Adolescent insomnia as a risk factor for early adult depression and substance abuse

Sleep. 2008 Oct;31(10):1351-6.


Study objective: To evaluate the association between adolescent insomnia and mental health during adolescence and young adulthood.

Design: Cross-sectional and prospective study.

Settings: School and in home.

Participants: Nationally based population sample of 4494 adolescents, 12 to 18 years old at baseline (mean = 15.83 years), with 3582 young adults, 18 to 25 years old (mean = 21.25 years) at 6- to 7-year follow-up.

Measures: Self-report measures of mental health.

Results: Insomnia symptoms were reported by 9.4% of the adolescents. Cross-sectionally, adolescent insomnia symptoms were associated with use of alcohol, cannabis, and drugs other than cannabis; depression; suicide ideation; and suicide attempts (all P values < 0.01) after controlling for sex. Prospectively, insomnia symptoms during adolescence were a significant risk factor for depression diagnosis (odds ratio = 2.3) in young adulthood after controlling for sex and baseline depression.

Conclusion: This study is the first to longitudinally evaluate insomnia symptoms during adolescence as a risk factor for mental health problems in young adulthood. The findings indicate that insomnia is a prevalent problem for adolescents and argue for future treatment-outcome studies to evaluate the efficacy and effectiveness of various insomnia interventions in this age group.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Alcoholism / epidemiology*
  • Alcoholism / psychology
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Humans
  • Incidence
  • Longitudinal Studies
  • Marijuana Abuse / epidemiology
  • Marijuana Abuse / psychology
  • Prospective Studies
  • Risk Factors
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / psychology
  • Suicide, Attempted / psychology
  • Suicide, Attempted / statistics & numerical data
  • United States
  • Young Adult