Pediatric insomnia could persist into adulthood, study finds

Childhood-onset insomnia symptoms can be long-lasting, persisting into adolescence and even adulthood, according to a study published in Pediatrics.

In a 15-year, longitudinal cohort study, researchers found that the odds of insomnia symptoms worsening into adult insomnia were 2.6-fold among children and 5.5-fold among adolescents who slept a short time in the lab setting.

Julio J. Fernandez-Mendoza, PhD, an associate professor and sleep researcher at the Penn State College of Medicine, presented the study in a video that accompanied the Pediatrics piece online.

“I’m pretty sure that many [providers] have at least once questioned, ‘Is this child really going to persist with insomnia symptoms all the way through adolescence and later on?’” Fernandez-Mendoza said. “[Pediatricians] working with adolescents or young adults, you may have a question yourself: ‘Do these insomnia symptoms ... truly, truly have an onset in childhood?’”

A total of 502 children a median age of 9 years old were studied 7.4 years later as adolescents, averaging 16 years old, and 15 years later as adults, averaging 24 years old. During the first stage, 118 subjects were identified to have insomnia symptoms, a number that increased to 120 at adolescence. The number rose to 214 subjects in the final count.

The team’s results indicated that 43% of children persisted with insomnia symptoms through young adulthood, whereas 20% worsened into adult insomnia, and the risk for insomnia symptoms worsening into adult insomnia was greatest among adolescents who were short sleepers.

“Among those with insomnia symptoms, the most common trajectory that we should expect, at least in 40% of children, is persistence all the way to adulthood,” Fernandez-Mendoza said.

The study noted that the second most common trajectory for insomnia symptoms was remission, with 27% of the observed children having remitted in the transition to adolescence, and an additional 11% remitting in the transition to young adulthood.

The researchers noted that early sleep interventions are a health priority, and pediatricians should not expect insomnia symptoms to resolve by themselves in a high proportion of children.

“These data not only call for early sleep interventions but also identify adolescence as a critical developmental period for the adverse prognosis of insomnia with objective short sleep duration phenotype,” Fernandez-Mendoza said.

Fernandez-Mendoza said in 2020 that insomnia remained a “persistent problem” for children, with an estimated 52% of youths possibly experiencing insomnia symptoms during their childhood. More recent research from Fernandez-Mendoza suggested symptoms have been shown to impact mental health of young adults.