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=8.8y) and follow-up (Mage=17y) data were 53.9% male and 21.9% racial/ethnic minorities. The persistence of childhood insomnia symptoms 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 Childhood insomnia symptoms 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 childhood insomnia symptoms vs. their incidence in adolescence. Childhood insomnia symptoms should not be expected to developmentally remit and should become a focus of integrated pediatric/behavioral health strategies.

中文翻译：

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从童年到青春期失眠症状的自然史：人口比例、健康差异和危险因素

研究目的 确定与从儿童到青春期过渡期间失眠症状的持续、缓解和发生率相关的社会人口学、行为和临床危险因素。方法 宾夕法尼亚州立大学儿童队列是 700 名儿童（基线时为 5-12 岁）的随机、基于人群的样本，其中 421 名在青少年时期进行了随访（随访时为 12-23 岁）。受试者在基线和随访时接受了多导睡眠图、临床病史、体检以及父母和自我报告的量表。失眠症状被定义为父母或自我报告难以入睡和/或保持睡眠。结果 421 名具有基线 (Mage=8.8y) 和随访数据 (Mage=17y) 的受试者为 53.9% 的男性和 21.9% 的种族/少数民族。儿童失眠症状的持续率为56%（95%CI=46.5-65.4），只有 30.3% (95%CI=21.5-39.0) 完全缓解。青少年失眠症状的发生率为31.1%（95%CI=25.9-36.3）。女性、种族/少数民族和低社会经济地位以及精神/行为或神经障碍、肥胖、吸烟和夜间睡眠类型与失眠症状的持续性或发生率较高有关。结论 儿童失眠症状是高度持续的，只有三分之一的儿童在过渡到青春期时会完全缓解。失眠中与性别、种族/民族和社会经济相关的差异早在儿童时期就存在，而不同的心理/身体健康和生活方式/昼夜节律风险因素在儿童失眠症状的长期性与青春期发病率之间起着关键作用。