(PS1-48) The Association Between Cigarette Use, Panic Attacks, and Insomnia Symptoms Among Adolescents

It is well known that individuals who experience panic attacks are particularly at risk for using cigarettes (Zvolensky, Feldner, Leen-Feldner, & McLeish, 2005), and tend to report high levels of sleep difficulties (Overbeek, van Diest, Schruers, Kruizinga, & Griez, 2005). Unfortunately, very little work has examined these associations among youth.  Previous work has demonstrated that adolescent cigarette use is more strongly associated with sleep onset latency issues among youth who are elevated in anxiety vulnerability (i.e., anxiety sensitivity) than among youth lower in anxiety vulnerability (Bilsky, Feldner, Knapp, Babson, & Leen-Feldner, 2016). However, to date, no work has examined the association among panic attacks, insomnia symptoms, and cigarette use among adolescents. The current study aims to address this gap by comparing the level of insomnia symptoms of adolescents who use cigarettes as well as experience panic attacks in a large nationally representative sample of adolescents. It is hypothesized that youth who report both using cigarettes and experiencing panic attacks will report higher levels of insomnia symptoms than youth who do not use cigarettes and do not experience panic attacks.

Data from the National Comorbidity Survey-Adolescent Supplement were examined. Participants (N=10,148, M_age=15.18, SD=1.51; 51.07% female) were administered the World Health Organization Composite International Diagnostic Interview Version 3.0 (CIDI), modified for adolescents, to assess for panic attack within the past 30 days, cigarette use, insomnia symptoms, and diagnostic covariates (i.e., lifetime diagnosis of major depressive disorder).

There was a significant small main effect of panic attacks and cigarette use on insomnia symptom severity after controlling for the effects of participants age, gender, SES, and lifetime diagnosis of a major depressive episode (F(3, 104070895)= 38839.86, p< .001, sr²=.011) . Planned contrasts revealed that adolescents who experience panic attacks and smoke cigarettes reported significantly greater insomnia symptom severity (M=1.36, SD=1.05) when compared to participants who did not smoke and experience panic attacks (M=1.09, SD=1.09, p< .001), participants who smoke and do not experience panic attacks (M=.72, SD=.96, p=< .001), and participants who do not smoke and do not experience panic attacks (M=.49, SD=.86, p< .001). 

Results of the current study suggest that adolescents who smoke cigarettes and experience panic attacks report higher levels of insomnia symptoms when compared to adolescents who only report panic attacks, adolescents who only report smoking cigarettes, and adolescents who do not report panic attacks or cigarette use. These findings represent a step towards parsing out the relationship between cigarette use, panic attacks, and insomnia symptoms among adolescents.