Childhood behavior problems linked to insomnia in adulthood

(Reuters Health) – Treating kids’ behavior problems might have the additional benefit of reducing their risk of insomnia as adults, a recent study suggests.

Researchers followed 8,050 people over more than four decades, assessing behavior problems at ages 5, 10 and 16, then administering sleep surveys when participants were 42 years old.

Overall, 78% of kids had normal behavior at age 5, while 13% had moderate behavior problems and 4% had severe behavior issues.

Kids with severe behavior issues were 39 percent more likely to have insomnia by the time they were adults than children who had normal behavior, researchers report in JAMA Network Open.

“The link between childhood behavior and adulthood insomnia could be partly explained by childhood sleep problems,” said Yohannes Adama Melaku, lead author of the study and a researcher at the Adelaide Institute for Sleep Health at Flinders University in Australia.

“Treating behavioral and sleep problems during childhood could reduce the risk of adulthood insomnia,” Melaku said by email. “Establishing healthy sleep behaviors in children is important for prevention of adulthood insomnia.”

Melaku’s team analyzed data from a long-term, ongoing study of a group of children born in the UK in 1970. During childhood and teenage years, researchers asked parents to rate how often kids exhibited several behaviors that could combine to signal problems, including: being fidgety; destroying or damaging things; fighting or arguing with other kids; not being liked by other kids; worrying about many things; being solitary; being fearful or anxious; missing school; upset in new situations; or a victim or perpetrator of bullying.

To assess insomnia symptoms in childhood, researchers asked the parents how often their children couldn’t fall asleep within 30 minutes of going to bed, how often they had trouble falling or staying asleep, and how often they felt unrested when they woke up in the morning. As adults, the study participants were asked similar questions.

During childhood, about 25% of kids at age 5 and about 16% of older children had parent-reported sleep difficulties.

As adults, study participants with moderate to severe sleep issues throughout childhood were 40% more likely to have insomnia than those with no childhood sleep issues. Those with no sleep issues at age 5 but who had developed moderate to severe sleep problems by age 16 were 34% more likely to have insomnia as adults.

After adjusting for other factors that could influence risk, researchers calculated that approximately 16% of the association between childhood behavior problems and adult insomnia could be explained by sleep difficulties at age 5. But the exact nature of that connection is unclear and requires further research, the authors write.

“Understanding how childhood behavioral challenges could cause adult sleep disturbance really depends on the reasons underlying these challenges,” said Kelly Sullivan, a researcher at Georgia Southern University who wasn’t involved in the study.

“Some childhood behavior challenges are caused by adverse experiences and stress, which have been shown to biologically alter the brain and affect health, learning and behavior,” Sullivan said by email. “Other children have underlying conditions that could impair development of executive function and self-regulation.”

The study findings highlight the importance of addressing behavior problems and sleep issues during childhood, before kids develop patterns that might make it harder for them to get the rest they need later in life, said Nicole Racine, a psychologist at the University of Calgary and Alberta Children’s Hospital Research Institute who wasn’t involved in the study.

“Parents of children who have behavioral difficulties are encouraged to seek support from a healthcare provider and participate in evidence-based interventions that provide skills and resources to parents to help best support their child,” Racine said by email.

“Positive sleep routines that include sticking to a consistent bedtime, winding down (e.g., reading, bath, quiet play), a quiet and comfortable place to sleep, and reducing screens and television before bed are important,” she added.

SOURCE: bit.ly/2lVGtFE JAMA Network Open, online September 6, 2019.

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