0921 Insomnia in Adolescents: Patient-Centered Outcomes and Perspectives

Abstract

Abstract Introduction An estimated 25-40% of adolescents endorse symptoms of insomnia. While research has demonstrated that insomnia is associated with impaired functioning, little is known regarding which insomnia symptoms or outcomes are most burdensome for adolescents. Patient-centered outcomes (PCO) are clinical and research questions and outcomes that are meaningful to patients. This study is the first to evaluate PCOs in adolescents with insomnia. Methods We conducted an online survey of adolescents in the USA, UK, Canada, Australia, and New Zealand who were 13 - 18 years old and reported experiencing one or more insomnia symptoms. Participants were recruited using targeted advertising on Facebook. Participants reported on insomnia symptom severity, frequency, and duration, help-seeking behavior, areas of insomnia-related impairment, and research priorities. Results Of the N=3034 respondents, 99.3% (n=3014) met inclusion criteria. Participants were predominantly female (77.0%) and white non-Hispanic (70.8%), with a mean age of 16.1 years (SD=1.3). Most (87.5%) met DSM-V diagnostic criteria for insomnia, yet only 29.3% reported seeking professional help. Over half (52.1%) reported a symptom duration of three or more years. Insomnia symptoms reported were sleep initiation difficulties (94.4%), sleep fragmentation (65.3%), premature awakening (54.5%), and difficulty sleeping independently (22.3%). The most burdensome areas of insomnia-related impairment were reported to be mood (72.2%), attentional focus (61.0%), pain (49.7%), worry (46.3%) and sleepiness (38.7%). Adolescents with insomnia most frequently endorsed the following research priorities: causes of insomnia (66.4%), early detection (66.1%), public education about sleep (49.1%) and non-pharmacological treatments (48.3%). Conclusion Adolescents with insomnia report significant insomnia-related distress and impairment, with symptoms often persisting for three or more years. However, adolescents with insomnia often do not seek professional help. Areas perceived as most problematic to adolescents living with insomnia (e.g., mood, focus, pain) should be considered as important outcomes for insomnia researchers. Support This publication was made possible with support from Grant Number UL1TR002529 (A Shekhar, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award and the Indiana University School of Medicine.