Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region.
Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region.
Sleep Med. 2018 Jul;47:93-99. doi: 10.1016/j.sleep.2018.03.025. Epub 2018 Apr 17.
Eveningness tendency and insomnia are common in adolescents, but whether they have an independent or synergistic effect on the risk of psychopathology have remained undefined. The present study aimed to examine eveningness chronotype and insomnia symptoms in relation to mental health and emotional and behavioural problems in a community-based adolescent population.
A total of 4948 adolescents (weighted mean age: 14.5 ± 1.8 years, weighted percentage of females: 48.9%) completed the measures. Insomnia was assessed by the Insomnia Severity Index (ISI), and chronotype preference was measured by the reduced version of the Morningness-Eveningness Questionnaire (MEQ). Emotional and behavioural problems and mental health were assessed by the Strengths and Difficulties Questionnaire (SDQ) and the General Health Questionnaire (GHQ-12), respectively. Potential confounders including demographic factors, pubertal status, general health, and sleep duration were controlled for in the analyses.
Insomnia symptoms were prevalent in evening-type adolescents (52% vs intermediate-type: 34.3%, morning-type: 18.0%, p < 0.001), especially two subtypes of insomnia symptoms, including difficulty initiating sleep and difficulty maintaining sleep. Eveningness and insomnia were independently associated with an increased risk of having emotional and behavioural problems (eveningness: adjusted odds ratio [AdjOR] = 1.88, 95% confidence interval [CI] = 1.61-2.19, p < 0.001; insomnia: AdjOR = 3.66, 95% CI = 2.73-4.91) as well as poor mental health in adolescents (eveningness: AdjOR = 1.25, 95% CI = 1.04-1.52, p < 0.001; insomnia: AdjOR = 3.63, 95% CI = 2.41-5.03).
Eveningness and insomnia symptoms are independently associated with the risk of psychopathology in adolescents. Our findings underscore the need to address both sleep and circadian factors in assessing and managing emotional and behavioural problems in the adolescent population.
晚睡倾向和失眠在青少年中很常见，但它们是否对精神病理学风险有独立或协同作用仍未确定。本研究旨在调查基于社区的青少年人群中，晚睡时型和失眠症状与心理健康以及情绪和行为问题的关系。
共有 4948 名青少年（加权平均年龄：14.5±1.8 岁，女性加权百分比：48.9%）完成了这些测量。失眠通过失眠严重程度指数（ISI）进行评估，时型偏好通过简化版的晨型-晚型问卷（MEQ）进行测量。情绪和行为问题以及心理健康分别通过优点和困难问卷（SDQ）和一般健康问卷（GHQ-12）进行评估。在分析中控制了潜在的混杂因素，包括人口统计学因素、青春期状态、一般健康和睡眠时间。
失眠症状在晚睡型青少年中更为普遍（52%比中间型：34.3%，晨型：18.0%，p<0.001），尤其是两种失眠症状亚型，包括入睡困难和睡眠维持困难。晚睡和失眠与情绪和行为问题的风险增加独立相关（晚睡：调整后的优势比[AdjOR] = 1.88，95%置信区间[CI] = 1.61-2.19，p<0.001；失眠：AdjOR = 3.66，95%CI = 2.73-4.91）以及青少年心理健康状况不佳（晚睡：AdjOR = 1.25，95%CI = 1.04-1.52，p<0.001；失眠：AdjOR = 3.63，95%CI = 2.41-5.03）。
晚睡和失眠症状与青少年精神病理学风险独立相关。我们的研究结果强调，在评估和管理青少年人群的情绪和行为问题时，需要同时考虑睡眠和昼夜节律因素。
