Understanding the Relationship Between Sleep Problems in Early Childhood and Borderline Personality Disorder: A Narrative Review
Marwaha, Steven Winsper, Catherine
Marwaha, Steven
Winsper, Catherine
Abstract
Objective
Recent research indicates that sleep problems in childhood precede the development of borderline personality disorder (BPD) symptoms, but the mechanisms by which sleep problems associate with BPD are still unknown. This narrative review aims to provide some potential explanations for how early sleep problems might associate with BPD.
Methods
We used the biosocial developmental model of BPD as a framework to discuss how sleep problems may associate with BPD. Articles were identified via PubMed and Embase, and papers published between January 1991 and April 2021 were extracted. Authors made a series of literature searches using the following keywords: Sleep problems, Insomnia, Nightmares, Hypothalamic–Pituitary–Adrenal Axis (HPA), Prefrontal Cortex, Family Psychopathology, Disrupted Attachment, Child Maltreatment, Impulsivity, Emotion Regulation, Internalizing, Externalizing, Rumination, Childhood, Adolescence, Young people. The inclusion criteria were published in peer-reviewed journals; human studies or reviews; published in English. The exclusion criteria were commentaries; abstracts from conferences; studies with animal samples. A total of 96 articles were included for the purpose of this review.
Results
The evidence from this review suggests that some biological factors and core features of BPD act as potential mechanisms mediating the associations between early sleep and subsequent BPD, while some family-related factors might constitute common risk factors for sleep problems and BPD.
Conclusion
The biosocial developmental model of BPD provides a plausible characterization of how sleep disruption might lead to subsequent BPD. Further research on new developmental and early intervention approaches to understand how sleep in early stages associates with BPD could have significant clinical impact on these patients and could inform targeted therapeutic interventions.
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Date
2021-12-20
Type
Article
Subject
Mental health
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Citation
Morales-Muñoz I, Durdurak BB, Bilgin A, Marwaha S, Winsper C. Understanding the Relationship Between Sleep Problems in Early Childhood and Borderline Personality Disorder: A Narrative Review. Nat Sci Sleep. 2021 Dec 20;13:2175-2202. doi: 10.2147/NSS.S311672. PMID: 34984039; PMCID: PMC8709557.
Journal / Source Title
Nature and Science of Sleep
DOI
10.2147/NSS.S311672
PMID
34984039
Publisher
Taylor and Francis Group
Publisher’s URL
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709557/