Point Prevalence and Risk Factors for Insomnia in Children and Adolescents: Findings of a Population-Based Survey

Insomnia in children and adolescents can be associated with poorer cognitive, emotional, social, and academic development. At present, no estimates of the prevalence of insomnia and its risk factors among adolescents in Germany are available from which the potential need for treatment could be assessed.

We conducted an online survey of a representative German sample of 1128 children and adolescents (age 10-17) and one parent for each. Levels of severity of insomnia as defined by the ICD-11 criteria were assessed by means of standardized selfreporting with use of the internationally established Insomnia Severity Index. The point prevalences of the levels of severity were calculated via relative frequencies. Potential risk factors for insomnia (sociodemographic factors, obesity, media consumption time, depression, anxiety, parental insomnia) were assessed with validated screening questionnaires and investigated in a multinomial regression model for the prediction of insomnia in childhood.

The following point prevalences were determined: mild insomnia, 26.6%; moderate insomnia, 21.4%; severe insomnia, 1.6%. The most important risk factors for moderate and severe insomnia were existing anxiety (odds ratio and 95% confidence interval 4.54 [2.09; 9.88] and 7.96 [1.72; 36.94], respectively) and parental insomnia (2.49 [1.66; 3.72] and 3.30 [1.06; 10.30], respec tively). The most important risk factor for mild and moderate insomnia was depression (1.83 [1.49; 2.24]), while older age (adolescents versus 10- to 13-year-olds) was protective ([0.51; 1.00]).

Many children and adolescents meet the ICD-11 criteria for insomnia according to their self-assessment. Critical life events and stressful experiences were not found to have any significant association with insomnia. A primarily nonpharmacological treatment approach involving the child and parents is indicated to alleviate the, often considerable, psychological strain on the family and prevent chronification of insomnia with adverse effects on the development of the child.