Bidirectional associations of insomnia symptoms with somatic complaints and posttraumatic stress disorder in child and adolescent earthquake survivors: a longitudinal study.

BACKGROUND

We aimed to explore insomnia symptoms among 2299 children and adolescents after an earthquake and their bidirectional relationship to somatic complaints and posttraumatic stress disorder (PTSD).

METHODS

The Patient Health Questionnaire-15 scale, the Children's Revised Impact of Event Scale, and three questions evaluating insomnia symptoms (including difficulty falling asleep, difficulty staying asleep, and early morning awakening) were administered to child and adolescent survivors 3 and 6 months after the Lushan earthquake.

RESULTS

The prevalence rates of insomnia symptoms among children and adolescents were 52 and 40% 3 and 6 months after the Lushan Earthquake, respectively. Insomnia symptoms evaluated after 3 months could significantly predict subsequent PTSD (odds ratio (OR), 1.476; 95% confidence interval (CI), 1.133-1.924) and all somatic symptoms, except for dizziness, evaluated after 6 months. PTSD (OR, 1.633; 95%CI, 1.315-2.027) and headache (OR, 1.545; 95%CI, 1.223-1.953) evaluated after 3 months significantly predicted insomnia symptoms evaluated after 6 months.

CONCLUSIONS

Insomnia symptoms, which were commonly seen after the earthquake, could longitudinally predict the development of PTSD and various somatic symptoms, and PTSD and headache could longitudinally predict the developments of insomnia symptoms among children and adolescent earthquake survivors. These findings highlight the importance of assessing and addressing insomnia symptoms in children and adolescents following a traumatic event.