Mapping insomnia symptoms and circadian preferences to mental health problems in men and women across the lifespan

Aim. To (1) identify subgroups in the general population based on the combinations in three night-time insomnia symptoms and four dimensions of circadian preferences ("sleep profiles") and (2) investigate the associations between sleep profiles and mental health problems (depression, anxiety, reactive aggression, inattention, hyperactivity/impulsivity, autism, alcohol drinking, drug use, and smoking) while exploring potential lifespan and sex differences.
Methods. The data came from the add-on study “Comorbid Conditions of ADHD” in the Dutch Lifelines study and included 37,716 individuals (aged 4-91 years) from the Dutch general population. Latent class analysis was used to identify sleep profiles in twelve age-sex subgroups. Associations between sleep profiles and mental health problems were tested with linear regression, with interactions between age, sex, and sleep profiles added as predictors. 
Results. In all age-sex subgroups, participants were classified into three sleep profiles: (1) "Healthy Larks", with the earliest circadian preferences and no insomnia symptoms; (2) "Sleepy Owls”, with latest circadian preferences and nonrestorative sleep; and (3) "Insomniacs", with either early or late circadian preferences and severe insomnia symptoms. Compared to “Healthy Larks”, all mental health problems were more severe in “Sleepy Owls” and even worse in “Insomniacs” in both men and women, although these associations weakened with age. However, “Sleepy Owls” and “Insomniacs” did not differ in heavy alcohol drinking, drug use, and smoking.
Conclusions. Our findings strengthened the evidence of the universal role of healthy sleep in mental wellbeing. Individuals with sleep profiles of “Sleepy Owls” and “Insomniacs” can be potential target groups to benefit most from mental health-related interventions.
Keywords: Aggression; Anxiety; Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Depression; Latent Class Analysis; Mental Disorders; Sleep; Substance-Related Disorders