Chronic Insomnia and Its Negative Consequences for Health and Functioning of Adolescents: A 12-Month Prospective Study

Division of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA.
Journal of Adolescent Health (Impact Factor: 3.61). 03/2008; 42(3):294-302. DOI: 10.1016/j.jadohealth.2007.09.016
Source: PubMed


To estimate prevalence and chronicity of insomnia and the impact of chronic insomnia on health and functioning of adolescents.
Data were collected from 4175 youths 11-17 at baseline and 3134 a year later sampled from managed care groups in a large metropolitan area. Insomnia was assessed by youth-reported DSM-IV symptom criteria. Outcomes are three measures of somatic health, three measures of mental health, two measures of substance use, three measures of interpersonal problems, and three of daily activities.
Over one-fourth reported one or more symptoms of insomnia at baseline and about 5% met diagnostic criteria for insomnia. Almost 46% of those who reported one or more symptoms of insomnia in Wave 1 continued to be cases at Wave 2 and 24% met DSM-IV symptom criteria for chronic insomnia (cases in Wave 1 were also cases in Wave 2). Multivariate analyses found chronic insomnia increased subsequent risk for somatic health problems, interpersonal problems, psychological problems, and daily activities. Significant odds (p < .05) ranged from 1.6 to 5.6 for poor outcomes. These results are the first reported on chronic insomnia among youths, and corroborate, using prospective data, previous findings on correlates of disturbed sleep based on cross-sectional studies.
Insomnia is both common and chronic among adolescents. The data indicate that the burden of insomnia is comparable to that of other psychiatric disorders such as mood, anxiety, disruptive, and substance use disorders. Chronic insomnia severely impacts future health and functioning of youths. Those with chronic insomnia are more likely to seek medical care. These data suggest primary care settings might provide a venue for screening and early intervention for adolescent insomnia.

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Available from: Hao T Duong, Mar 05, 2015
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    • "Sleep problems are frequent in this age group, as reflected in a high prevalence of insomnia [2]. Sleep problems during adolescence constitute a public health concern in its own right, but they are also associated with several health-related problems, as well as increased use of health care services [3] [4]. The functional significance of sleep problems in adolescents may also be evident in their school attendance and school performance. "
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    ABSTRACT: Background: The aim of this study was to examine the link between adolescent sleep and non-attendance in school. Methods: A large population-based study from Norway conducted in 2012, the youth@hordaland study, surveyed 8,347 adolescents aged 16-19 years (54% girls). Self-reported sleep measures included bedtime, rise time, sleep duration, sleep efficiency, sleep onset latency (SOL), wake after sleep onset (WASO), insomnia symptoms, tiredness, and sleepiness. School attendance was obtained from national administrative registries. Results: Most sleep parameters were associated with increased risk of school non-attendance. After adjusting for gender and socioeconomic status, short sleep duration and sleep deficiency were the sleep measures with the highest odds of non-attendance (OR=4.61, CI 95% 3.29-6.46) and (OR=3.26, CI 95% 2.67-3.99), respectively). Also, large bedtime discrepancies in weekend versus weekdays were associated with non-attendance (OR=2.43, CI 95% 1.93-2.02), as well as insomnia (OR=2.25, CI % 1.89-2.67) and daytime tiredness (OR=2.09, CI 95% 1.70-2.57). The associations were somewhat reduced after additional adjustment for depression, but remained significant in the fully adjusted model. Conclusion: The demonstrated relationship between sleep problems and school absence suggests that careful assessment of sleep is warranted when adolescents present with extensive school absence future studies on how the sleep-school absence relationship in adolescence may impact later work affiliation in adulthood are needed.
    Scandinavian Journal of Public Health 11/2014; 43(1). DOI:10.1177/1403494814556647 · 1.83 Impact Factor
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    • "For adolescent DSPD, Moore and Meltzer (2008) report a prevalence of 5–10 %, and Gradisar et al. (2011) report a prevalence of 7–16 %. For insomnia a distinction in reported prevalences can be made between insomnia diagnosis [4–5 % (Ohayon et al. 2000; Roberts et al. 2008)] and current insomnia symptoms (9.4 % (Johnson et al. 2006); 25–27 % (Ohayon et al. 2000; Roberts et al. 2008)). From these varying prevalences, we chose 15 % as a conservative estimate of general prevalence of sleep reduction symptoms. "
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    ABSTRACT: Sleep reduction, resulting from insufficient or poor sleep, is a common phenomenon in adolescents. Due to its severe negative psychological and behavioral daytime consequences, it is important to have a reliable and valid measure to assess symptoms of sleep reduction. This study aims to validate the Sleep Reduction Screening Questionnaire (SRSQ) that can be used to screen for symptoms of sleep reduction in adolescents. Various samples from the general population and clinical cases were included in the study. The SRSQ is a nine-item questionnaire that is based on the longer, four dimensional Chronic Sleep Reduction Questionnaire (Meijer 2008). Items were selected on the basis of principal components analysis, item-total correlations, and substantive consideration. The SRSQ was validated by calculating correlations with self-reported and objective sleep and self-reported daytime functioning. Cut-off scores were determined so that the SRSQ can be used as a screening instrument. Internal consistencies of the SRSQ were good (Cronbach’s alpha = .79 in the general population). Correlations with self-reported sleep, daytime functioning and objective sleep variables were satisfactory and in the expected directions. The SRSQ discriminates well between clinical and non-clinical cases. When accounting for prevalence of sleep reduction symptoms in the general population, the Area Under the Curve (AUC) was .91, sensitivity was .80 and specificity was .87. The SRSQ appears to be a reliable and valid questionnaire. Due to the limited number of items and the availability of cut-off scores, it is a practical tool for clinical and research purposes.
    Child and Youth Care Forum 04/2014; in press, accepted(5). DOI:10.1007/s10566-014-9256-z · 1.25 Impact Factor
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    • "In contrast, sleep disturbances have been reported in more than 25% of adolescents worldwide; poor sleep in adolescence has become a significant public mental and physical health problem [14] [20]. Cross-sectional [21] [22] and longitudinal studies [23] [24] have shown that acute and chronic sleep loss during development persists over time, with negative effects on adolescents' physical and mental health. At the same time, poor psychological well-being may itself negatively affect adolescents' sleep [14] [25]. "
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    ABSTRACT: Mental toughness (MT) is understood as the display of confidence, commitment, challenge, and control. Mental toughness is associated with resilience against stress. However, research has not yet focused on the relation between MT and objective sleep. The aim of the present study was therefore to explore the extent to which greater MT is associated with objectively assessed sleep among adolescents. A total of 92 adolescents (35% females; mean age, 18.92 years) completed the Mental Toughness Questionnaire. Participants were split into groups of high and low mental toughness. Objective sleep was recorded via sleep electroencephalograms and subjective sleep was assessed via a questionnaire. Compared with participants with low MT, participants with high MT had higher sleep efficiency, a lower number of awakenings after sleep onset, less light sleep, and more deep sleep. They also reported lower daytime sleepiness. Adolescents reporting higher MT also had objectively better sleep, as recorded via sleep electroencephalograms. A bidirectional association between MT and sleep seems likely; therefore, among adolescence, improving sleep should increase MT, and improving MT should increase sleep.
    Journal of Adolescent Health 01/2014; 54:109-113. DOI:10.1016/j.jadohealth.2013.07.017 · 3.61 Impact Factor
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