Trajectories of Insomnia Symptoms From Childhood Through Young Adulthood.
Trajectories of Insomnia Symptoms From Childhood Through Young Adulthood.
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DOI：
10.1542/peds.2021-053616
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发表时间：
2022-03-01
期刊：
影响因子：
8
通讯作者：
Bixler EO
中科院分区：
文献类型：
--
作者：
Fernandez-Mendoza J;Lenker KP;Calhoun SL;Qureshi M;Ricci A;Bourchtein E;He F;Vgontzas AN;Liao J;Liao D;Bixler EO
失眠症状可转化为生理和心理健康障碍。由于缺乏具有客观睡眠测量和长期随访的以人群为基础的队列，对儿童失眠症状的慢性性知之甚少。我们确定了失眠症状的发展轨迹，它们演变成成人失眠，以及客观睡眠时间在向成年过渡中的作用。共有502名儿童（中位年龄9岁，有效率71.7%）在7.4年后成为青少年（中位年龄16岁）和15年后成为成年人（中位年龄24岁）进行研究。通过所有3个时间点的父母或自我报告，确定失眠症状为中度至重度睡眠启动和/或维持困难，通过青年期自我报告确定成人失眠，通过儿童期和青春期多导睡眠仪确定客观短睡眠时间。在有失眠症状的儿童中，最常见的轨迹是持续（43.3%），其次是缓解（童年以来26.9%，青春期以来11.2%）和消长模式（18.6%）。在睡眠正常的儿童中，最常见的轨迹是持续（48.1%），其次是出现失眠症状（青春期以来15.2%，成年期20.7%）和起起落落模式（16.0%）。失眠症状恶化为成人失眠的几率（儿童22.0%，青少年20.8%）在短睡眠儿童和青少年中分别是2.6倍和5.5倍。早期睡眠干预是一项健康优先事项，因为儿科医生不应期望在很大比例的儿童中失眠症状会在发育过程中得到缓解。客观的睡眠测量在青春期可能是临床有用的，这是短睡眠时间失眠表型不良预后的关键时期。
Insomnia symptoms are transdiagnostic to physical and mental health disorders. Given the lack of population-based cohorts with objective sleep measures and long-term follow-ups, little is known about the chronicity of childhood insomnia symptoms. We determined the developmental trajectories of insomnia symptoms, their evolution into adult insomnia, and the role of objective sleep duration in the transition to adulthood. A total of 502 children (median 9 years old, 71.7% response rate) were studied 7.4 years later as adolescents (median 16 years old) and 15 years later as adults (median 24 years old). Insomnia symptoms were ascertained as moderate-to-severe difficulties initiating and/or maintaining sleep via parent- or self reports at all 3 time points, adult insomnia via self-report in young adulthood, and objective short-sleep duration via polysomnography in childhood and adolescence. Among children with insomnia symptoms, the most frequent trajectory was persistence (43.3%), followed by remission (26.9% since childhood, 11.2% since adolescence) and a waxing-and-waning pattern (18.6%). Among children with normal sleep, the most frequent trajectory was persistence (48.1%), followed by developing insomnia symptoms (15.2% since adolescence, 20.7% in adulthood) and a waxing-and-waning pattern (16.0%). The odds of insomnia symptoms worsening into adult insomnia (22.0% of children, 20.8% of adolescents) were 2.6-fold and 5.5-fold among short-sleeping children and adolescents, respectively. Early sleep interventions are a health priority because pediatricians should not expect insomnia symptoms to developmentally remit in a high proportion of children. Objective sleep measures may be clinically useful in adolescence, a critical period for the adverse prognosis of the insomnia with short-sleep duration phenotype.
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影响因子：
10.5
作者：
de Zambotti M;Goldstone A;Colrain IM;Baker FC
通讯作者：
Baker FC
影响因子：
4.8
作者：
Calhoun, Susan L.;Fernandez-Mendoza, Julio;Vgontzas, Alexandros N.;Liao, Duanping;Bixler, Edward O.
通讯作者：
Bixler, Edward O.
影响因子：
3.7
作者：
Johann, Anna F.;Hertenstein, Elisabeth;Spiegelhalder, Kai
通讯作者：
Spiegelhalder, Kai
影响因子：
24
作者：
Fernandez-Mendoza, Julio;He, Fan;Bixler, Edward O.
通讯作者：
Bixler, Edward O.
DOI：
10.1016/j.bbi.2016.12.026
发表时间：
2017-03
期刊：
Brain, behavior, and immunity
影响因子：
--
作者：
Fernandez-Mendoza J;Baker JH;Vgontzas AN;Gaines J;Liao D;Bixler EO
通讯作者：
Bixler EO