Early-Life Behavioral Problems Associated With Adult Insomnia

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Study suggests an unfavorable association of early-life behavioral problems with adulthood sleep health, underlining the importance of treating behavioral problems in children and addressing insomnia from a life-course perspective.

Behavior problems in childhood may increase the risk for insomnia later in life, according to a study published in JAMA Network Open.

Investigators used data from the ongoing 1970 British Birth Cohort Study to investigate parent-reported childhood behavioral problems at ages 5 years (n=8050), 10 years (n=9090), and 16 years (n=7653), and self-reported insomnia symptoms at age 42 years. Externalized and internalized behavior problems were measured using the Rutter Behavioral Scale and classified as normal (80th percentile), moderate (>80th to 95th percentile), and severe (>95th percentile).

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Log-binomial logistic regression analysis showed that participants with severe behavioral problems at 5 years of age had a 39% higher risk of difficulty initiating sleep (odds ratio [OR], 1.39; 95% CI, 1.04-1.84; P =.06 for trend) compared with those without behavioral problems.

Moderate behavioral problems at 16 years of age were positively associated with difficulty initiating or maintaining sleep (OR, 1.28; 95% CI, 1.07-1.52), as were severe behavioral problems (OR, 1.67; 95% CI, 1.22-2.30; P <.001 for trend). Moderate and severe problems at 16 years of age were also positively associated with difficulty initiating or maintaining sleep plus not feeling rested on waking (moderate: OR, 1.32; 95% CI, 1.11-1.56; severe: OR, 1.47; 95% CI, 1.09-1.98; P <.001 for trend).

Externalizing behavioral problems (eg, lying, disobedience, bullying, taking things belonging to others, destroying belongings, fighting, or restlessness) at 5 and 10 years of age were positively associated with insomnia symptoms at 42 years of age.

It should be noted that attrition rates were 24.7% from 5 to 42 years of age, 33.8% from 10 to 42 years of age, and 15.3% from 16 to 42 years of age, which may have limited investigators’ ability to detect changes in some outcomes.

However, the findings suggest that “early intervention to manage [childhood behavioral problems], specifically externalizing behaviors, may reduce the risk of adulthood insomnia,” investigators wrote.


Melaku YA, Appleton S, Reynolds AC, et al. Association between childhood behavioral problems and insomnia symptoms in adulthood. JAMA Netw Open. 2019;2(9):e1910861.