title: Longitudinal course and outcome of chronic insomnia in Hong Kong Chinese children: a 5-year follow-up study of a community-based cohort.
abstract: OBJECTIVE
  There are limited data on the long-term outcome of childhood insomnia. We explored the longitudinal course, predictors, and impact of childhood insomnia in a community-based cohort.
  
  
  METHODS
  5-year prospective follow-up.
  
  
  METHODS
  Community-based.
  
  
  METHODS
  611 children (49% boys) aged 9.0 ± 1.8 years at baseline; 13.7 ± 1.8 years at follow-up.
  
  
  METHODS
  NA.
  
  
  METHODS
  Chronic insomnia was defined as difficulty initiating sleep, difficulty maintaining sleep and/or early morning awakening ≥ 3 times/week in the past 12 months.
  
  
  METHODS
  General health, upper airway inflammatory diseases, and behavioral problems in recent one year were assessed at both time points, while mental health and lifestyle practice were assessed at follow-up study. The questionnaires at baseline and follow-up were reported by parents/caretakers and adolescents themselves, respectively.
  
  
  RESULTS
  The prevalence of chronic insomnia was 4.2% and 6.6% for baseline and follow-up, respectively. The incidence and persistence rates of chronic insomnia were 6.2% and 14.9%, respectively. New incidence of insomnia was associated with lower paternal education level, baseline factors of frequent temper outbursts and daytime fatigue as well as alcohol use and poor mental health at follow-up. Baseline chronic medical disorders, frequent temper outbursts, and poor mental health at follow-up were associated with the persistence of insomnia in adolescents. Baseline insomnia was associated with frequent episodes of laryngopharyngitis and lifestyle practice (coffee and smoking) at follow-up.
  
  
  CONCLUSIONS
  Chronic insomnia is a common problem with moderate persistent rate in children. The associations of adverse physical and mental health consequences with maladaptive lifestyle coping (smoking and alcohol) argue for rigorous intervention of childhood insomnia.
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
authors.forename: Jihui
authors.initials: J
authors.lastname: Zhang
authors.forename: Siu Ping
authors.initials: SP
authors.lastname: Lam
authors.forename: Shirley Xin
authors.initials: SX
authors.lastname: Li
authors.forename: Albert Martin
authors.initials: AM
authors.lastname: Li
authors.forename: Kelly Y C
authors.initials: KY
authors.lastname: Lai
authors.forename: Yun-Kwok
authors.initials: YK
authors.lastname: Wing
mesh_terms: D000293:Adolescent; D002648:Child; D002652:Child Behavior; D002908:Chronic Disease; D004522:Educational Status; D005221:Fatigue / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D015995:Prevalence; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires