Trajectories of Insomnia Symptoms From Childhood Through Young Adulthood

Fernández-Mendoza, Julio; Lenker, Kristina; Calhoun, Susan L.; Qureshi, Myra; Ricci, Anna; Bourchtein, Elizaveta; He, Fan; Vgontzas, Alexandros N.; Liao, Jiangang; Liao, Duanping; Bixler, Edward O.

doi:10.1542/peds.2021-053616

Cited by 24 publications

(16 citation statements)

References 47 publications

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“…From a developmental standpoint, the ISSD phenotype, defined in youth as having parent‐ or self‐reported insomnia and sleeping objectively for <7.5 h (Fernandez‐Mendoza, 2017), has been associated in six studies with increased cortisol levels (Fernandez‐Mendoza et al, 2014), increased beta EEG power during sleep onset latency (SOL) and NREM sleep (Fernandez‐Mendoza et al, 2016a), increased C‐reactive protein levels (Fernandez‐Mendoza et al, 2017), clinically elevated internalising symptoms (Calhoun et al, 2017; Fernandez‐Mendoza et al, 2016b), and greater likelihood of worsening into adult insomnia disorder (Fernandez‐Mendoza et al, 2022).…”

Section: Resultsmentioning

confidence: 99%

Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes

Nyhuis

Fernández-Mendoza

2023

Journal of Sleep Research

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SummaryInsomnia nosology has significantly evolved since the Diagnostic and Statistical Manual (DSM)‐III‐R first distinguished between ‘primary’ and ‘secondary’ insomnia. Prior International Classification of Sleep Disorders (ICSD) nosology ‘split’ diagnostic phenotypes to address insomnia's heterogeneity and the DSM nosology ‘lumped’ them into primary insomnia, while both systems assumed causality for insomnia secondary to health conditions. In this systematic review, we discuss the historical phenotypes in prior insomnia nosology, present findings for currently proposed insomnia phenotypes based on more robust approaches, and critically appraise the most relevant ones. Electronic databases PsychINFO, PubMED, Web of Science, and references of eligible articles, were accessed to find diagnostic manuals, literature on insomnia phenotypes, including systematic reviews or meta‐analysis, and assessments of the reliability or validity of insomnia diagnoses, identifying 184 articles. The data show that previous insomnia diagnoses lacked reliability and validity, leading current DSM‐5‐TR and ICSD‐3 nosology to ‘lump’ phenotypes into a single diagnosis comorbid with health conditions. However, at least two new, robust insomnia phenotyping approaches were identified. One approach is multidimensional‐multimethod and provides evidence for self‐reported insomnia with objective short versus normal sleep duration linked to clinically relevant outcomes, while the other is multidimensional and provides evidence for two to five clusters (phenotypes) based on self‐reported trait, state, and/or life‐history data. Some approaches still need replication to better support whether their findings identify true phenotypes or simply different patterns of symptomatology. Regardless, these phenotyping efforts aim at improving insomnia nosology both as a classification system and as a mechanism to guide treatment.

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Section: Resultsmentioning

confidence: 99%

Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes

Nyhuis

Fernández-Mendoza

2023

Journal of Sleep Research

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“…For example, specific sleep problems, such as sleep breathing problems, enuresis, and parasomnia, are highly comorbid . Others show distinct changes in prevalence between childhood and adolescence, decreasing or increasing at pubertal onset. Such studies indicate that the transition into adolescence is a pivotal point in the experience of sleep problems during development and may be a period whereby intervention programs could prove more effective.…”

Section: Introductionmentioning

confidence: 99%

Associations of Changes in Sleep and Emotional and Behavioral Problems From Late Childhood to Early Adolescence

