM DISORDERS IN CHILDREN AND ADOLESCENTS: NEUROPSYCHIATRIC CONSEQUENCES
TL;DR
Experimental and translational findings suggest that sleep loss during sensitive developmental periods may affect limbic functioning and synaptic plasticity, potentially contributing to long-term neurodevelopmental vulnerability.
Abstract
Background: Sleep is a key determinant of psychomotor and cognitive development in children and adolescents. Increasing exposure to evening blue light, irregular sleep schedules, and lifestyle factors contribute to circadian misalignment and sleep–wake rhythm disorders, which are increasingly recognized as clinically relevant in pediatric mental health. Objective: To summarize current evidence on neuropsychiatric consequences of sleep–wake rhythm disorders in children and adolescents and to outline major contributing factors and management strategies. Methods: A narrative review of the literature was conducted using PubMed and selected full-text publications, with emphasis on studies published within the last 10 years addressing sleep physiology, circadian regulation, and neuropsychiatric outcomes of sleep disturbances in pediatric populations. Results: Circadian rhythm sleep–wake disorders, particularly delayed sleep–wake phase disorder, are common during adolescence and are driven by pubertal circadian phase delay, evening light exposure, and behavioral sleep restriction. Sleep–wake rhythm disruption is associated with internalizing symptoms, including anxiety and depression, and evidence supports a bidirectional relationship between sleep disturbances and mental disorders. Sleep problems are also frequent in attention-deficit/hyperactivity disorder and may exacerbate executive dysfunction, impulsivity, irritability, and behavioral dysregulation. Experimental and translational findings suggest that sleep loss during sensitive developmental periods may affect limbic functioning and synaptic plasticity, potentially contributing to long-term neurodevelopmental vulnerability. Conclusions: Sleep–wake rhythm disorders represent modifiable risk factors for adverse neuropsychiatric outcomes in youth. Early identification, sleep hygiene, chronotherapy, and appropriately timed melatonin may improve sleep timing and daytime functioning and should be integrated into clinical practice and preventive strategies.