Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Guangdong Mental Health Center, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
J Affect Disord. 2021 Nov 1;294:533-542. doi: 10.1016/j.jad.2021.07.033. Epub 2021 Jul 19.
Eveningness and insomnia are highly comorbid and closely related to psychopathology in adolescents. We aimed to prospectively investigate the trajectories and associations of eveningness and insomnia with daytime functioning, depression and suicidal risk in adolescents.
A 3-year longitudinal study was conducted among 414 Chinese adolescents. The associations of eveningness and insomnia with daytime functioning, depression and suicidal ideation were analyzed using logistic regressions.
The prevalence rates of eveningness were similar at baseline and follow-up (19.3% vs 22.5%; p = 0.27), while the prevalence of insomnia increased at follow-up (29.2% vs 40.8%; p < 0.001). Among those eveningness adolescents (n=80) at baseline, 46.2% remained as stable evening-type at follow-up, and among those insomnia adolescents (n=121) at baseline, 64.5% had persistent insomnia at follow-up. Logistic regressions showed that stable, incident, and resolved eveningness were associated with excessive daytime sleepiness (EDS) at follow-up, while only persistent and incident insomnia increased the risk of EDS. Persistent and incident insomnia, as well as stable eveningness were independently associated with depression at follow-up. Persistent and incident insomnia, but not eveningness, were associated with suicidal ideation.
The outcome assessments were based on self-reported questionnaires and the sample size is modest.
Persistent eveningness and insomnia are significantly associated with greater risks of EDS and depression in adolescents, while both persistent and incident insomnia, but not eveningness, increased the risk of suicidal ideation. These findings underscore the importance of addressing sleep and circadian factors in the management of adolescent mood and daytime functioning.
晚睡和失眠在青少年中高度共病且与精神病理学密切相关。我们旨在前瞻性研究青少年中晚睡和失眠的轨迹及其与日间功能、抑郁和自杀风险的关联。
在中国 414 名青少年中进行了一项为期 3 年的纵向研究。使用逻辑回归分析晚睡和失眠与日间功能、抑郁和自杀意念的关联。
基线和随访时晚睡的患病率相似（19.3%与 22.5%；p=0.27），而失眠的患病率在随访时增加（29.2%与 40.8%；p<0.001）。在基线时为晚睡的青少年（n=80）中，46.2%在随访时仍为稳定的晚型，在基线时有失眠的青少年（n=121）中，64.5%在随访时仍有持续性失眠。逻辑回归显示，稳定的、新发生的和缓解的晚睡与随访时的日间嗜睡（EDS）相关，而只有持续性和新发性失眠增加了 EDS 的风险。持续性和新发性失眠以及稳定的晚睡与随访时的抑郁独立相关。持续性和新发性失眠，而不是晚睡，与自杀意念相关。
结局评估基于自我报告的问卷，样本量适中。
持续性晚睡和失眠与青少年 EDS 和抑郁的风险显著增加相关，而持续性和新发性失眠，而不是晚睡，增加了自杀意念的风险。这些发现强调了在青少年情绪和日间功能管理中解决睡眠和昼夜节律因素的重要性。
