Sleep duration and mental health in young adults

Background The association between sleep duration and mental illness has been established in middle-aged and older populations, yet remains less explored in younger adults. Additionally, a common limitation to existing studies is the lack of statistical power to explore less common disorders. The purpose of this study was to examine sleep duration as a predictor for a range of mental disorders and well-being in a longitudinal sample of young adults. Methods Data were derived from two waves (w1, w2) of the SHoT survey, which invited all full-time university and college students in Norway. The response rates were 34.4 % (n = 62,498) in 2021 (w1) and 35.1 % (n = 59,554) 2022 (w2). This study utilized a nested longitudinal sample from both w1 and w2, encompassing 21,289 students. Demographics, sleep duration (w1), and mental health (w2) were measured by self-report questionnaires. Sex-stratified linear regression models and log-link binomial regression analyses were employed to determine the proportion and calculate the risk ratios, respectively, for mental illness across different sleep duration categories. Results The mean age of the sample was 24.8 years ± 4.5 years (w1). Students with shorter sleep durations, and to some degree longer sleep durations (illustrating a ᒐ-shaped association), exhibited a higher risk for all assessed mental disorders and well-being outcomes one year later, compared to students sleeping 8–9 h. The ᒐ-shaped trend was consistent for both female and male students. Conclusion Sleep duration appears to be a transdiagnostic marker for mental health in young adults.publishedVersio

Trajectories and stability of self-reported short sleep duration from adolescence to adulthood

The trajectories and stability of self-reported sleep duration recorded at ages 13, 15, and 23 years on reported sleep duration at age 30 years among 1105 students (55% male) who participated in the Norwegian Longitudinal Health and Behaviour Study were examined. Questionnaire data were used to obtain demographic and sleep variables. Dichotomised short sleep duration was based on normative values and set as ≤8.5 h (age 13 years), ≤8 h (age 15 years) and ≤7 h (ages 23 and 30 years). Results indicated a significant overall reduction in total sleep duration (h per night) across age groups. Sleep duration (continuous) at age 15 and 23 years (whole group) was moderately but positively correlated with sleep duration at age 30 years (P < 0.01). When split by sex, at age 15 years, this association was present among females only (P < 0.01); however, at age 23 years, this association was present in both male and females (both P < 0.001). Categorical short sleep at age 23 years (whole group) was associated with short sleep at age 30 years (unadjusted odds ratio = 3.67, 95% confidence interval 2.36-5.69). Following sex stratification, this effect was significant for both males (unadjusted odds ratio = 3.77, 95% confidence interval: 2.22-6.42) and females (unadjusted odds ratio = 2.71, 95% confidence interval: 1.46-5.04). No associations were noted for categorical short sleep at ages 13 or 15 years, and subsequent short sleep at 30 years. Habitual short sleep duration during middle adulthood is not sustained from the time of early adolescence. Rather, these trends appear to be formed during early adulthood

Prevalence of mental disorders, suicidal ideation and suicides in the general population before and during the COVID-19 pandemic in Norway: A population-based repeated cross-sectional analysis

Background Self-report data on mental distress indicate a deterioration of population mental health in many countries during the COVID-19 pandemic. A Norwegian epidemiological diagnostic psychiatric interview survey was conducted from January to September 2020, allowing for comparison of mental disorder and suicidal ideation prevalence from before through different pandemic periods. Prevalence of suicide deaths were compared between 2020 and 2014–2018. Methods Participants from the Trøndelag Health Study (HUNT) in Trondheim were recruited through repeated probability sampling. Using the Composite International Diagnostic Interview (CIDI 5.0) (n = 2154), current prevalence of mental disorders and suicidal ideation was examined in repeated cross-sectional analyzes. Data on suicide deaths was retrieved from the Norwegian Cause of Death Registry and compared for the months March to May in 2014–2018 and 2020. Findings Prevalence of current mental disorders decreased significantly from the pre-pandemic period (January 28th to March 11th 2020; 15•3% (95% CI 12•4–18•8)) to the first pandemic period (March 12th – May 31st; 8•7% (6•8–11•0)). Prevalences were similar between the pre-pandemic period and the interim (June 1st July 31st; 14•2% (11•4–17•5)) and second periods (August 1st-September 18th; 11•9% (9•0–15•6)). No significant differences were observed in suicidal ideation or in suicide deaths. Interpretation Except for a decrease in mental disorders in the first pandemic period, the findings suggest stable levels of mental disorders, suicidal ideation and suicide deaths during the first six months of the COVID-19 pandemic compared to pre-pandemic levels. Potential methodological and contextual explanations of these findings compared with findings from other studies are discussed.publishedVersio

