Sleep Reactivity and Related Factors in Adolescence: An Increased Risk for Insomnia? A Longitudinal Assessment

Abstract

Purpose

The individual vulnerability for stress-related sleep difficulties (eg, sleep reactivity) is known as a predisposing factor of insomnia in adults, yet relatively little is known about sleep reactivity in adolescence. The study goal is to determine factors related to sleep reactivity and to investigate whether sleep reactivity and related factors predict current and new incidents of insomnia in adolescents.

Patients and Methods

At baseline, 11-to-17-year-olds (N = 185, M_age = 14.3 years, SD = 1.8, 54% female) answered an age-appropriate version of the Ford Insomnia Response to Stress Test, questionnaires about sleep, stress, psychological symptoms, and resources, filled out a sleep diary and used actigraphy. Insomnia diagnoses according to ISCD-3 criteria were assessed at baseline, after 9 months and after one and a half years.

Results

Adolescents with high compared to low sleep reactivity had increased pre-sleep arousal, negative sleep-related cognitions, pre-sleep mobile phone use, stress experience, stress vulnerability, internalizing and externalizing symptoms, less social resources, and a later midpoint of bedtime. High sleep reactivity increased the likelihood for currently having insomnia, but not for the development of insomnia at subsequent assessments.

Conclusion

The findings suggest that high sleep reactivity is related to poor sleep health and mental health but cast doubt on sleep reactivity as a pivotal predisposing factor for the development of insomnia in adolescence.

Keywords:

• sleep vulnerability
• sleep disorder
• mental health
• stress
• resources
• youth

Data Sharing Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Ethics Approval and Informed Consent

The study was approved by the local ethics committee of Bielefeld University [EUB 2017-203]. All participants and their caregivers gave informed consent. We confirm that our study complies with the Declaration of Helsinki.

Disclosure

Ms Maren-Jo Kater reports grants from Deutsche Forschungsgemeinschaft (DFG), publication funding from Open Access Publication Fund of Bielefeld University, before and after the conduction of the study. Dr Arnold Lohaus reports grants from German Research Foundation (Deutsche Forschungsgemeinschaft, DFG), before the conduct of the study. The authors report no other conflicts of interest in this work.

Additional information

Funding

This work was supported by the German Research [funding codes LO 337/30-1 and SCHL 1909/8-1]. We acknowledge support for the publication costs by the Open Access Publication Fund of Bielefeld University and the Deutsche Forschungsgemeinschaft (DFG). The funders had no role in study design and administration, data analysis or interpretation, manuscript writing, or the decision to submit the paper for publication.