Blank Madeleine, Zhang Jihui, Lamers Femke, Taylor Adrienne D, Hickie Ian B, Merikangas Kathleen R
Sleep. 2015;38(2):197-204. doi: 10.5665/sleep.4396.
To estimate the prevalence and health correlates of insomnia symptoms and their association with comorbid mental disorders in a nationally representative sample of adolescents in the United States.
National representative cross-sectional study.
Population-based sample from the US adolescents.
A total of 6,483 individuals aged between 13–18 y in the National Comorbidity Survey-Adolescent Supplement (NCS-A) with both individual and parental reports of mental health were included in this study. Participants were classified with insomnia symptoms if they reported difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakening, nearly every day for at least 2 w in the past year. Nearly one-third of adolescents reported insomnia symptoms for at least 2 w during the previous year. Hispanic and black youth were significantly more likely to report insomnia symptoms (42.0% and 41.3%, respectively) than non-Hispanic white youth (30.4%). Adolescents with insomnia symptoms were at a higher risk for all classes of mental disorders {odds ratio [OR] (95% confidence interval [CI]: 3.4 (2.9–4.0)} including mood, anxiety, behavioral, substance use, and eating disorders, suicidality [OR (95% CI): 2.63 (1.34–5.16)], poor perceived mental health [OR (95% CI): 2.01 (1.02–3.96)], chronic medical conditions [OR (95% CI): 1.94 (1.55–2.43)], smoking [OR (95% CI: 2.60 (1.00–6.72)], and obesity [OR (95% CI: 1.46 (1.10–1.93)] than those without insomnia symptoms. Adolescents with insomnia symptoms and comorbid mental disorders manifested even greater rates of these indicators of negative health behaviors and disorders than those with mental disorders alone (P < 0.05).
Insomnia symptoms are reported by one-third of adolescents in the general population. Insomnia symptoms, even in the absence of concomitant depression or other mental disorders, are associated with serious health conditions, risk factors, and suicidality. Comorbid mental disorders potentiate the effect of insomnia symptoms on both physical and mental health. Further evaluation of the causes and effective interventions to reduce insomnia symptoms may have a significant effect on public health.
在美国具有全国代表性的青少年样本中，估计失眠症状的患病率及其与健康的相关性，以及它们与共病精神障碍的关联。
全国代表性横断面研究。
基于美国青少年的人群样本。
全国共病调查青少年补充版（NCS-A）中共有6483名年龄在13至18岁之间、有个人及父母心理健康报告的个体纳入本研究。如果参与者报告在过去一年中几乎每天至少连续2周存在入睡困难、睡眠维持困难和/或早醒，则被归类为有失眠症状。近三分之一的青少年报告在前一年中至少有2周存在失眠症状。西班牙裔和黑人青少年报告失眠症状的可能性（分别为42.0%和41.3%）显著高于非西班牙裔白人青少年（30.4%）。有失眠症状的青少年患各类精神障碍的风险更高{优势比[OR]（95%置信区间[CI]）：3.4（2.9 - 4.0）}，包括情绪、焦虑、行为、物质使用和饮食障碍、自杀倾向[OR（95%CI）：2.63（1.34 - 5.16）]、心理健康自评差[OR（95%CI）：2.01（1.02 - 3.96）]、慢性疾病[OR（95%CI）：1.94（1.55 - 2.43）]、吸烟[OR（95%CI：2.60（1.00 - 6.72）]和肥胖[OR（95%CI：1.46（1.10 - 1.93）]，均高于无失眠症状的青少年。有失眠症状且共病精神障碍的青少年出现这些负面健康行为和障碍指标的比例甚至高于仅患有精神障碍的青少年（P < 0.05）。
普通人群中三分之一的青少年报告有失眠症状。失眠症状即使在没有并发抑郁症或其他精神障碍的情况下，也与严重的健康状况、危险因素和自杀倾向相关。共病精神障碍会增强失眠症状对身心健康的影响。进一步评估失眠症状的原因及有效干预措施可能对公众健康产生重大影响。
