![]() The importance of increasing our attention to sleep problems in mental health care services in general was also demonstrated in a study of adults receiving treatment in public mental health service clinics, where sleep problems were an independent predictor of impaired functioning and fewer benefits from treatment. A Norwegian study found a higher level of sleep problems assessed by five items from the Youth Self Report Questionnaire in the clinical sample of adolescents attending specialty health care clinic (31%), relative to a community sample (5%). ![]() The results indicated later weeknight bedtime, shorter weeknight sleep duration, greater weekend bedtime delay, and both short and long periods of weekend oversleep were associated with increased odds of mood, anxiety, substance use, and behavioral disorders. This study assessed sleep patterns, not sleep disorders, across several psychiatric diagnoses among over 10,000 adolescents aged 13 to 18 years. One study that has shed light on sleep patterns among adolescents with psychiatric disorders, is the National Comorbidity Study from 2000 to 2004 that is based on a nationally representative sample recruited from the USA. Still, we know little about the prevalence of sleep problems among adolescents seeking help from child and adolescent mental health services (CAMHS). This shift has also led to a greater emphasis on diagnosing and treating sleep problems when these co-occur alongside a mental health disorder. This change in perspective is also manifested in the transition from DSM-IV to DSM-5, where the previous distinction between insomnia with and without a co-existing mental disorder is no longer included in the latest revision. This bidirectional perspective is in sharp contrast to the previously often held belief that sleep problems were secondary to a psychiatric disorder, and thus rarely diagnosed or targeted in mental health care interventions. Sleep problems may be a causal factor in the development of such psychiatric disorders, but also a consequence of these. Sleep problems are commonly listed as core symptoms of many psychiatric disorders, including major depressive disorder (MDD) and generalized anxiety disorder (GAD). Adolescents with mental health problems have an even higher prevalence of sleep problems across diagnosed disorders. Sleep during this developmental stage is characterized by short sleep duration on weekdays, a delayed sleep phase, and a high prevalence of insomnia. Sleep problems are prevalent among adolescents after puberty. ![]() This underscores the need for treating sleep problems in CAMHS, and transdiagnostic treatment approaches are warranted. In addition, some disorder-specific patterns emerged, such as a higher prevalence of insomnia among adolescents with depression, and DSWPS among adolescents with conduct disorder. Insomnia, delayed sleep-phase wake disorder, and poor sleep efficiency were confirmed as transdiagnostic sleep problems across psychiatric disorders. All diagnostic groups had a mean sleep efficiency below (85%), indicating poor sleep quality. Insomnia ranged from 29% among adolescents diagnosed with ADHD (PR = 1.79 95% CI 1.41–2.29) to 48% among adolescents diagnosed with depression (PR = 2.53, 95% CI 2.19–2.92). However, questionnaire-based measurement of insomnia from the study indicated that insomnia was highly prevalent across disorders in comparison to a reference group of adolescents who were not within mental health care. Psychiatric disorders were based on clinical diagnoses from the NPR, while insomnia, delayed sleep–wake-phase disorder (DSWPD), and other sleep problems/patterns were assessed by self-report questionnaires from The prevalence of diagnosed sleep disorders among adolescents seeking mental health services was 0.6%, yielding an estimated prevalence of 0.07% of the population. The data are drawn from the study, a large population-based study conducted in 2012, linked to the Norwegian Patient Registry (NPR) ( n = 9077). There is insufficient knowledge about sleep among adolescents within child and adolescent mental health services (CAMHS) in comparison to the general population. Sleep problems are prevalent among adolescents, especially among those diagnosed with mental health disorders.
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