Prevalence and Correlates of Hypersomnolence Symptoms in US Teens.

OBJECTIVE: Recent attention to pervasive sleep deficits in U.S. adolescents has focused on sleep patterns and insomnia, but there are limited data on the prevalence and correlates of hypersomnolence symptoms.

METHOD: The sample included 6,483 adolescents ages 13-18 years who were interviewed directly and had parent reports in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally representative sample of US youth. Information on sleep patterns/symptoms that were collected in the interview was used to determine the population prevalence of DSM-5 criterion-A defined hypersomnolence and component symptoms. Logistic regression analyses were used to examine associations between sleepiness and sub-symptoms of hypersomnolence with weekday/weekend bedtime, sleep duration, mental disorders and psychotropic medication use.

RESULTS: 41.5% of US adolescents reported feeling sleepy during the daytime and 11.7% met criteria for hypersomnolence. The prevalence of hypersomnolence varied depending on age (p<0.001) and was more common in adolescent girls (OR=1.40; 95% CI=1.09-1.78). Excessive sleepiness and hypersomnolence symptoms were associated with reduced sleep duration and delayed bedtimes on weekdays and weekends Hypersomnolence was significantly associated with insomnia (OR=2.45; 95% CI=1.87-3.21) and mental disorders (OR=1.99; 95% CI=1.42-2.77). After accounting for insomnia, hypersomnolence was no longer associated with use of psychotropic medication (OR=1.61; CI=0.97-2.66).

CONCLUSION: Among adolescents with adequate sleep duration, we found that 11.7% still report symptoms of hypersomnolence. The strong association between hypersomnolence with insomnia suggests that sleep disorders in adolescents may fluctuate between over- and under-sleeping. Potential mechanisms underpinning the strong associations between sleep disturbances and mental disorders should be further pursued and may provide insight into prevention efforts.