STUDY OBJECTIVE To examine longitudinal, bidirectional associations among behavioral sleep problems, internalizing and externalizing symptoms, and domains of health-related quality of life (HRQoL) from early childhood to adolescence in a population sample of Australian children. METHOD Data were drawn from the Longitudinal Study of Australian Children (LSAC), a national prospective cohort study with 4,983 children participating in the Kindergarten cohort. Data were collected when children were ages 4-5, 6-7, 8-9, 10-11, 12-13 years. At each study wave, the primary parent (97% mothers) reported on behavioral child sleep problems, internalizing and externalizing symptoms, and HRQoL domains (psychosocial and physical). Cross-lagged structural equation models were used to evaluate bidirectional associations. RESULTS At nearly every age, behavioral sleep problems were associated with worse subsequent psychosocial and physical HRQoL. Despite bidirectional associations between mental health and HRQoL at many waves, HRQoL domains more strongly predicted later internalizing symptoms, while externalizing symptoms more strongly predicted later HRQoL. Many of the bidirectional associations among sleep, mental health, and HRQoL were found earlier in childhood. CONCLUSION Behavioral sleep problems may forecast later HRQoL psychosocial and physical impairments. Attending to both sleep problems and HRQoL could prevent the progression of internalizing conditions, while a focus on externalizing concerns could prevent the worsening of these symptoms, sleep problems and HRQoL, particularly during the transition to school.

中文翻译：

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睡眠问题、内化和外化症状以及与健康相关的生活质量领域：从幼儿期到青春期早期的双向关联

研究目的 研究澳大利亚儿童人群样本中从幼儿期到青春期的行为睡眠问题、内化和外化症状以及健康相关生活质量 (HRQoL) 领域之间的纵向双向关联。方法 数据来自澳大利亚儿童纵向研究 (LSAC)，这是一项全国性前瞻性队列研究，共有 4,983 名儿童参与了幼儿园队列研究。数据是在儿童 4-5、6-7、8-9、10-11、12-13 岁时收集的。在每个研究浪潮中，主要父母（97% 的母亲）报告了行为儿童睡眠问题、内化和外化症状以及 HRQoL 领域（心理社会和身体）。交叉滞后结构方程模型用于评估双向关联。结果几乎在每个年龄段，行为睡眠问题与随后较差的心理社会和身体 HRQoL 相关。尽管心理健康与 HRQoL 在许多波次之间存在双向关联，但 HRQoL 领域更强烈地预测了后期的内化症状，而外化症状更强烈地预测了后期的 HRQoL。睡眠、心理健康和 HRQoL 之间的许多双向关联是在童年早期发现的。结论 行为睡眠问题可以预测以后的 HRQoL 心理社会和身体障碍。关注睡眠问题和 HRQoL 可以防止内化条件的进展，而关注外化问题可以防止这些症状、睡眠问题和 HRQoL 的恶化，尤其是在向学校过渡期间。