Persistent childhood insomnia symptoms linked with risk of internalizing disorders in adulthood

A 15-year longitudinal study shows that childhood insomnia symptoms that persist into adulthood are strong determinants of mood and anxiety disorders in young adults.

Results show that insomnia symptoms persisting from childhood through adolescence and into adulthood were associated with a 2.8-fold increased risk of internalizing disorders. Insomnia symptoms that newly developed over the course of the study were associated with a 1.9-fold increased risk of internalizing disorders. No increased risk of internalizing disorders was found for those children in whom insomnia symptoms remitted during the study period.

"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," said lead author Julio Fernandez-Mendoza, who has a doctorate in psychobiology and is an associate professor at Penn State College of Medicine. He is a psychologist board certified in behavioral sleep medicine at Penn State Health Sleep Research and Treatment Center in Hershey, Pennsylvania.

Data were analyzed from the Penn State Child Cohort, a population-based sample of 700 children with a median age of 9 years. The researchers had followed up 8 years later with 421 participants when they were adolescents (median age of 16 years) and now 15 years later with 492 of them when they were young adults (median age of 24 years). Insomnia symptoms were defined as moderate-to-severe difficulties initiating or maintaining sleep.

The symptoms were parent-reported in childhood and self-reported in adolescence and young adulthood. The presence of internalizing disorders was defined as a self-report of a diagnosis or treatment for mood and/or anxiety disorders. Results were adjusted for sex, race/ethnicity, age, and any prior history of internalizing disorders or use of medications for mental health problems.

According to the authors, childhood insomnia symptoms have been shown to be associated with internalizing disorders, which include depressive disorders and anxiety disorders.

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."

Julio Fernandez-Mendoza, Lead Author