SLEEP–WAKE RHYTHM DISORDERS IN CHILDREN AND ADOLESCENTS: NEUROPSYCHIATRIC CONSEQUENCES

Authors

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.5987

Keywords:

Sleep Wake Disorders, Circadian Rhythm, Adolescent, Child, Sleep Deprivation, Insomnia, Attention Deficit Disorder With Hyperactivity, Anxiety Disorders Depressive Disorder, Melatonin

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.

References

Owens, J. A. (2015). Insufficient sleep in adolescents: Causes and consequences. Nature and Science of Sleep, 7, 1–12. https://doi.org/10.2147/NSS.S55807

Shochat, T., Tavor, O., & Tzischinsky, O. (2015). Functional consequences of inadequate sleep in adolescents: A systematic review. Nature and Science of Sleep, 7, 1–16. https://doi.org/10.2147/NSS.S51941

Short, M. A., & Louca, M. (2015). Sleep deprivation leads to mood deficits in healthy adolescents. Nature and Science of Sleep, 7, 57–68. https://doi.org/10.2147/NSS.S73536

Dewald-Kaufmann, J. F., Oort, F. J., & Meijer, A. M. (2016). The effects of sleep extension on adolescents’ academic performance: A systematic review. Sleep Medicine Reviews, 28, 29–38. https://doi.org/10.1016/j.smrv.2015.06.006

Chang, A. M., Aeschbach, D., Duffy, J. F., & Czeisler, C. A. (2015). Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proceedings of the National Academy of Sciences of the United States of America, 112(4), 1232–1237. https://doi.org/10.1073/pnas.1418490112

Cain, N., & Gradisar, M. (2016). Electronic media use and sleep in school-aged children and adolescents: A review. Sleep Medicine, 20, 64–72. https://doi.org/10.1016/j.sleep.2015.11.013

Touitou, Y., Touitou, D., & Reinberg, A. (2017). Disruption of adolescents’ circadian clock: The vicious circle of media use, exposure to light at night, sleep loss and risk behaviors. Nature and Science of Sleep, 9, 247–259. https://doi.org/10.2147/NSS.S125637

Meltzer, L. J., Williamson, A. A., & Mindell, J. A. (2018). Sleep and pediatric chronic illness: A systematic review. Sleep Medicine Reviews, 41, 211–221. https://doi.org/10.1016/j.smrv.2018.02.003

Gregory, A. M., & Sadeh, A. (2020). Annual research review: Sleep problems in childhood psychiatric disorders—A review of the latest science. The Lancet Psychiatry, 7(6), 497–508. https://doi.org/10.1016/S2215-0366(20)30042-1

Alvaro, P. K., Roberts, R. M., & Harris, J. K. (2017). A systematic review assessing bidirectionality between sleep disturbances and mental disorders. Sleep Medicine Reviews, 36, 29–45. https://doi.org/10.1016/j.smrv.2016.09.002

Alfano, C. A., & Gamble, A. L. (2019). The role of sleep in childhood anxiety disorders. Child and Adolescent Psychiatric Clinics of North America, 28(3), 457–468. https://doi.org/10.1016/j.chc.2019.02.002

Baglioni, C., Battagliese, G., Feige, B., et al. (2016). Insomnia as a predictor of depression: A meta-analytic evaluation. The Lancet Psychiatry, 3(6), 524–534. https://doi.org/10.1016/S2215-0366(16)00099-1

Paruthi, S., Brooks, L. J., D’Ambrosio, C., et al. (2016). Recommended amount of sleep for pediatric populations: A consensus statement. Journal of Clinical Sleep Medicine, 12(6), 785–786. https://doi.org/10.5664/jcsm.5866

Blumberg, M. S., Gall, A. J., & Todd, W. D. (2017). The development of sleep–wake rhythms and the search for elemental circuits in the infant brain. Sleep Medicine Reviews, 32, 66–76. https://doi.org/10.1016/j.smrv.2016.03.007

Sadeh, A., Tikotzky, L., & Kahn, M. (2015). Sleep in infancy and childhood: Implications for emotional and behavioral development. Nature and Science of Sleep, 7, 19–28. https://doi.org/10.2147/NSS.S75589

Tarokh, L., Raffray, T., Van Reen, E., & Carskadon, M. A. (2016). Developmental changes in the human sleep EEG during early adolescence. Current Opinion in Neurobiology, 40, 64–69. https://doi.org/10.1016/j.conb.2016.06.014

