Chronic insomnia and its negative consequences for health and functioning of adolescents: a 12-month prospective study.

PURPOSE To estimate prevalence and chronicity of insomnia and the impact of chronic insomnia on health and functioning of adolescents. METHODS Data were collected from 4175 youths 11-17 at baseline and 3134 a year later sampled from managed care groups in a large metropolitan area. Insomnia was assessed by youth-reported DSM-IV symptom criteria. Outcomes are three measures of somatic health, three measures of mental health, two measures of substance use, three measures of interpersonal problems, and three of daily activities. RESULTS Over one-fourth reported one or more symptoms of insomnia at baseline and about 5% met diagnostic criteria for insomnia. Almost 46% of those who reported one or more symptoms of insomnia in Wave 1 continued to be cases at Wave 2 and 24% met DSM-IV symptom criteria for chronic insomnia (cases in Wave 1 were also cases in Wave 2). Multivariate analyses found chronic insomnia increased subsequent risk for somatic health problems, interpersonal problems, psychological problems, and daily activities. Significant odds (p < .05) ranged from 1.6 to 5.6 for poor outcomes. These results are the first reported on chronic insomnia among youths, and corroborate, using prospective data, previous findings on correlates of disturbed sleep based on cross-sectional studies. CONCLUSIONS Insomnia is both common and chronic among adolescents. The data indicate that the burden of insomnia is comparable to that of other psychiatric disorders such as mood, anxiety, disruptive, and substance use disorders. Chronic insomnia severely impacts future health and functioning of youths. Those with chronic insomnia are more likely to seek medical care. These data suggest primary care settings might provide a venue for screening and early intervention for adolescent insomnia.