Racial/Ethnic Disparities in the Trajectories of Insomnia Symptoms from Childhood to Young Adulthood.

STUDY OBJECTIVES:To examine differences in the longitudinal prevalence of childhood insomnia symptoms across Black/African American, Hispanic/Latinx, and non-Hispanic White groups. METHODS:Participants were 519 children from the Penn State Child Cohort (baseline (V1) from 2000-2005) who were followed up 8 years later as adolescents (V2) and 15 years later as young adults (S3). Mean age at S3 was 24.1±2.7 years. Approximately, 76.5% identified as non-Hispanic White, 12.9% as Black/African American, 7.1% as Hispanic/Latinx, and 3.5% as "other" race/ethnicity. Insomnia symptoms were defined as parent-reported (childhood) or self-reported (adolescence, young adulthood) moderate-to-severe difficulties initiating/maintaining sleep. Longitudinal trajectories of insomnia symptoms were identified across three time-points and the odds of each trajectory were compared between racial/ethnic groups, adjusting for sex, age, overweight, sleep apnea, periodic limb movements, psychiatric/behavioral disorders and psychotropic medication use. RESULTS:Black/African Americans compared to non-Hispanic Whites were at significantly higher odds to have a childhood-onset persistent trajectory through young adulthood (OR = 2.58, 95% CI [1.29, 5.14]), while Hispanics/Latinx were at non-significantly higher odds to have the same trajectory (OR = 1.81, 95% CI [0.77, 4.25]). No significant racial/ethnic differences were observed for remitted and waxing-and-waning trajectories since childhood or incident/new-onset trajectories in young adulthood. CONCLUSIONS:The results indicate that disparities in insomnia symptoms among Black/African American and, to a lesser extent, Hispanic/Latinx groups start early in childhood and persist into young adulthood. Identifying and intervening upon upstream determinants of racial/ethnic insomnia disparities are warranted to directly address these disparities and to prevent their adverse health sequelae.