The Association Between High Levels of Aggression and Insomnia in Chinese Adolescents: A Longitudinal Latent Profile Analysis

Abstract

Background: Aggression has been reported to be associated with insomnia in adolescents. However, the impact of aggression and different levels of aggression on insomnia needs further exploration. This study aimed to explore the association of aggression, as well as different profiles of aggression, with insomnia in Chinese adolescents.

Method: This was a prospective cohort study with an 8-month follow-up period. The Short-Form Buss–Perry Aggression Questionnaire (BPAQ-SF) was used to assess the aggression; the Insomnia Severity Index (ISI) was used to assess the symptoms of insomnia. Latent profile analysis (LPA) was conducted to identify profiles of aggression. The association between different profiles of aggression and insomnia was assessed using logistic regression analysis. We also used the restricted cubic spline model to investigate the pattern of the association.

Results: A total of 1124 students completed the questionnaire. The aggression was classified into three profiles: low aggression (n = 931, 82.8%), moderate aggression (n = 153, 13.6%), and high aggression (n = 40, 3.6%). A follow-up survey after 8 months found 228 (20.3%) new cases of insomnia. Moreover, high aggression was associated with a significantly increased risk of insomnia after adjustment for age, sex, ethnicity, anxiety state, and depressive state (odds ratio [OR]: 9.98, 95%CI: 4.94–20.15). The relationship between aggression and the risk of insomnia was linear in the restricted cubic spline regression analysis.

Conclusion: High levels of aggression were significantly associated with insomnia among Chinese adolescents. Therefore, targeted interventions aimed at addressing insomnia among adolescents with high levels of aggression are needed to improve their mental well-being.