Adolescent insomnia linked to depression and substance abuse during adolescence and young adulthood

A unique longitudinal study is the first to analyse insomnia in adolescents both in association with mental health problems during adolescence and as a risk factor for mental health problems in young adulthood.

A study in the 1 October issue of the journal Sleep shows that adolescent insomnia symptoms are associated with depression, suicide ideation and attempts, and the use of alcohol, cannabis and other drugs such as cocaine.

Findings suggest that the presence of insomnia in adolescents increases the risk of developing mental health problems and also may increase the severity of these problems. Results indicate that adolescents who had symptoms of insomnia were 2.3 times more likely to develop depression in early adulthood than adolescents without symptoms of insomnia. Specifically, at baseline, the insomnia group was more likely to use alcohol, cannabis, and non-cannabis drugs, and was more likely to suffer from depression, suicide thoughts, and suicide attempts. The insomnia group also had a greater risk of developing new incidences of depression and suicide attempts after excluding participants who suffered from these specific psychopathologies at baseline.

When excluding participants who endorsed any mental health problem at baseline, the insomnia group was significantly more likely to develop incident depression. In addition, gender differences emerged for alcohol use, cannabis use, non-cannabis drug use, and depression. Independently of insomnia status, males were significantly more likely to endorse alcohol use, cannabis use, and the use of other drugs, while females were twice as likely to develop depression.

"Previous research in adults has found similar results to this study," said principal investigator and lead author Brandy M Roane, MS, a doctoral student at the University of North Texas. "The current study suggests adolescents with insomnia are more prone to developing mental disorders, specifically depression."

Insomnia symptoms were reported by 9.4 percent of the adolescents in the study. Information discovered during this study could potentially provide parents, educators and mentors with a sign of a risk factor for the development of mental health issues.

The study involved 4,494 adolescents between 12 and 18 years of age at the beginning of the study, and 3,582 young adults between the ages of 18 and 25 years in a six-to-seven year follow up. One-hundred and forty-five US middle, junior and high schools were selected to participate based on size, school type, census region, level of urbanisation, percentage of Caucasian and African-American students, grade span and curriculum. Health-related variables such as height, weight, pubertal development, mental health status, and chronic and disabling conditions were obtained through in-home interviews and self-report.

Adolescents who reported having trouble falling asleep every day or almost every day were categorised as having insomnia symptoms. Binge drinking was defined as drinking five or more alcoholic beverages in a row, and suicide ideation was based on whether or not a participant had endorsed having thoughts of suicide in the last year.

(Source: Sleep: American Academy of Sleep Medicine: October 2008)