Clinically Oriented Subtyping of Chronic Insomnia of Childhood

Oliviero Bruni, Stefania Sette, Marco Angriman, Emma Baumgartner, Lara Selvaggini, Cristina Belli, Raffaele Ferri

Research output: Contribution to journalArticle

Abstract

Objectives: To identify different profiles of pediatric insomnia, based on the most frequent clinical presentations (nocturnal awakenings, difficulty in falling asleep, nocturnal restlessness, early morning awakenings). Study design: A structured parent interview was conducted in 338 children (mean age 21.29 months, SD 10.56) referred by pediatricians because of insomnia resistant to behavioral approaches and common drug treatments. The aim was to assess the characteristics of insomnia in children, together with family sleep-related history. A latent class analysis was run to identify profiles of insomnia. ANOVA and the χ2 test were used to examine differences between profiles. Results: A 3-class model was built by latent class analysis: 17% (n = 58) of children constituted the first class, characterized by difficulties in falling asleep, with restlessness, nocturnal restlessness, and awakenings during the night; the second class, characterized by early morning awakenings, comprised 21% (n = 71) of children; 62% (n = 209) of children fell within the third class because of their high frequency of nocturnal awakenings and difficulties in falling asleep. The first class reported longer sleep latency and the presence of restless legs syndrome and anemia in the family history; depression and/or mood disorders were more frequent in class 2 and allergies and/or food intolerance were more frequent in class 3. Conclusions: Our study suggests the existence of 3 different phenotypes of insomnia in children, based on clinical, personal, and familial data. The identification of these different phenotypes might help to optimize the assessment and treatment of insomnia in young children.

Original languageEnglish
JournalJournal of Pediatrics
DOIs
Publication statusAccepted/In press - Jan 1 2018

Keywords

  • child
  • drug treatment
  • infant
  • insomnia
  • sleep phenotypes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Bruni, O., Sette, S., Angriman, M., Baumgartner, E., Selvaggini, L., Belli, C., & Ferri, R. (Accepted/In press). Clinically Oriented Subtyping of Chronic Insomnia of Childhood. Journal of Pediatrics. https://doi.org/10.1016/j.jpeds.2018.01.036