Sleep problems among adolescents within child and adolescent mental health services. An epidemiological study with regis
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ORIGINAL CONTRIBUTION
Sleep problems among adolescents within child and adolescent mental health services. An epidemiological study with registry linkage Mari Hysing1,2 · Ove Heradstveit2,3 · Allison G. Harvey7 · Sondre Aasen Nilsen2 · Tormod Bøe1,2 · Børge Sivertsen4,5,6 Received: 3 August 2020 / Accepted: 25 October 2020 © The Author(s) 2020
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. Keywords Insomnia · Short sleep duration · DSWPD · Psychiatric disorders · Adolescence
Introduction * Mari Hysing [email protected] 1
Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
2
Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
3
Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
4
Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
5
Department of Research & Innovation, Helse-Fonna HF, Haugesund, Norway
6
Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
7
Department of Psychology, University of California, Berkeley, USA
Sleep problems are prevalent among adolescents after puberty [1]. Sleep during this developmental stage is characterized by short sleep duration
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