1. In this large population-based cross-sectional study, adolescents in foster care and receiving welfare services were found to have increased sleep problems, including higher incidence of insomnia and shorter sleep duration.
2. Additionally, exposure to adverse life events amongst adolescents receiving welfare services accounted for a substantial proportion of increased sleep problems.
Evidence Rating Level: 2 (Good)
Sleep problems are common in adolescence, and recent findings show an increased proportion of adolescents fitting the criteria for insomnia and reporting poorer sleep parameters. Past literature has highlighted the association between adolescence and sleep problems; however, there is a dearth of information exploring this relationship amongst at-risk adolescent groups. This study specifically aimed to identify any relationship between sleep problems and at-risk children who access welfare services.
This study used data from the youth@hordaland study conducted in 2012, which included adolescents born between 1993 to 1995 in West Norway, for the purposes of assessing service use, mental health, and lifestyle factors. Participants were removed for nonresponse to welfare service access questions as well as invalid sleep variable information. Study group was cohorted to control group (n=9166), foster care (n=132), and in-home welfare service (n=123). The primary outcome aimed to identify differences in sleep duration and insomnia prevalence amongst these cohorts.
Overall, this study identified 255 individuals that were either in foster care or receiving in-home welfare services. Sleep duration was significantly lower in both foster care and in-home service groups versus the general population of adolescents. Incidence of insomnia was significantly increased in the group that required in-home welfare services but not those in foster care. This pattern was replicated in sleep onset latency and oversleeping sleep variables. This study also identified that controlling for adverse life events led to an attenuation of sleep problems in those who lived under foster care. However, this study was limited by its self-reporting nature and the inability to differentiate between adverse life events, hindering the ability to explore difference in sleep problem prevalence. Nonetheless, this study suggests that in-home welfare services and foster care may place children at an increased risk of sleep problems.
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