The impact of insomnia and excessive daytime sleepiness on depression and suicidal ideation in adolescents: A three-year longitudinal study.

BACKGROUND

Insomnia and excessive daytime sleepiness (EDS) were associated with adverse mental health outcomes in adolescents, but their combined effects remained unclear. This study examined the associations between insomnia and EDS with mental health outcomes over a 3-year follow-up period.

METHODS

This study was a three-year longitudinal investigation. Adolescents were invited to fill in a set of questionnaires covering their insomnia symptoms, daytime sleepiness, and mental health outcomes. They were categorised into four groups: 1) insomnia-only, 2) EDS-only, 3) both insomnia and EDS, and 4) healthy adolescents. Logistic regression analyses were employed to examine the associations between insomnia and EDS with depression and suicidal ideation, adjusting for potential confounders.

RESULTS

A total of 458 adolescents (Mean age: 13.8 ± 1.2 years old at baseline; female 53.9%) participated in this study. Our results suggested an increased prevalence of EDS and a decrease in the prevalence of insomnia symptoms over the three-year period. Compared to the healthy group, adolescents with insomnia + EDS or either condition had higher odds of depression after controlling for confounders. For suicidal ideation, significant associations were found in the insomnia + EDS group and the insomnia-only group, but not in the EDS-only group.

CONCLUSIONS

These findings indicate an increased prevalence of EDS during adolescence. The co-occurrence of insomnia and EDS is associated with the heightened risk of depression and suicidality, representing a high-risk clinical group. Early interventions with this comorbid group may help mitigate the mental health risks in adolescents.