Fernandez, L. M. J., & Lüthi, A. (2020). Sleep spindles: Mechanisms and functions. Nature Reviews Neuroscience, 21(9), 473–485. https://doi.org/10.1038/s41583-020-0364-6

Helfrich, R. F., Mander, B. A., Jagust, W. J., Knight, R. T., & Walker, M. P. (2019). Old brains come uncoupled in sleep: Slow wave–spindle synchrony, brain atrophy, and forgetting. Trends in Cognitive Sciences, 23(9), 666–679. https://doi.org/10.1016/j.tics.2019.06.005

Purcell, S. M., Manoach, D. S., Demanuele, C., et al. (2017). Characterizing sleep spindles in 11,630 individuals. Neuron, 95(4), 1–13. https://doi.org/10.1016/j.neuron.2017.06.048

Scammell, T. E., Arrigoni, E., & Lipton, J. O. (2017). Neural circuitry of wakefulness and sleep. Neuron, 93(4), 747–765. https://doi.org/10.1016/j.neuron.2017.01.014

Galland, B. C., Taylor, B. J., Elder, D. E., & Herbison, P. (2018). Normal sleep patterns in infants and children: A systematic review. Sleep Medicine Reviews, 40, 92–101. https://doi.org/10.1016/j.smrv.2017.06.001

Ohayon, M. M., Carskadon, M. A., Guilleminault, C., & Vitiello, M. V. (2017). Meta-analysis of quantitative sleep parameters from childhood to old age. Sleep, 40(3), zsx001. https://doi.org/10.1093/sleep/zsx001

McClain, I. J., Lustenberger, C., Achermann, P., et al. (2016). Developmental changes in sleep spindle characteristics and their relation to learning. Developmental Cognitive Neuroscience, 20, 67–75. https://doi.org/10.1016/j.dcn.2016.06.007

Ujma, P. P., Sandor, P., Szakadat, S., et al. (2019). Sleep spindles and intelligence in early childhood. Sleep Medicine Reviews, 44, 1–11. https://doi.org/10.1016/j.smrv.2018.12.001

Campbell, I. G., & Feinberg, I. (2016). Maturational patterns of EEG activity during non-REM sleep in childhood and adolescence. Sleep, 39(6), 1–12. https://doi.org/10.5665/sleep.5826

Kaczor, M., & Skalski, M. (2015). Circadian sleep–wake cycle disorders in adolescents: A literature review. Current Problems of Psychiatry, 49(3), 349–356. https://doi.org/10.20966/chn.2015.49.349

Gruber, R., Salamon, L., Tauman, R., & Al-Yagon, M. (2023). Sleep disturbances in adolescents with attention-deficit/hyperactivity disorder. Nature and Science of Sleep, 15, 275–286. https://doi.org/10.2147/NSS.S386435

Woods, H. C., & Scott, H. (2016). #Sleepyteens: Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. Journal of Adolescence, 51, 41–49. https://doi.org/10.1016/j.adolescence.2016.05.008

Arns, M., Kooij, J. J. S., & Coogan, A. N. (2021). Identification and management of circadian rhythm sleep disorders as a transdiagnostic feature in child and adolescent psychiatry. Journal of the American Academy of Child & Adolescent Psychiatry, 60(9), 1085–1095. https://doi.org/10.1016/j.jaac.2020.12.035

Ordway, M. R., Logan, S., & Sutton, E. H. (2022). Sleep deficiency in young children. Clinics in Chest Medicine, 43(2), 229–237. https://doi.org/10.1016/j.ccm.2022.02.007

Crowley, S. J., Acebo, C., & Carskadon, M. A. (2007). Sleep, circadian rhythms, and delayed sleep–wake phase in adolescence. Sleep Medicine, 8(6), 602–612. https://doi.org/10.1016/j.sleep.2006.12.002

American Academy of Sleep Medicine. (2014). International classification of sleep disorders (3rd ed.). American Academy of Sleep Medicine.

Tonetti, L., Fabbri, M., Martoni, M., & Natale, V. (2012). Circadian typology and mood seasonality in adolescents. Psychiatry and Clinical Neurosciences, 66(2), 157–159. https://doi.org/10.1111/j.1440-1819.2011.02290.x

Walęcka-Matyja, K. K., & Tabała, K. (2025). Family system and sleep and circadian rhythm disorders in children and adolescents. Fides et Ratio, 61(1), 33–46.

