Source:

Fernandez-Mendoza
J
,
Lenker
KP
,
Calhoun
SL
, et al
.
Trajectories of insomnia symptoms from childhood through young adulthood
.
Pediatrics
.
2022
;
149
(
3
):
e2021053616
; doi:
https://doi.org/10.1542/peds.2021-053616

Investigators from multiple institutions conducted a cohort study to assess the trajectory of insomnia symptoms from childhood through adolescence and into young adulthood and evaluate whether objective short sleep duration (OSSD) is a predictor of adult insomnia in children with insomnia symptoms. Study participants were enrolled in the Penn State Child Cohort study between the ages of 5-12 years. Among 5,740 participants in the cohort, 1,000 were randomly selected to participate in an in-laboratory polysomnography (PSG) study at baseline (study visit 1 [V1]) and at study visit 2 (V2) when they were 12-23 years old. At V1 and V2, parents of study participants completed the Pediatric Behavior Scale, which included an item about difficulty in initiating or maintaining sleep (DIMS). Participants were defined as having insomnia symptoms if their parent reported “often/moderate,” or “very often/severe,” DIMS and/or use of sleep medication. When participants were 18-31 years old, they were asked to respond to a similar question to identify adult insomnia symptoms. Another item, “Do you have insomnia?” was used to classify participants as having adult insomnia.

The analysis was limited to participants who completed self-reports of sleep when they were adults. Regression analyses were conducted to assess the developmental trajectories of insomnia symptoms in children with insomnia symptoms at V1 and those with normal sleep; covariates in the models included demographics and presence of learning and psychiatric disorders. Logistic regression was used to assess whether OSSD, defined as a total sleep time of <7.7 hours during a 9-hour PSG study, was associated with an increased risk of adult insomnia in children with insomnia symptoms

Data were analyzed on 502 participants. Median ages at V1, V2, and adult follow-up were 8.6 ± 1.7, 16.5 ± 2.2, and 24.0 ± 2.6 years, respectively. The prevalence of insomnia symptoms was 23.5% at V1, 36.0% at V2, and 42.6% in adults. Among 118 children with insomnia symptoms at V1, insomnia symptoms persisted into adulthood in 43.3%, 26.9% had remission, and 18.6% had a waxing and waning pattern. Conversely, in those with normal sleep at V1 (N = 384), 48.1% remained a normal sleeper as an adult, 20.7% developed insomnia symptoms, 16.0% had a waxing and waning pattern, and 15.2% developed insomnia symptoms by V2 that persisted into adulthood. The prevalence of adult insomnia was 12.3%. Among children with insomnia symptoms at V1, those with OSSD were at significantly increased risk of adult insomnia (OR, 2.63; 95% CI, 1.03, 6.61). Similarly, in participants with insomnia symptoms at V2, OSSD was a predictor of adult insomnia (OR, 5.54; 95% CI, 2.01, 17.0).

The authors conclude that insomnia symptoms in children often persist into adulthood.

Dr. Dubik has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a...

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