Sleep patterns and insomnia among adolescents receiving child welfare services: A population-based study

Mia Amalie Jensen Almaas,Ove Heradstveit,Kristin Gärtner Askeland,Børge Sivertsen,Sondre Aasen Nilsen,Mari Hysing

doi:10.1016/j.sleh.2021.09.006

Abstract

ObjectivesSleep problems are common in adolescence. We aimed to investigate sleep patterns and insomnia in Norwegian adolescents who have been in contact with child welfare services (CWS), both adolescents living in foster care (FC) and adolescents receiving in-home-services (IHS). Both groups were compared to youth who reported they were not receiving child welfare interventions. DesignCross-sectional. SettingThe population-based study youth@hordaland from 2012 in Hordaland, Norway. ParticipantsAbout 9421 adolescents (53.8% girls), age range 16-19 years, were divided into 3 groups; IHS group (n = 123), FC group (n = 132), and control group (n = 9166). MeasurementsSelf-reported information about demographics, detailed sleep patterns, sleep problems, and adverse life events. ResultsAdolescents receiving IHS (vs. controls) had significantly shorter sleep duration, lower sleep efficiency, longer sleep onset latency (SOL), wake after sleep onset (WASO), and higher prevalence of insomnia. They had increased odds of insomnia (adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] = 1.19-2.62) and SOL ≥ 30 minutes (AOR = 1.95, CI = 1.32-2.87). Adolescents in FC (vs. controls) reported lower sleep efficiency and longer WASO. When adjusting for sex and age, the associations did not substantially change. When additionally adjusting for adverse life events, the associations were considerably attenuated for both groups, and were no longer significant for the FC group. ConclusionOur results indicate a higher rate of sleep problems among adolescents receiving interventions from CWS, particularly those receiving IHS. Adverse life events accounted for a substantial part of the increased risk of sleep problems.

Highlights

Short sleep duration is common during adolescence, and the proportion of youth not obtaining sufficient sleep is on the rise.[1]
While the focus on sleep patterns and insomnia in childhood and adolescence has increased in recent years, little is known about sleep in at-risk subgroups, such as adolescents receiving interventions from child welfare services (CWS)
Compared with the general population, adolescents receiving IHS or living in foster care (FC) were somewhat younger, more likely to be of foreign origin, and more likely to have unemployed- or parents with low levels of education

Summary

Introduction

Short sleep duration is common during adolescence, and the proportion of youth not obtaining sufficient sleep is on the rise.[1] the high proportion of adolescents fulfilling the criteria for insomnia suggests that insufficient sleep quality is a public health concern.[2] The known negative associations between poor sleep and mental health problems and adjustment underlines the importance of addressing sleep in this age group.[3,4] While the focus on sleep patterns and insomnia in childhood and adolescence has increased in recent years, little is known about sleep in at-risk subgroups, such as adolescents receiving interventions from child welfare services (CWS)

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Conclusion