{"doi":"10.1093/sleep/zsaa187","title":"Natural history of insomnia symptoms in the transition from childhood to adolescence: population rates, health disparities, and risk factors","abstract":"STUDY OBJECTIVES: To determine the sociodemographic, behavioral, and clinical risk factors associated with the persistence, remission, and incidence of insomnia symptoms in the transition from childhood to adolescence. METHODS: The Penn State Child Cohort is a random, population-based sample of 700 children (5-12 years at baseline), of whom 421 were followed-up as adolescents (12-23 years at follow-up). Subjects underwent polysomnography, clinical history, physical exam, and parent- and self-reported scales at baseline and follow-up. Insomnia symptoms were defined as a parent- or self-report of difficulty falling and/or staying asleep. RESULTS: The 421 subjects with baseline (Mage = 8.8 years) and follow-up (Mage = 17 years) data were 53.9% male and 21.9% racial/ethnic minorities. The persistence of childhood insomnia symptoms (CIS) was 56% (95% CI = 46.5-65.4), with only 30.3% (95% CI = 21.5-39.0) fully remitting. The incidence of adolescent insomnia symptoms was 31.1% (95% CI = 25.9-36.3). Female sex, racial/ethnic minority, and low socioeconomic status as well as psychiatric/behavioral or neurological disorders, obesity, smoking, and evening chronotype were associated with a higher persistence or incidence of insomnia symptoms. CONCLUSIONS: CIS are highly persistent, with full remission occurring in only a third of children in the transition to adolescence. Sex-, racial/ethnic-, and socioeconomic-related disparities in insomnia occur as early as childhood, while different mental/physical health and lifestyle/circadian risk factors play a key role in the chronicity of CIS versus their incidence in adolescence. CIS should not be expected to developmentally remit and should become a focus of integrated pediatric/behavioral health strategies.","journal":"SLEEP","year":2020,"id":63089,"datarank":1.1689328650051225,"base_score":3.8712010109078907,"endowment":3.8712010109078907,"self_citation_contribution":0.5806801516361837,"citation_network_contribution":0.5882527133689388,"self_endowment_contribution":0.5806801516361837,"citer_contribution":0.5882527133689388,"corpus_percentile":82.47853330239035,"corpus_rank":2266,"citation_count":47,"citer_count":35,"citers_with_citation_signal":22,"citers_with_endowment":22,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.6695,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":333812,"name":"Elizaveta Bourchtein","orcid":"0000-0002-1898-6985","position":1,"is_corresponding":false},{"id":317816,"name":"Susan L. Calhoun","orcid":"0000-0003-2034-4380","position":2,"is_corresponding":false},{"id":319244,"name":"Kristina Puzino","orcid":null,"position":3,"is_corresponding":false},{"id":333813,"name":"Cynthia K. Snyder","orcid":"0000-0002-9462-8565","position":4,"is_corresponding":false},{"id":317815,"name":"Fan He","orcid":"0000-0002-4145-9999","position":5,"is_corresponding":false},{"id":317817,"name":"Alexandros N. Vgontzas","orcid":"0000-0002-8323-7526","position":6,"is_corresponding":false},{"id":275265,"name":"Duanping Liao","orcid":"0000-0001-7405-6152","position":7,"is_corresponding":false},{"id":319246,"name":"Edward O. Bixler","orcid":null,"position":8,"is_corresponding":false},{"id":317814,"name":"Julio Fernández‐Mendoza","orcid":"0000-0001-9584-6161","position":0,"is_corresponding":true}],"reference_count":55,"raw_metadata":null,"created_at":"2026-07-18T21:11:00.632961Z","pmid":"32929504","pmcid":"PMC7953218","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}