Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, 0213, Norway.
Department of Psychology, Faculty of Social Sciences, University of Oslo, PO Box 1094, Blindern, Oslo, 0317, Norway.
BMC Public Health. 2023 Jul 18;23(1):1372. doi: 10.1186/s12889-023-16301-7.
Parental drinking, mental health and family socioeconomic status are all associated with offspring sleep problems, but there is a paucity of research that considers the effect of risk factors, as they co-occur within and across families. Also, sleep problems are closely linked with mental health problems. Disentangling the effects on one or the other are important. We examined whether parental risk constellations are differently associated with offspring's subsequent prescription drug use for sleep problems during nine years with or without prescription drug use for anxiety and/or depression.
The sample included 8773 adolescent offspring of 6696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway. The exposures were five parental risk constellations, previously identified via Latent Profile Analysis, characterized by drinking frequencies and quantities, mental health, and years of education. The outcomes were dispensed prescription drugs in offspring during 2008-2016 for (a) only sleep problems (b) sleep problems and anxiety/depression or (c) only anxiety/depression. We used multinomial logistic regression to model the odds of the outcomes.
Compared to the overall low-risk parental constellation, none of the risky constellations were significantly associated with increased risk of being dispensed prescription drugs only for sleep problems. Offspring from two different risk profiles were at increased risk for being dispensed both sleep and anxiety/depression prescription drugs. These were parental profiles marked by (1) low education, symptoms of mental health problems and weekly binge drinking in both parents (OR 1.90, CI = 1.06;3.42); and (2) frequent heavy drinking in both parents and symptoms of mental health problems in fathers (OR 3.32, CI = 1.49;7.39). Offspring from the risk profile with lowest parental education had increased risk of only anxiety/depression prescription drugs (OR 1.25, CI = 1.05;1.49).
Our findings suggest that parental risk constellations are not associated with increased risk of offspring receiving sleep medications without also receiving anxiety/depression medications, as two risk constellations were associated with increased risk of dispensation of both sleep and anxiety/depression prescription drugs. Receiving both may be an indication of severity. The findings underscore the importance of including measures of mental health problems when investigating sleep problems to avoid misattribution of effects.
父母饮酒、心理健康和家庭社会经济地位均与子女睡眠问题相关，但鲜有研究考虑这些风险因素的共同作用，因为它们在家庭内和家庭间同时存在。此外，睡眠问题与心理健康问题密切相关。厘清它们各自的影响很重要。我们研究了父母风险组合是否与子女随后因睡眠问题使用处方药物相关，在 9 年内是否有因焦虑和/或抑郁使用处方药物。
本研究样本包括来自挪威北特伦德拉格健康研究的 8773 名青少年子女及其 6696 对双亲家庭，参与者接受了调查。暴露因素是通过潜在剖面分析确定的五个父母风险组合，特征为饮酒频率和数量、心理健康和受教育年限。结果是在 2008 年至 2016 年期间子女开出的治疗睡眠问题（a）仅睡眠问题、（b）睡眠问题和焦虑/抑郁或（c）仅焦虑/抑郁的处方药物。我们使用多项逻辑回归模型来评估结果的比值比。
与整体低风险父母组合相比，没有任何一种风险组合与因睡眠问题开出处方药物的风险增加显著相关。来自两种不同风险特征的子女开出睡眠和焦虑/抑郁处方药物的风险增加。这些风险特征包括：（1）父母双方受教育程度低、有心理健康问题症状且每周都有狂饮行为（比值比 1.90，置信区间 [CI] = 1.06;3.42）；（2）父母双方都有重度饮酒行为且父亲有心理健康问题症状（比值比 3.32，CI = 1.49;7.39）。来自父母受教育程度最低的风险组合的子女开出仅焦虑/抑郁处方药物的风险增加（比值比 1.25，CI = 1.05;1.49）。
我们的研究结果表明，父母风险组合与子女接受睡眠药物治疗但不接受焦虑/抑郁药物治疗的风险增加无关，因为有两种风险组合与开出睡眠和焦虑/抑郁处方药物的风险增加相关。同时开出两种药物可能表明情况严重。研究结果强调了在调查睡眠问题时纳入心理健康问题测量的重要性，以避免对影响的错误归因。
