SLEEP DISORDER DIAGNOSIS IN ADOLESCENCE AND SUBSEQUENT MENTAL HEALTH DIAGNOSES - A RETROSPECTIVE COHORT STUDY
Author(s)
Karen G. Farrar1, Nina B. Masters, PhD2, Duy Hoang, PhD2, Brianna Cartwright, MS2.
1Bellevue, WA, USA, 2Truveta, Bellevue, WA, USA.
1Bellevue, WA, USA, 2Truveta, Bellevue, WA, USA.
OBJECTIVES: To examine the association between sleep disorder diagnoses during adolescence and subsequent mental health diagnoses within one year.
METHODS: We conducted a retrospective cohort study using de-identified electronic health record data from Truveta. Adolescents aged 12-17 with a first-time sleep disorder diagnosis between 2018 and 2025, no prior mental health diagnosis or treatment, and evidence of healthcare use at least a year before and after the index date were compared with adolescents without a sleep disorder diagnosis meeting the same criteria. Cohorts were matched 1:5 on age, sex, and encounter month. Baseline characteristics (e.g., demographics, comorbidities, healthcare utilization) were balanced using ATT-weighted propensity scores. After weighting, covariate balance was assessed using standardized mean differences, with all values <0.1. Weighted logistic regression modeled odds ratios for mental health diagnoses within one year.
RESULTS: The study included 34,127 adolescents (13,718 with a sleep disorder diagnosis and 20,409 matched comparators). Insomnia (37.4%) and sleep apnea (30.6%) were the most common sleep disorder diagnoses, followed by nocturnal enuresis (12.9%). After weighting, adolescents with a sleep disorder diagnosis had higher odds of receiving any mental health diagnosis within one year compared with matched comparators (odds ratio [OR] 1.49, 95% CI 1.38-1.61). Within one year, adolescents with sleep disorders were more likely than comparators to be diagnosed with anxiety (9.4% vs 4.8%, OR 1.62, 95% CI 1.47-1.79), depression (8.4% vs 4.5%, OR 1.47, 95% CI 1.33-1.63), and attention-deficit/hyperactivity disorder (3.2% vs 2.0%, OR 1.38, 95% CI 1.19-1.62).
CONCLUSIONS: A sleep disorder diagnosis during adolescence was associated with higher odds of subsequent mental health diagnoses, particularly anxiety and depression, consistent with prior evidence of a bidirectional relationship between sleep and mental health. These findings highlight adolescence as a critical period for integrated mental health screening following sleep disorder diagnosis.
METHODS: We conducted a retrospective cohort study using de-identified electronic health record data from Truveta. Adolescents aged 12-17 with a first-time sleep disorder diagnosis between 2018 and 2025, no prior mental health diagnosis or treatment, and evidence of healthcare use at least a year before and after the index date were compared with adolescents without a sleep disorder diagnosis meeting the same criteria. Cohorts were matched 1:5 on age, sex, and encounter month. Baseline characteristics (e.g., demographics, comorbidities, healthcare utilization) were balanced using ATT-weighted propensity scores. After weighting, covariate balance was assessed using standardized mean differences, with all values <0.1. Weighted logistic regression modeled odds ratios for mental health diagnoses within one year.
RESULTS: The study included 34,127 adolescents (13,718 with a sleep disorder diagnosis and 20,409 matched comparators). Insomnia (37.4%) and sleep apnea (30.6%) were the most common sleep disorder diagnoses, followed by nocturnal enuresis (12.9%). After weighting, adolescents with a sleep disorder diagnosis had higher odds of receiving any mental health diagnosis within one year compared with matched comparators (odds ratio [OR] 1.49, 95% CI 1.38-1.61). Within one year, adolescents with sleep disorders were more likely than comparators to be diagnosed with anxiety (9.4% vs 4.8%, OR 1.62, 95% CI 1.47-1.79), depression (8.4% vs 4.5%, OR 1.47, 95% CI 1.33-1.63), and attention-deficit/hyperactivity disorder (3.2% vs 2.0%, OR 1.38, 95% CI 1.19-1.62).
CONCLUSIONS: A sleep disorder diagnosis during adolescence was associated with higher odds of subsequent mental health diagnoses, particularly anxiety and depression, consistent with prior evidence of a bidirectional relationship between sleep and mental health. These findings highlight adolescence as a critical period for integrated mental health screening following sleep disorder diagnosis.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH103
Topic
Epidemiology & Public Health
Disease
SDC: Pediatrics