Summary: Children and adolescents from racial and ethnic minority groups—particularly Black youth—are disproportionately affected by insomnia that begins in childhood and persists into young adulthood. This long-term study highlights the chronic nature of childhood-onset insomnia and its association with serious health risks, including cardiometabolic disease and mental health disorders, underscoring the need for early identification and treatment.
Researchers from Penn State followed more than 500 participants from the Penn State Child Cohort and found that 23.3% experienced persistent insomnia symptoms across three developmental stages. Black and Hispanic/Latino participants were at higher risk of persistent symptoms, with Black children showing the greatest disparity compared with non-Hispanic white peers. These findings emphasize the importance of recognizing insomnia early in life and offering age-appropriate interventions to prevent long-term consequences.
Key Facts:
- Black children were 2.6 times more likely than non-Hispanic white children to experience chronic, childhood-onset insomnia that persisted into young adulthood.
- Overall, 23.3% of study participants reported persistent insomnia symptoms at all three evaluation points, demonstrating the condition’s prolonged course for a substantial minority.
- Early detection and treatment of insomnia in childhood are essential to reduce future health risks, with special attention needed for minority groups facing higher rates of persistent symptoms.
Background
Many people have brief bouts of sleeplessness, but for a notable subset of children and adolescents, disruptions in falling or staying asleep represent a chronic problem that can continue into adulthood. The Penn State team set out to determine whether insomnia symptoms that begin in childhood typically resolve with maturation or persist across developmental stages, and how trajectories differ across racial and ethnic groups.
Julio Fernandez-Mendoza, professor at Penn State College of Medicine and senior author of the study, emphasizes that insomnia is a public health concern. The research reveals that childhood-onset insomnia can be chronic, and long-term exposure to poor sleep is linked to increased risk for cardiometabolic conditions, depression, anxiety, and other adverse outcomes. Unlike transient phenomena such as sleep terrors or sleepwalking, insomnia symptoms often do not resolve with puberty and maturation for many affected children.
Study design and participants
The study tracked 519 participants originally recruited as school-age children (ages 5–12) from the Penn State Child Cohort, a population-based sample launched in 2000. Follow-up assessments occurred roughly 8 years later during adolescence and about 15 years after baseline in young adulthood, with mean ages at follow-up of approximately 9, 16, and 24 years. At each stage, parents (for children) or participants (for adolescents and young adults) reported moderate-to-severe difficulty initiating or maintaining sleep, and participants completed in-lab sleep studies to assess sleep disorders such as sleep apnea.
The longitudinal approach allowed the research team to classify trajectories of insomnia symptoms across childhood, adolescence, and young adulthood and to examine how those trajectories differed across racial and ethnic groups after adjusting for sex, age, overweight status, sleep apnea, periodic limb movements, psychiatric or behavioral disorders, and use of psychotropic medications.
Main findings
Nearly one in four participants (23.3%) had persistent insomnia symptoms present at all three time points. An additional 16.8% developed insomnia symptoms in young adulthood. When examining trajectories by race and ethnicity, Black participants comprised the largest share of persistent insomnia cases, followed by Hispanic/Latino youth. Compared with non-Hispanic white participants, Black youth were 2.6 times more likely to have childhood-onset insomnia that persisted through young adulthood and had 3.44 times greater odds that symptoms would persist rather than resolve after childhood. Hispanic/Latino participants had 1.8 times higher odds of persistent symptoms compared with white participants, though some findings were less precisely estimated.
Implications
These results indicate that disparities in sleep health emerge early and can remain across critical developmental stages. Childhood-onset persistent insomnia exposes individuals to chronic sleep deprivation at vulnerable ages, which may amplify risk for negative physical and mental health outcomes over time. The authors argue that clinicians, schools, and families should take insomnia symptoms seriously in childhood and adolescence rather than assuming they are transient. Early screening and evidence-based, age-appropriate treatments could help reduce long-term harm and address racial and ethnic sleep disparities.
Contributors and funding
The study team included investigators from Penn State’s departments of psychiatry and behavioral health and public health sciences, collaborators at the National Institute on Aging, and researchers from the National Institute of Environmental Health Sciences. Funding came from multiple institutes within the National Institutes of Health, including the National Heart, Lung, and Blood Institute; the National Center for Advancing Translational Sciences; the National Institute on Aging; the National Institute on Minority Health and Health Disparities; and the Intramural Programs of the NIH.
About this sleep and neurodevelopment research news
Author: Christine Yu
Source: Penn State
Contact: Christine Yu – Penn State
Image: Image credited to Neuroscience News
Original Research: Closed access. “Racial/ethnic disparities in the trajectories of insomnia symptoms from childhood to young adulthood” by Julio Fernandez-Mendoza et al. Published in Sleep.
Abstract
Racial/ethnic disparities in the trajectories of insomnia symptoms from childhood to young adulthood
Study Objectives
To examine racial and ethnic differences in the long-term prevalence and developmental trajectories of insomnia symptoms from childhood through young adulthood.
Methods
The analysis included 519 participants from the Penn State Child Cohort who were evaluated at baseline (2000–2005) during childhood and reassessed approximately 8 and 15 years later. Insomnia symptoms were defined by moderate-to-severe difficulty initiating or maintaining sleep reported by parents in childhood and by participants in adolescence and young adulthood. Trajectories across three time points were identified and compared between Black/African American, Hispanic/Latinx, and non-Hispanic white groups while controlling for demographic, clinical, and sleep-related covariates.
Results
Black participants had significantly higher odds of a childhood-onset persistent insomnia trajectory through young adulthood compared with non-Hispanic white participants (OR = 2.58). Hispanic/Latinx participants showed higher but less precisely estimated odds for the same trajectory (OR = 1.81). No significant racial/ethnic differences were observed for remitted, waxing-and-waning, or new-onset trajectories limited to young adulthood.
Conclusions
Disparities in insomnia symptoms for Black, and to a lesser extent Hispanic/Latinx, youth begin in childhood and often continue into young adulthood. Identifying upstream determinants and implementing early interventions are important steps to reduce these disparities and prevent their long-term adverse health consequences.