Prevalence and Correlates of Hypersomnolence Symptoms in U.S. Teens

Objective: Recent attention to pervasive sleep deficits in U.S. adolescents has focused on sleep patterns and insomnia, but there are limited data on the prevalence and correlates of hypersomnolence symptoms. Method: The sample included 6,483 adolescents 13 to 18 years of age who were interviewed directly and had parent reports in the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A), a nationally representative sample of U.S. youth. Information on sleep patterns/symptoms that were collected in the interview was used to determine the population prevalence of DSM-5 criterion A–defined hypersomnolence and component symptoms. Logistic regression analyses were used to examine associations between sleepiness and sub-symptoms of hypersomnolence with weekday/weekend bedtime, sleep duration, mental disorders, and psychotropic medication use. Results: Of the sample, 41.5% reported feeling sleepy during the daytime and 11.7% met criteria for hypersomnolence. The prevalence of hypersomnolence varied depending on age (p <.001) and was more common in adolescent girls (odds ratio [OR] 1.40, 95% CI 1.09–1.78). Excessive sleepiness and hypersomnolence symptoms were associated with shorter sleep duration and delayed bedtimes on weekdays and weekends Hypersomnolence was significantly associated with insomnia (OR 2.45, 95% CI 1.87–3.21) and mental disorders (OR 1.99, 95% CI 1.42–2.77). After accounting for insomnia, hypersomnolence was no longer associated with use of psychotropic medication (OR 1.61, 95% CI 0.97–2.66). Conclusion: Of adolescents with adequate sleep duration, 11.7% still reported symptoms of hypersomnolence. The strong association between hypersomnolence and insomnia suggests that sleep disorders in adolescents can fluctuate between over- and under-sleeping. Potential mechanisms underpinning the strong associations between sleep disturbances and mental disorders should be further pursued and could provide insight into prevention efforts.