Johnson Eric O, Roth Thomas, Schultz Lonni, Breslau Naomi
Substance Abuse Epi, Prevention, and Risk Behavior, Research Triangle Institute International, Research Triangle Park, NC 27709-2194, USA.
Pediatrics. 2006 Feb;117(2):e247-56. doi: 10.1542/peds.2004-2629.
The confluence of sleep/wake cycle and circadian rhythm changes that accompany pubertal development and the social and emotional developmental tasks of adolescence may create a period of substantial risk for development of insomnia. Although poor sleep affects cognitive performance and is associated with poor emotional and physical health, epidemiologic studies among adolescents have been limited. In this first epidemiologic study of insomnia defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria in a US sample of adolescents, we estimated lifetime prevalence of insomnia, examined chronicity and onset, and explored the role of pubertal development.
Data come from a random sample of 1014 adolescents who were 13 to 16 years of age, selected from households in a 400000-member health maintenance organization encompassing metropolitan Detroit. Response rate was 71.2%. The main outcome measured was DSM-IV-defined insomnia.
Lifetime prevalence of insomnia was 10.7%. A total of 88% of adolescents with a history of insomnia reported current insomnia. The median age of onset of insomnia was 11. Of those with insomnia, 52.8% had a comorbid psychiatric disorder. In exploratory analyses of insomnia and pubertal development, onset of menses was associated with a 2.75-fold increased risk for insomnia. There was no difference in risk for insomnia among girls before menses onset relative to boys, but a difference emerged after menses onset. In contrast, maturational development was not associated with insomnia in boys.
Insomnia seems to be common and chronic among adolescents. The often found gender difference in risk for insomnia seems to emerge in association with onset of menses.
睡眠/觉醒周期与昼夜节律变化的交汇，以及青春期伴随的社会和情感发展任务，可能会导致青少年出现失眠的风险大幅增加。尽管睡眠质量差会影响认知表现，并与情绪和身体健康不佳有关，但针对青少年的流行病学研究一直有限。在这项首次以美国青少年样本为对象、依据《精神疾病诊断与统计手册》第四版（DSM-IV）标准定义失眠的流行病学研究中，我们估计了失眠的终生患病率，研究了慢性失眠情况和发病情况，并探讨了青春期发育的作用。
数据来自从底特律都会区一个拥有40万会员的健康维护组织的家庭中随机抽取的1014名13至16岁的青少年。回复率为71.2%。主要测量结果是DSM-IV定义的失眠。
失眠的终生患病率为10.7%。有失眠病史的青少年中，共有88%报告目前仍有失眠症状。失眠的中位发病年龄为11岁。在患有失眠的青少年中，52.8%同时患有精神疾病。在对失眠与青春期发育的探索性分析中，月经初潮与失眠风险增加2.75倍相关。月经初潮前女孩与男孩的失眠风险没有差异，但月经初潮后出现了差异。相比之下，男孩的成熟发育与失眠无关。
失眠在青少年中似乎很常见且具有慢性特点。经常发现的失眠风险的性别差异似乎与月经初潮有关。
