Mayo Clinic, Rochester, MN.
Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD.
J Am Acad Child Adolesc Psychiatry. 2019 Jul;58(7):712-720. doi: 10.1016/j.jaac.2018.09.435. Epub 2018 Oct 30.
Recent attention to pervasive sleep deficits in US adolescents has focused on sleep patterns and insomnia, but there are limited data on the prevalence and correlates of hypersomnolence symptoms.
The sample included 6,483 adolescents 13 to 18 years of age who were interviewed directly and had parent reports in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally representative sample of US youth. Information on sleep patterns/symptoms that were collected in the interview was used to determine the population prevalence of DSM-5 criterion A-defined hypersomnolence and component symptoms. Logistic regression analyses were used to examine associations between sleepiness and sub-symptoms of hypersomnolence with weekday/weekend bedtime, sleep duration, mental disorders, and psychotropic medication use.
Of the sample, 41.5% reported feeling sleepy during the daytime and 11.7% met criteria for hypersomnolence. The prevalence of hypersomnolence varied depending on age (p < .001) and was more common in adolescent girls (odds ratio [OR] 1.40, 95% CI 1.09-1.78). Excessive sleepiness and hypersomnolence symptoms were associated with shorter sleep duration and delayed bedtimes on weekdays and weekends Hypersomnolence was significantly associated with insomnia (OR 2.45, 95% CI 1.87-3.21) and mental disorders (OR 1.99, 95% CI 1.42-2.77). After accounting for insomnia, hypersomnolence was no longer associated with use of psychotropic medication (OR 1.61, 95% CI 0.97-2.66).
Of adolescents with adequate sleep duration, 11.7% still reported symptoms of hypersomnolence. The strong association between hypersomnolence and insomnia suggests that sleep disorders in adolescents can fluctuate between over- and under-sleeping. Potential mechanisms underpinning the strong associations between sleep disturbances and mental disorders should be further pursued and could provide insight into prevention efforts.
最近，人们对美国青少年普遍存在的睡眠不足问题越来越关注，关注焦点主要集中在睡眠模式和失眠上，但关于过度嗜睡症状的流行率和相关因素的数据有限。
本研究样本包括 6483 名 13 至 18 岁的青少年，他们直接接受访谈，并在国家共病调查青少年补充调查（NCS-A）中接受了父母的报告。NCS-A 是美国青少年的全国代表性样本。访谈中收集的睡眠模式/症状信息用于确定 DSM-5 标准 A 定义的过度嗜睡和症状组成部分的人群患病率。采用逻辑回归分析来检查嗜睡与过度嗜睡的亚症状之间的关联与工作日/周末就寝时间、睡眠时间、精神障碍和精神药物使用的关系。
在该样本中，41.5%的人报告白天感到困倦，11.7%的人符合过度嗜睡标准。过度嗜睡的患病率因年龄而异（p<0.001），在少女中更为常见（优势比[OR]1.40，95%置信区间[CI]1.09-1.78）。过度嗜睡和过度嗜睡症状与工作日和周末睡眠时间缩短以及就寝时间延迟有关。过度嗜睡与失眠显著相关（OR 2.45，95%CI 1.87-3.21）和精神障碍（OR 1.99，95%CI 1.42-2.77）。在考虑到失眠后，过度嗜睡与精神药物使用不再相关（OR 1.61，95%CI 0.97-2.66）。
在睡眠时间充足的青少年中，仍有 11.7%报告有过度嗜睡症状。过度嗜睡与失眠之间的强烈关联表明，青少年的睡眠障碍可能在过度和不足睡眠之间波动。睡眠障碍与精神障碍之间的强关联的潜在机制应进一步研究，并可为预防工作提供深入了解。
