Figure 3. PedsQL Scores in participants with ICSD2-derived insomnia.

The presence of insomnia is associated with decreased HRQOL across all domains except the physical scale. Persistent insomnia is associated with further worsening of overall, social and psychosocial HRQOL. *Significantly different (p < 0.05) from no insomnia, **significantly different from intermittent insomnia. Insomnia required the presence of at least one of the following symptoms of trouble falling asleep, staying asleep, or waking up too early in the morning in addition to reporting adequate time in bed (≥9 hours) and the presence of at least one of the following daytime symptoms–learning problems, daytime sleepiness, or concern about not getting enough sleep. PedsQL scores were adjusted for age, gender, ethnicity, family income, parent education, reported obstructive sleep apnea and use of psychiatric medication.