Childhood Insomnia Symptoms Often Persist into Adulthood, Study Finds

A major newstudy shows that a plurality of children who experience insomnia symptoms will continue to experience sleep problems as adults.

The study, published in the journal Pediatrics, tracked children for 15 years in order to see how their symptoms and sleep changed over time. It found that 43.3% of children with insomnia symptoms reported that those symptoms persisted into adulthood, while 48.1% of children with normal sleep during childhood continued to have normal sleep as adults.

Julio Fernandez-Mendoza, Ph.D., of the Penn State Health Milton S. Hershey Medical Center, and colleagues, noted that sleep difficulties are reported in 20% to 25% of children, with rates increasing through adolescence and into adulthood. However, to date there has been little research looking at childhood insomnia symptoms from a longitudinal perspective.

The authors wanted to better understand the trajectories of patients with insomnia, and so they turned to the Penn State Child Cohort, a random, population-based cohort of school-aged children.

The cohort initially had 5,470 children between the ages of 5 and 12. One thousand members of the cohort were asked to undergo an in-laboratory polysomnography study at baseline (between the years 2000 and 2005), and 70% agreed. Members of the cohort were subsequently asked to undergo similar tests an average of 7.4 years later, during adolescence. Parents (and later the patients themselves) were asked to complete questionnaires about their sleep at childhood, adolescence, and as adults. A total of 502 children were included in the final analysis.

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At the first visit, during which the children were 9 years old, 23.5% of children had insomnia symptoms. Those rates increased steadily at adolescence (36.0%) and into adulthood (42.6%).

Next, investigators looked at individual patient trajectories to see which outcomes were most likely among children with insomnia. They found more than 4 in 10 had persistent symptoms through adulthood. Remission was the next-most-likely outcome, with 26.9% of patients with symptoms as a child experiencing remission.

Among those who still had symptoms as adolescents, the rate of remission by young adulthood was just 11.2%.

Another 18.6% of children went on to have a waxing-and-waning pattern of symptoms.

Among children with normal sleep habits, the odds of developing insomnia symptoms were 15.2% by adolescence and 20.7% in adulthood. Sixteen percent of children with normal sleep as children experienced waxing-and-waning symptoms as adults.

Children and adolescents with poor sleep had a 2.6-fold and 5.5-fold higher risk of developing adult insomnia, respectively, the authors said.

Fernandez-Mendoza told Managed Healthcare Executive®that the adolescent brain is changing rapidly during adolescence as the body undergoes significant change and growth. He said the study shows adolescence is a key time for sleep trajectories.

“Together, this accumulated knowledge means that adolescence insomnia should be paid even closer attention and treated as an independent condition and not attributed simply to ‘bad habits’ ‘teen behavior,’ or ‘a symptom of mood/behavioral issues,’ even if those do contribute in part to the worsening sleep problem,” he said.

Fernandez-Mendoza said cognitive behavioral therapy for insomnia is becoming more common as a first-line treatment for insomnia. The therapy can be modified in some cases, he added, so that it addresses specific behavioral or biological factors that contribute to sleep problems in adolescents