Abstract
Sleep problems are prevalent among adolescents, especially among those diagnosed with mental health disorders. There is insufficient knowledge about sleep among adolescents within child and adolescent mental health services (CAMHS) in comparison to the general population. The data are drawn from the youth@hordaland study, a large population-based study conducted in 2012, linked to the Norwegian Patient Registry (NPR) (n = 9077). Psychiatric disorders were based on clinical diagnoses from the NPR, while insomnia, delayed sleep–wake-phase disorder (DSWPD), and other sleep problems/patterns were assessed by self-report questionnaires from youth@hordaland. The prevalence of diagnosed sleep disorders among adolescents seeking mental health services was 0.6%, yielding an estimated prevalence of 0.07% of the population. However, questionnaire-based measurement of insomnia from the youth@hordaland study indicated that insomnia was highly prevalent across disorders in comparison to a reference group of adolescents who were not within mental health care. Insomnia ranged from 29% among adolescents diagnosed with ADHD (PR = 1.79; 95% CI 1.41–2.29) to 48% among adolescents diagnosed with depression (PR = 2.53, 95% CI 2.19–2.92). All diagnostic groups had a mean sleep efficiency below (85%), indicating poor sleep quality. Insomnia, delayed sleep-phase wake disorder, and poor sleep efficiency were confirmed as transdiagnostic sleep problems across psychiatric disorders. In addition, some disorder-specific patterns emerged, such as a higher prevalence of insomnia among adolescents with depression, and DSWPS among adolescents with conduct disorder. This underscores the need for treating sleep problems in CAMHS, and transdiagnostic treatment approaches are warranted.
Highlights
Sleep problems are prevalent among adolescents after puberty [1]
Among the participants in the clinical group, only six adolescents were registered as having a sleep disorder diagnosis (0.6% of people connected with services)
The current study provides new evidence of even higher prevalence of delayed sleep–wake-phase disorder (DSWPD) among adolescents with psychiatric disorders
Summary
Sleep problems are prevalent among adolescents after puberty [1]. Sleep during this developmental stage is characterized by short sleep duration on weekdays, a delayed sleep phase, and a high prevalence of insomnia [2, 3]. Sleep problems may be a causal factor in the development of such psychiatric disorders [6], and a consequence of these [7] This bidirectional perspective is in sharp contrast to the previously often held belief that sleep problems were secondary to a psychiatric disorder [8], and rarely diagnosed or targeted in mental health care interventions. This change in perspective is manifested in the transition from DSM-IV to DSM-5, where the
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