Subtyping at‐risk adolescents for predicting response toward insomnia prevention program
Bibliographic Data
BACKGROUND: Previous study has shown that a brief cognitive-behavioral prevention insomnia program could reduce 71% risk of developing insomnia among at-risk adolescents. This study aimed to evaluate the differential response to insomnia prevention in subgroups of at-risk adolescents. METHODS: Adolescents with a family history of insomnia and subthreshold insomnia symptoms were randomly assigned to a 4-week insomnia prevention program or nonactive control group. Assessments were conducted at baseline, 1 week, and 6- and 12-month after the intervention. Baseline sleep, daytime, and mood profiles were used to determine different subgroups by using latent class analysis (LCA). Analyses were conducted based on the intention-to-treat approach. RESULTS: LCA identified three subgroups: (a) insomnia symptoms only, (b) insomnia symptoms with daytime sleepiness and mild anxiety, and (c) insomnia symptoms with daytime sleepiness, mild anxiety, and depression. The incidence rate of insomnia disorder over the 12-month follow-up was significantly reduced for adolescents receiving intervention in subgroup 3 compared with the controls (hazard ratio [HR] = 0.37; 95% confidence interval [CI]: 0.13-0.99; p = .049) and marginally for subgroup 2 (HR = 0.14; 95% CI: 0.02-1.08; p = .059). In addition, adolescents who received intervention in subgroups 2 and 3 had a reduced risk of excessive daytime sleepiness (subgroup 2: adjusted OR [AdjOR] = 0.45, 95% CI: 0.23-0.87; subgroup 3: AdjOR = 0.32, 95% CI: 0.13-0.76) and possible anxiety (subgroup 2: AdjOR = 0.47, 95% CI: 0.27-0.82; subgroup 3: AdjOR = 0.33, 95% CI: 0.14-0.78) compared with the controls over the 12-month follow-up. CONCLUSIONS: Adolescents at risk for insomnia can be classified into different subgroups according to their psychological profiles, which were associated with differential responses to the insomnia prevention program. These findings indicate the need for further phenotyping and subgrouping at-risk adolescents to develop personalized insomnia prevention
Anxiety · Confidence interval · Hazard ratio · Insomnia · Mood · Psychiatry · Subgroup analysis · Attention Deficit Hyperactivity Disorder · Internal Medicine · Medicine · Psychology · Sleep and related disorders · Sleep and Wakefulness Research
Diagnostic and Statistical Manual of Mental Disorders
Association between Puberty and Delayed Phase Preference
Mechanisms underlying the association between insomnia, anxiety, and depression in adolescence
The Insomnia Severity Index
Effect sizes for growth-modeling analysis for controlled clinical trials in the same metric as for classical analysis.
Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children
Assessing insomnia in adolescents
Latent Class Analysis
Horne & Östberg morningness-eveningness questionnaire
Validation of the Insomnia Severity Index as an outcome measure for insomnia research
Why do many psychiatric disorders emerge during adolescence?
The Hospital Anxiety and Depression Scale
Psychometric evaluation of the Hospital Anxiety and Depression Scale in a large community sample of adolescents in Hong Kong
Latent Class Analysis
| Highly cited | No |
|---|