Shinjyo, N., Waddell, G., & Green, J. (2020). Valerian root in treating sleep problems and associated disorders: A systematic review and meta-analysis. Journal of Evidence-Based Integrative Medicine, 25, 2515690X20967323. https://doi.org/10.1177/2515690X20967323

Lin, K. H., Chang, Y. J., Chang, T. M., et al. (2025). Impact of sleep disturbance on mental health in schoolchildren with atopic dermatitis. JAAD International, 24, 50–60. https://doi.org/10.1016/j.jdin.2025.08.013

Royant-Parola, S. (2021). International expert opinions on the use of melatonin in insomnia and circadian sleep disturbances. Frontiers in Psychiatry, 12, 688890. https://doi.org/10.3389/fpsyt.2021.688890

Wilson, S., Anderson, K., Baldwin, D., et al. (2019). Evidence-based guidelines for the treatment of insomnia and circadian rhythm disorders. Journal of Psychopharmacology, 33, 923–947. https://doi.org/10.1177/0269881119855343

Palagini, L., Manni, R., Aguglia, E., et al. (2020). Consensus recommendations on the assessment and management of insomnia. Frontiers in Psychiatry, 11, 558. https://doi.org/10.3389/fpsyt.2020.00558

Diaz-Roman, A., Hita-Yanez, E., & Buela-Casal, G. (2016). Sleep characteristics in children with ADHD: Systematic review and meta-analysis. Journal of Clinical Sleep Medicine, 12, 747–756. https://doi.org/10.5664/jcsm.5890

Bandopadhyay, U., Diaz-Orueta, U., & Coogan, A. N. (2021). Sleep and circadian rhythms in children with ADHD: A systematic review. Journal of Attention Disorders, 25, 1087054720978556. https://doi.org/10.1177/1087054720978556

Larsson, I., Aili, K., Lönn, M., et al. (2023). Sleep interventions for children with ADHD: A systematic review. Sleep Medicine, 102, 64–75. https://doi.org/10.1016/j.sleep.2022.12.021

Jankowski, K. S., & Linke, M. (2020). Bad night owls: Emotionality and aggressiveness in adolescent chronotypes. Chronobiology International, 37, 1–8. https://doi.org/10.1080/07420528.2019.1709335

Schlarb, A. A., Sopp, R., Ambiel, D., & Grünwald, J. (2013). Aggression and antisocial behavior in relation to chronotype. Chronobiology International, 31, 1–16. https://doi.org/10.3109/07420528.2013.809421

Ochoa-Fuentes, D. A., et al. (2022). Stress, anxiety and depression in children and adolescents. Revista Médica del Instituto Mexicano del Seguro Social, 60(3), 338–344.

Milman, N. E. P., Tinsley, C. E., Raju, R. M., & Lim, M. M. (2022). Consequences of developmental sleep disruption. Neurobiology of Sleep and Circadian Rhythms, 14, 100085. https://doi.org/10.1016/j.nbscr.2022.100085

Dawson, G., Rieder, A. D., & Johnson, M. H. (2023). Prediction of autism in infants. The Lancet Neurology, 22(3), 244–254. https://doi.org/10.1016/S1474-4422(22)00407-0

Horne, J. A., & Östberg, O. (1976). A self-assessment questionnaire to determine morningness–eveningness. International Journal of Chronobiology, 4, 97–110.

van Andel, E., Bijlenga, D., Vogel, S. W. N., et al. (2020). Chronotherapy in ADHD with delayed sleep–wake phase disorder. Chronobiology International, 29, 1–10. https://doi.org/10.1080/07420528.2020.1835943

Van der Heijden, K. B., Smits, M. G., Van Someren, E. J. W., et al. (2007). Effect of melatonin on sleep, behavior and cognition in ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 233–241. https://doi.org/10.1097/01.chi.0000246055.76167.0d

Downloads

Published

2026-08-14

How to Cite

Kowalewska-Kurek, A., Kowalska , K. ., Grygorcewicz, H., Mikuła, L., & Strycharczuk, J. (2026). SLEEP–WAKE RHYTHM DISORDERS IN CHILDREN AND ADOLESCENTS: NEUROPSYCHIATRIC CONSEQUENCES. International Journal of Innovative Technologies in Social Science, 1(3(51). https://doi.org/10.31435/ijitss.3(51).2026.5987

Most read articles by the same author(s)