Predictors of insomnia in childhood : a study of Norwegian children followed from age 4 to 10

Abstract

Sleep problems in childhood are associated with a range of cognitive, emotional and behavioural difficulties. Although insomnia is the most common sleep disorder among children, there are several gaps in research regarding its prevalence, stability and predictors in preschool and middle childhood. Applying a general developmental framework combined with adult theories of insomnia, this study examined temperamental negative affectivity and bedtime parent-child conflicts as predictors of DSM-IV defined insomnia. A community sample of Norwegian children was followed biennially from ages 4 to 10 (n = 1,041) capturing insomnia with semi-structured psychiatric interviews of participating children and their parents. At age 4, insomnia was prevalent in 15.9 %, whereas the corresponding numbers for ages 6, 8 and 10 were 20.2 %, 15.5 %, and 13.8 %, respectively. Those with insomnia had 2 - 4 times higher odds of insomnia two years later compared to those not diagnosed with insomnia. Temperamental negative affectivity measured by the parent-reported Child Behavior Checklist (CBQ) at ages 4 and 6 predicted insomnia at ages 6 and 10, while bedtime parent-child conflicts at age 6 forecasted insomnia at age 8, both adjusted for baseline levels of insomnia. This is the first study to demonstrate these two factors to predict later insomnia and takes us one step further in mapping out the factors contributing to the development of insomnia in children, thus informing preventive and treatment efforts.