Childhood insomnia that persists into adulthood impacts mental health of young adults

Childhood-onset insomnia symptoms that continued into adulthood served as “strong determinants” of internalizing disorders in young adults, according to findings from a 15-year longitudinal study presented at the virtual SLEEP 2021 meeting.

This association remained regardless of previous diagnoses or medication use, according to the study results, which also showed that childhood insomnia symptoms that lessened in the shift to adolescence did not result in greater risk for internalizing disorders in young adulthood. Researchers first published the findings in Sleep, the journal of the Sleep Research Society, and presented recently at the society’s annual meeting, which is being held virtually.

“We found that about 40% of children do not outgrow their insomnia symptoms in the transition to adolescence and are at risk of developing mental health disorders later on during early adulthood,” Julio J. Fernandez-Mendoza, PhD, associate professor and director of the behavioral sleep medicine training program at Penn State Health Sleep Research and Treatment Center in Hummelstown, Penn., said in a press release.

According to Fernandez-Mendoza and colleagues, internalizing disorders are the most common form of psychopathology, with a “large proportion of individuals” experiencing the first onset after the age of 18. Research has demonstrated a correlation between childhood insomnia symptoms, such as problems falling asleep or staying asleep, and internalizing disorders, but “little is known” about the developmental trajectories of insomnia symptoms and the related risk for internalizing disorders as a childhood transitions into adulthood. Fernandez-Mendoza and colleagues analyzed the risk for internalizing in young adulthood in connection with the longitudinal trajectories of insomnia symptoms across three developmental stages.

Researchers looked at data from the Penn State Child Cohort, a population-based sample of 700 children (median age, 9 years). They followed up with participants 8 years later as adolescents (n = 421; median age, 16 years) and 15 years later as young adults (n = 492; median age, 24 years).

Fernandez-Mendoza and colleagues defined insomnia symptoms by parent report when participants were in childhood or self-report when participants were in adolescence and young adulthood. Specifically, they looked at difficulties initiating or maintaining sleep on a moderate-to-severe scale. The researchers described the developmental course of insomnia symptoms in each of the three periods as never, remitted, waxing and waning, persistent and incident. They defined the incidence of internalizing disorders as a self-report of a diagnosis or a treatment for mood and/or anxiety disorders and adjusted Cox regression models for sex, race/ethnicity, age and childhood/adolescent history of internalizing disorders or psychoactive medication use.

The researchers found that a “persistent developmental trajectory” correlated with a 2.8-fold greater risk for adult internalizing disorders (HR = 2.83; 95% CI, 1.79-4.49) and an incident trajectory with a 1.9-fold greater risk (HR = 1.88; 95% CI, 1.1-3.2). A waxing-and-waning trajectory “marginally” correlated with adult internalizing disorders, according to the study results (HR = 1.7; 95% CI, 0.99-2.91). A remitting trajectory did not correlate with a greater risk for adult internalizing disorders (HR = 0.92; 95% CI, 0.38-2.24), Fernandez-Mendoza and colleagues found.

“These new findings further indicate that early sleep interventions are warranted to prevent future mental health problems, as children whose insomnia symptoms improved over time were not at increased risk of having a mood or anxiety disorder as young adults,” Fernandez-Mendoza said in the release.

Reference:

SLEEP 2021. Persistent insomnia symptoms since childhood associated with mood, anxiety disorders in adulthood. Available at: https://www.sleepmeeting.org/persistent-insomnia-symptoms-since-childhood-associated-with-mood-anxiety-disorders-adulthood/. Accessed June 10, 2021.