Asbjørn Junker1, Johan Håkon Bjørngaard2, David Gunnell3, Ottar Bjerkeset4. 1. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. 2. Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway ; Forensic Department and Research Centre Brøset, St. Olavs University Hospital, Trondheim, Norway. 3. School of Social and Community Medicine, Bristol University, Bristol, UK. 4. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway ; Faculty of Health Sciences, Nord-Trøndelag University College (HiNT), Levanger, Norway.
Abstract
OBJECTIVES: To investigate the association between sleeping problems in adolescence and subsequent hospital admission for self-harm (SH). DESIGN: Prospective cohort study, linking health survey information on sleep problems to hospital-based patient records. SETTING: Residents of Nord-Trøndelag County, Norway, aged 13-19 years in 1995-97. PATIENTS OR PARTICIPANTS: 10,202 adolescents were invited to participate in the Young-HUNT study; 8,983 (88%) completed the health survey. MEASUREMENTS AND RESULTS: 10% of participants reported difficulties initiating sleep, 4% reported early morning wakening. Ninety-eight participants (27% male) were hospitalized following SH over a mean 12 years follow-up. Difficulties initiating sleep/early morning wakening were associated with increased risk of SH (HR 2.11, 95% CI 1.29-3.46, sex- and age-adjusted) compared with no problems, yet coexistent symptoms of combined anxiety/depression explained most of the association with sleep problems (fully adjusted HR 1.19, 95% CI 0.66-2.16). The HR of combined difficulties initiating sleep/early morning wakening differed in those with and without anxiety/depression at baseline (P interaction = 0.03); among those without caseness symptoms of anxiety/depression it was 5.58 (95% CI 2.02-15.40), while in those with caseness symptoms of anxiety/ depression it was 0.82 (95% CI 0.19-3.44). CONCLUSIONS: Sleep problems are common among Norwegian adolescents. The strong association between sleep problems and subsequent hospitalization for self-harm could mainly be related to coexistent symptoms of anxiety and depression. Prevention of adolescent sleep problems, anxiety and depression should be targeted when seeking to reduce and prevent self-harm.
OBJECTIVES: To investigate the association between sleeping problems in adolescence and subsequent hospital admission for self-harm (SH). DESIGN: Prospective cohort study, linking health survey information on sleep problems to hospital-based patient records. SETTING: Residents of Nord-Trøndelag County, Norway, aged 13-19 years in 1995-97. PATIENTS OR PARTICIPANTS: 10,202 adolescents were invited to participate in the Young-HUNT study; 8,983 (88%) completed the health survey. MEASUREMENTS AND RESULTS: 10% of participants reported difficulties initiating sleep, 4% reported early morning wakening. Ninety-eight participants (27% male) were hospitalized following SH over a mean 12 years follow-up. Difficulties initiating sleep/early morning wakening were associated with increased risk of SH (HR 2.11, 95% CI 1.29-3.46, sex- and age-adjusted) compared with no problems, yet coexistent symptoms of combined anxiety/depression explained most of the association with sleep problems (fully adjusted HR 1.19, 95% CI 0.66-2.16). The HR of combined difficulties initiating sleep/early morning wakening differed in those with and without anxiety/depression at baseline (P interaction = 0.03); among those without caseness symptoms of anxiety/depression it was 5.58 (95% CI 2.02-15.40), while in those with caseness symptoms of anxiety/ depression it was 0.82 (95% CI 0.19-3.44). CONCLUSIONS: Sleep problems are common among Norwegian adolescents. The strong association between sleep problems and subsequent hospitalization for self-harm could mainly be related to coexistent symptoms of anxiety and depression. Prevention of adolescent sleep problems, anxiety and depression should be targeted when seeking to reduce and prevent self-harm.
Entities:
Keywords:
Difficulties initiating sleep; adolescents; anxiety and depression; cohort study; early morning wakening; self-harm
Authors: Christopher P Fairholme; Elizabeth L Nosen; Yael I Nillni; Julie A Schumacher; Matthew T Tull; Scott F Coffey Journal: Behav Res Ther Date: 2013-06-14
Authors: Nicola Madge; Keith Hawton; Elaine M McMahon; Paul Corcoran; Diego De Leo; Erik Jan de Wilde; Sandor Fekete; Kees van Heeringen; Mette Ystgaard; Ella Arensman Journal: Eur Child Adolesc Psychiatry Date: 2011-08-17 Impact factor: 4.785