Department of Epidemiology and Biostatistics, Western University, London, Canada.
Department of Epidemiology and Biostatistics, Western University, London, Canada; Department of Obstetrics and Gynecology, Western University, London, Canada; Department of Paediatrics, Western University, London, Canada; Children's Health Research Institute, London, Canada; Lawson Health Research Institute, London, Canada.
J Psychosom Res. 2020 Dec;139:110279. doi: 10.1016/j.jpsychores.2020.110279. Epub 2020 Oct 11.
Both inadequate sleep and internalizing problems, such as symptoms of anxiety and depression, are prevalent among adolescents with sparse epidemiological literature outlining sex-specific relationships at this critical age.
To examine cross-sectional and prospective relationships between self-reported sleep problems, indicated by sleep duration, difficulties getting to sleep and changes in difficulties getting to sleep with internalizing problems in early adolescence.
This study was a secondary analysis of data from the Canadian National Longitudinal Survey of Children and Youth. Multivariable linear regression was used to estimate cross-sectional and longitudinal associations. Relevant family and social context variables were controlled for in multivariable analyses. Family functioning was assessed as a potential effect modifier.
There were 993 and 736 participants [longitudinal cohort entry age of 10 or 11 years; 49% male] in longitudinal and cross-sectional analyses, respectively. Most cross-sectional multivariable analyses of sleep duration and internalizing problems revealed no statistical associations. Difficulties sleeping and concurrent internalizing problems were positively associated in 12/13 year old females (β = 1.77 [0.94, 2.61], R = 17%) and males (β = 1.18 [0.36, 2.01], R = 16%). High persistent difficulties sleeping in females aged 12/13 to 14/15 years also positively predicted internalizing problems in females age 14/15 years (β = 1.90 [0.52, 3.29], R = 21%) while controlling for initial internalizing symptoms. Family functioning was not found to be an effect modifier.
Findings highlight the potential role of difficulties sleeping for adolescents' mental health. Public health initiatives to promote sleep hygiene in this population subgroup are critical to prevent the potential long-term health impact of sleep problems.
睡眠不足和内化问题（如焦虑和抑郁症状）在青少年中很普遍，但流行病学文献很少描述这个关键时期的性别特异性关系。
研究青少年早期自我报告的睡眠问题（以睡眠时间、入睡困难和入睡困难变化来表示）与内化问题之间的横断面和前瞻性关系。
本研究是对加拿大全国儿童和青年纵向调查数据的二次分析。多变量线性回归用于估计横断面和纵向关联。在多变量分析中控制了相关的家庭和社会环境变量。家庭功能被评估为潜在的效应修饰剂。
分别有 993 名和 736 名参与者（纵向队列进入年龄为 10 岁或 11 岁；49%为男性）参加了纵向和横断面分析。大多数关于睡眠时间和内化问题的横断面多变量分析没有显示出统计学关联。在 12/13 岁的女性（β=1.77 [0.94, 2.61]，R=17%）和男性（β=1.18 [0.36, 2.01]，R=16%）中，入睡困难与同时存在的内化问题呈正相关。在 12/13 岁至 14/15 岁的女性中，持续存在严重的入睡困难也正向预测了 14/15 岁女性的内化问题（β=1.90 [0.52, 3.29]，R=21%），同时控制了初始内化症状。没有发现家庭功能是一个效应修饰剂。
研究结果强调了入睡困难对青少年心理健康的潜在作用。在这个人群亚组中，促进睡眠卫生的公共卫生举措对于预防睡眠问题可能带来的长期健康影响至关重要。
