Citation

Junker A, Bjørngaard JH, Gunnell D, Bjerkeset O. Sleep 2014; 37(3): 579-585.

Affiliation

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.

Copyright

(Copyright © 2014, American Academy of Sleep Medicine, Publisher Associated Professional Sleep Societies)

DOI

10.5665/sleep.3502

PMID

24587581

PMCID

PMC3920324

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. CITATION: Junker A; Bjørngaard JH; Gunnell D; Bjerkeset O. Sleep problems and hospitalization for self-harm: a 15-year follow-up of 9,000 Norwegian adolescents. the Young-HUNT study. SLEEP 2014;37(3):579-585.

Language: en