et al. 2023

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ImportanceSleep problems and psychopathology symptoms are highly comorbid and bidirectionally correlated across childhood and adolescence. Whether these associations are specific to discrete profiles of sleep problems and specific internalizing and externalizing phenomena is currently unclear.ObjectiveTo characterize individual changes in profiles of sleep problems and their prospective associations with psychopathology symptoms across the transition from childhood to adolescence.Design, Setting, and ParticipantsThis observational cohort study used baseline data (participant age of 9 to 11 years) and 2-year follow-up data (participant age of 11 to 13 years) from the community-setting, multicenter Adolescent Brain Cognitive Development (ABCD) study. Individuals were assessed for a range of sleep problems at both waves and categorized into profiles via latent profile analysis. The stability and change in these profiles over time was assessed via latent transition analysis. Logistic regression models examined whether psychopathology symptoms were cross-sectionally associated with profile membership and whether transitions between profiles were associated with changes psychopathology symptoms over time. Data were collected from September 2016 to January 2020, and data were analyzed from August 2021 to July 2022.ExposuresSleep problems were assessed at both baseline and follow-up via the parent-reported Sleep Disturbance Scale for Children (SDSC).Main Outcomes and MeasuresPsychopathology symptoms at both baseline and follow-up were assessed using the internalizing and externalizing dimension scores derived from the parent-reported Child Behavior Checklist.ResultsA total of 10 313 individuals (4913 [47.6%] were female) were categorized into 4 latent profiles of sleep problems at both baseline and follow-up: a low disturbance profile, a sleep onset/maintenance problems profile, a moderate and nonspecific disturbance profile (termed mixed disturbance), and a high disturbance profile. Individuals in the 3 more severe problem profiles displayed greater risk of concurrent internalizing symptoms (sleep onset/maintenance problems: odds ratio [OR], 1.30; 95% CI, 1.25-1.35; P &lt; .001; mixed disturbance: OR, 1.29; 95% CI, 1.25-1.33; P &lt; .001; high disturbance: OR, 1.44; 95% CI, 1.40-1.49; P &lt; .001) and externalizing symptoms (sleep onset/maintenance problems: OR, 1.20; 95% CI, 1.16-1.23; P &lt; .001; mixed disturbance: OR, 1.17; 95% CI, 1.14-1.20; P &lt; .001; high disturbance: OR, 1.24; 95% CI, 1.21-1.28; P &lt; .001). Transitions between sleep profiles over time were associated with prospective internalizing and externalizing symptoms, but not vice versa.Conclusions and RelevanceThere are substantial changes in sleep problems across the transition to adolescence that are associated with later internalizing and externalizing symptoms. Sleep profiles could be targeted in future intervention and treatment programs to improve sleep-related and mental health–related outcomes across development.

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“…Insomnia is one of the most severe sleep problems during adolescence owing to its frequent comorbidity with psychiatric disorders, manifested by difficulties in sleep onset and maintenance, recurrent perceived sleep dissatisfaction, as well as daytime dysfunction and consequent distress (Alvaro et al, 2017). Insomnia symptoms generally increase significantly during the transition from childhood to early adolescence (Fernandez‐Mendoza et al, 2022). Further, insomnia tends to be chronic, as a previous study found that 88% of adolescents with a lifetime history of insomnia reported recurrent insomnia symptoms within the past month (Johnson et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

The trajectories and associations of insomnia symptoms with addictive behaviours in adolescents: A two‐year longitudinal study

Liu

Wang

Gong

et al. 2023

Journal of Sleep Research

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Summary Insomnia displays heterogeneous trajectories across adolescence, which may induce addictive behaviours, including internet gaming disorder and substance use. This study aimed to investigate the latent trajectory classes of insomnia symptoms over 2 years and to examine the associations between insomnia trajectories and these addictive behaviours. Participants were 910 adolescents from six middle schools in Shanghai, China (52.7% males; mean age = 13.17 years). The three‐wave survey measured insomnia symptoms, internet gaming disorder, substance use, depressive symptoms, and sociodemographic characteristics from 7th to 9th grade. Latent class growth modelling was performed to identify the latent trajectory classes of insomnia symptoms. Then multivariable logistic regressions were conducted within the best‐fitting latent class growth model to examine the associations of insomnia trajectories with internet gaming disorder and substance use. Two latent trajectory classes of insomnia symptoms were recognised: the non‐insomnia group (71.8%) and the insomnia group (28.2%). In the multivariable analysis controlling for baseline demographic variables and depressive symptoms, the insomnia group had a higher risk of developing internet gaming disorder (OR = 2.203 [95% CI: 1.258–3.858]) and substance use (OR = 2.215 [95% CI: 1.324–3.705]) compared with the non‐insomnia group. These findings add to a growing body of research on heterogeneous trajectories of insomnia symptoms during adolescence, suggesting that intervention strategies are needed to target the characteristics or developmental patterns of different insomnia subgroups. The ultimate goal is to mitigate the impact of insomnia symptoms on adolescent addictive behaviours.

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Trajectories of Insomnia Symptoms From Childhood Through Young Adulthood

Cited by 24 publications

References 47 publications

Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes

Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes

Associations of Changes in Sleep and Emotional and Behavioral Problems From Late Childhood to Early Adolescence

The trajectories and associations of insomnia symptoms with addictive behaviours in adolescents: A two‐year longitudinal study

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