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

BACKGROUND: Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. FINDINGS: Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9-3·0) for men and 3·5 years (3·4-3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78-0·92) and 1·2 years (1·1-1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. INTERPRETATION: Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. FUNDING: Bill & Melinda Gates Foundation

Fear of missing out and binge-drinking among adolescents

Introduction No previous studies have examined the cross-sectional association between fear of missing out (FOMO) and binge-drinking among adolescents. The aim of the present study was: (i) to estimate the magnitude of this association; (ii) to assess the impact of potential confounders (i.e. sensation-seeking, symptoms of depression and self-regulation); and (iii) determine if it is uniform across all levels of these characteristics. Methods Cross-sectional study of adolescents from 33 middle schools in Norway, stratified according to geographic location, urban and rural locations, and standard of living. Participants were a nation-wide sample of N = 2646 adolescents (mean age 16.2 years, 43% boys). Self-report data were collected on binge-drinking, FOMO, sensation-seeking, symptoms of depression and self-regulation. Results Overall, 21% reported binge-drinking ≤ once per month in the past 12 months, while 9% reported binge-drinking more than once per month. Multinomial logistic regression showed that the crude effect, where greater FOMO was associated with greater risk of binge-drinking, was substantial (relative-risk ratio = 1.50 [1.35, 1.66], P < 0.001), but somewhat attenuated after including all potential confounders (relative-risk ratio = 1.28 [1.14, 1.43], P < 0.001). Effect modification analyses showed that the effect of FOMO on binge-drinking ≤ once per month was stronger for adolescents with low symptom levels of depression and weaker for adolescents at high levels of depression. Discussion and Conclusion Norwegian adolescents with higher FOMO have greater risk of binge-drinking.publishedVersio

Fear of missing out and binge-drinking among adolescents

Introduction No previous studies have examined the cross-sectional association between fear of missing out (FOMO) and binge-drinking among adolescents. The aim of the present study was: (i) to estimate the magnitude of this association; (ii) to assess the impact of potential confounders (i.e. sensation-seeking, symptoms of depression and self-regulation); and (iii) determine if it is uniform across all levels of these characteristics. Methods Cross-sectional study of adolescents from 33 middle schools in Norway, stratified according to geographic location, urban and rural locations, and standard of living. Participants were a nation-wide sample of N = 2646 adolescents (mean age 16.2 years, 43% boys). Self-report data were collected on binge-drinking, FOMO, sensation-seeking, symptoms of depression and self-regulation. Results Overall, 21% reported binge-drinking ≤ once per month in the past 12 months, while 9% reported binge-drinking more than once per month. Multinomial logistic regression showed that the crude effect, where greater FOMO was associated with greater risk of binge-drinking, was substantial (relative-risk ratio = 1.50 [1.35, 1.66], P < 0.001), but somewhat attenuated after including all potential confounders (relative-risk ratio = 1.28 [1.14, 1.43], P < 0.001). Effect modification analyses showed that the effect of FOMO on binge-drinking ≤ once per month was stronger for adolescents with low symptom levels of depression and weaker for adolescents at high levels of depression. Discussion and Conclusion Norwegian adolescents with higher FOMO have greater risk of binge-drinking

Symptoms of depression and difficulty initiating sleep from early adolescence to early adulthood: a longitudinal study

STUDY OBJECTIVES: To assess the direction of the relationship and degree of shared associations between symptoms of depression and difficulty initiating sleep (DIS) from early adolescence to early adulthood. DESIGN: Cross-sectional and longitudinal assessment of the symptoms of depression-DIS association from early adolescence (age 13 y) to early adulthood (age 23 y). SETTING: Hordaland, Norway. PARTICIPANTS: There were 1,105 individuals (55% male) who took part in the Norwegian Longitudinal Health Behaviour Study (NLHB) and participated at least once across seven data collection waves during the years 1990-2000. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Characteristic data were obtained during the first assessment. Symptoms of depression and instances of DIS were assessed during each data collection wave. Symptoms of depression and DIS were associated in all data waves, and one-step cross-lagged bivariate correlations were significant and comparatively high for both factors. Structural equation modelling indicated that DIS and symptoms of depression at wave 1 remain relatively stable across waves (all P &lt; 0.001), and a significant and consistent unidirectional cross-lagged effect was noted running from symptoms of depression to DIS from early adolescence to early adulthood. DIS is only marginally and inconsistently associated with the lagged symptoms of depression score across waves. CONCLUSIONS: These results suggest that symptoms of depression established in early adolescence are a moderate predictor of difficulty initiating sleep (DIS) in early adulthood, whereas the reverse association of DIS predicting depression was not convincingly supported. These findings are in contrast to previous findings that suggest sleep problems as a risk factor for the later development of depression