Li Sophie H, Graham Bronwyn M, Werner-Seidler Aliza
Black Dog Institute, University of New South Wales, Randwick, Australia.
School of Psychology, University of New South Wales, Kensington, Australia.
JMIR Form Res. 2021 Mar 23;5(3):e22498. doi: 10.2196/22498.
Insomnia and sleep disturbance are pervasive and debilitating conditions affecting up to 40% of adolescents. Women and girls are at greater risk of insomnia, yet differences in treatment responsiveness between genders have not been adequately investigated. Additionally, while women report greater symptom severity and burden of illness than men, this discrepancy requires further examination in adolescents.
The purpose of this study was to examine gender differences in sleep symptom profiles and treatment response in adolescents.
Digital cognitive behavioral therapy for insomnia (CBT-I) treatment responsiveness, as indexed by changes in Insomnia Severity Index (ISI) and Global Pittsburgh Sleep Quality Index (PSQI) scores, was compared in boys and girls (aged 12-16 years; N=49) who participated in a pilot evaluation of the Sleep Ninja smartphone app. Gender differences in self-reported baseline insomnia symptom severity (ISI), sleep quality (PSQI), and sleep characteristics derived from sleep diaries were also examined.
Compared with boys, we found that girls reported greater symptom severity (P=.04) and nighttime wakefulness (P=.01 and P=.04) and reduced sleep duration (P=.02) and efficiency (P=.03), but not poorer sleep quality (P=.07), more nighttime awakenings (P=.16), or longer time to get to sleep (P=.21). However, gender differences in symptom severity and sleep duration were accounted for by boys being marginally younger in age. Treatment response to CBT-I was equivalent between boys and girls when comparing reductions in symptom severity (P=.32); there was a trend showing gender differences in improvements in sleep quality, but this was not statistically significant (P=.07).
These results demonstrate the presence of gender differences in insomnia symptoms and severity in adolescents and suggest further research is required to understand gender differences in insomnia symptom profiles to inform the development of gender-specific digital interventions delivered to adolescents.
失眠和睡眠障碍普遍存在且使人衰弱，影响着多达40%的青少年。女性和女孩患失眠的风险更高，但性别之间在治疗反应性上的差异尚未得到充分研究。此外，虽然女性报告的症状严重程度和疾病负担比男性更大，但这种差异在青少年中还需要进一步研究。
本研究的目的是探讨青少年睡眠症状特征和治疗反应中的性别差异。
比较了参与Sleep Ninja智能手机应用试点评估的男孩和女孩（年龄12 - 16岁；N = 49）对失眠的数字认知行为疗法（CBT - I）的治疗反应性，以失眠严重程度指数（ISI）和匹兹堡睡眠质量指数（PSQI）总分的变化为指标。还研究了自我报告的基线失眠症状严重程度（ISI）、睡眠质量（PSQI）以及睡眠日记中得出的睡眠特征方面的性别差异。
与男孩相比，我们发现女孩报告的症状严重程度更高（P = 0.04）、夜间觉醒更多（P = 0.01和P = 0.04）、睡眠时间缩短（P = 0.02）和睡眠效率降低（P = 0.03），但睡眠质量较差（P = 0.07）、夜间觉醒次数更多（P = 0.16）或入睡时间更长（P = 0.21）方面并不显著。然而，症状严重程度和睡眠时间的性别差异是由于男孩年龄略小。比较症状严重程度的降低时，男孩和女孩对CBT - I的治疗反应相当（P = 0.32）；睡眠质量改善方面存在性别差异的趋势，但无统计学意义（P = 0.07）。
这些结果表明青少年失眠症状和严重程度存在性别差异，并建议需要进一步研究以了解失眠症状特征中的性别差异，为向青少年提供针对性别的数字干预措施提供依据。
