Early Onset Sleep Disparities and Insomnia: Understanding the Impact on Youth

A research team, headed by Penn State researchers, discovered that kids and teenagers from minority racial and ethnic groups are disproportionately impacted by ongoing insomnia symptoms that start in childhood and extend into young adulthood. In particular, Black children were 2.6 times more likely to suffer from these long-term sleep issues compared to white children. These results highlight the importance of detecting insomnia symptoms early and providing appropriate treatment for different age groups.

“Insomnia is a problem that affects public health,” stated Julio Fernandez-Mendoza, a professor at Penn State College of Medicine.The lead author and senior researcher of the study, which was recently published in the journal SLEEP, stated, “We’ve determined that more individuals than we previously believed are afflicted with childhood-onset insomnia, in which symptoms begin in childhood and persist as chronic issues into young adulthood.” This is significant because poor sleep has been connected to cardiometabolic disease, depression, anxiety, and other health concerns. However, when it comes to children and their sleep patterns, symptoms of insomnia are not always taken seriously. Fernandez-Mendoza emphasized that most people assume that difficulty falling asleep and staying asleep is just a phase that kids will eventually grow out of. “Insomnia is different from childhood sleep terrors or sleepwalking.The problem of childhood-onset insomnia does not disappear as kids grow older, according to Fernandez-Mendoza. He pointed out that chronic sleeplessness at a young age can lead to more serious health issues. This is especially true for Black and Hispanic/Latino children, who may face greater risks due to differences in sleep patterns compared to non-Hispanic white children. The researchers tracked 519 participants in the Penn State Child Cohort, a study that began in 2000. The participants were initially recruited as school-age children, between 5 and 12 years old, and were then monitored through their adolescent years.The study followed young adults at ages 9, 16, and 24 to assess their sleep patterns. Participants or their parents reported on sleep difficulties and underwent in-lab sleep studies at each stage. The goal was to understand whether insomnia that begins in childhood resolves with age or continues into adulthood. This longitudinal study provided valuable insight into sleep patterns during this specific lifespan period. The researchers wanted to determine the long-term effects of childhood insomnia on sleep. This study is one of the first to examine the connection between childhood and adulthood sleep patterns.Throughout the study, the researchers focused on how insomnia symptoms change over time and examined the differences in the trajectory of insomnia among different racial and ethnic groups, which is a gap in the existing research. According to Fernandez-Mendoza, 23.3% of the participants experienced persistent insomnia symptoms, meaning they had symptoms at all three time points, while 16.8% developed insomnia symptoms during young adulthood. When looking at the breakdown by race and ethnicity, it was found that Black participants had the highest percentage of persistent insomnia symptoms, followed by Hispanic/Latino youth. Specifically, compared to non-Hispanic white participants.According to the study, black participants were 2.6 times more likely to experience insomnia symptoms that continued into young adulthood. Additionally, they had 3.44 times higher odds of their insomnia symptoms persisting rather than resolving after childhood compared to non-Hispanic white participants. This indicates that among black children with ongoing symptoms from childhood to adolescence, their symptoms are less likely to resolve as they transition into adulthood. Hispanic/Latino participants were also 1.8 times more likely to have persistent insomnia symptoms compared to white participants.

“We mustn’t wait until someone arrives at the clinic as an adult with a history of poor sleep. We should pay more attention to insomnia symptoms in children and adolescents,” Fernandez-Mendoza stated.

Other Penn State authors of the paper include: Edward Bixler, professor emeritus; Alexandros Vgontzas, professor; Kristina Lenker, assistant professor; Susan Calhoun, associate professor; and Raegan Atha, sleep medicine specialist, all members of the department of psychiatry and behavioral health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine. Jiangang Liao, Fan He, and Duanping Liao are also co-authors.All the authors are from the department of public health sciences at Penn State College of Medicine. Rupsha Singh, a postdoctoral fellow at the National Institute on Aging, and Chandra Jackson, a senior investigator at the National Institute of Environmental Health Sciences of the National Institutes of Health (NIH), also contributed to the article.

The research was supported by the National Heart, Lung, and Blood Institute, the National Center for Advancing Translational Sciences of the NIH, National Institute of Environmental Health Sciences, National Institute on Aging, National Institute on Minority Health and Health Disparities, and the Intramural Programs at the NIH.