Insomnia, Health-Related Quality of Life and Health Outcomes in Children: A Seven Year Longitudinal Cohort.
Insomnia is common in children, and is associated with decreased school performance and increased psychopathology. Although adult insomnia is linked to worsened health-related quality of life (HRQOL), there is insufficient data evaluating insomnia and HRQOL in children. We examined the HRQOL and health associations of insomnia in a longitudinal cohort of 194 children (96 girls, age at study start 8.7 ± 1.6 years, age at data analysis 15.0 ± 1.8 years) over 7 years. International Classification of Sleep Disorders, second edition (ICSD2) derived insomnia was seen intermittently in 27% of children, and was persistent in 4%. Children reporting ICSD2-derived insomnia had lower HRQOL. Additionally, the presence of insomnia was associated with an increased risk of reporting a new medical condition (intermittent insomnia odds ratio 5.9 [95% CI 1.3-26.7, p = 0.04], persistent insomnia odds ratio 8 [95% CI 2.3-27.7, p = 0.001]). Persistent ICSD2-derived insomnia was associated with an increased risk of reporting a new medication (odds ratio 4.9 (95% CI 1.0-23.6), p = 0.049), and reporting a new psychiatric medication (odds ratio 13.7, 95% CI: 2.6-73.5, p = 0.002). These associations were present even after adjusting for socioeconomic factors and the presence of obstructive sleep apnea. Insomnia in children is associated with worsened HRQOL and health outcomes.
Department of Pediatrics, University of Arizona, Tucson, AZ, USA.|Department of Medicine, University of Arizona, Tucson, AZ, USA.|Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.
Daniel
D
Combs
Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.
James L
JL
Goodwin
Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.|Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
Stuart F
SF
Quan
Department of Pediatrics, University of Arizona, Tucson, AZ, USA.|Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.
Wayne J
WJ
Morgan
Department of Medicine, University of Arizona, Tucson, AZ, USA.|Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.|Center for Sleep Disorders and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, USA.
Safal
S
Shetty
Department of Medicine, University of Arizona, Tucson, AZ, USA.|Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.|Center for Sleep Disorders and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, USA.
Sairam
S
Parthasarathy
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017286:Polysomnography; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000473:pathology; D007319:Sleep Initiation and Maintenance Disorders / Q000473:pathology*; D012959:Socioeconomic Factors