Study Objectives The primary aim of the present study was to estimate the incidence per annum of acute insomnia and to what extent those that develop acute insomnia recover good sleep or develop chronic insomnia. Unlike prior studies, a dense-sampling approach was used here (i.e. daily diaries) and this allowed for a more precise detection of acute insomnia and the follow-on states (the transitions to either recovery or chronic insomnia). Methods Good sleeper subjects (n = 1,248; 67% female) that were at least 35 years old participated in this prospective study on the natural history of insomnia. Subjects were recruited nationwide and completed online assessments for 1 year. The online measures consisted primarily of daily sleep diaries, as well as weekly/bi-weekly and monthly measures of sleep, stress, and psychological and physical health. Results The 1-year incidence rate of acute insomnia was 27.0% (n = 337). The incidence rate of chronic insomnia was 1.8% (n = 23). Of those that developed acute insomnia, 72.4% (n = 244) went on to recover good sleep. 19.3% (n = 65) of the acute insomnia sample continued to experience persistent poor sleep, but did not meet criteria for chronic insomnia. Conclusions The incidence rate of acute insomnia (3 or more nights a week for between 2 and 12 weeks) is remarkably high. This said, most incident cases resolve within a few days to weeks. Incident chronic insomnia only occurs in about 2 in 100 individuals.

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ABSTRACT Study Objectives Nocturnal wakefulness is a risk factor for suicide and suicidal ideation in clinical populations. However, these results have not been demonstrated in general community samples or compared to sleep duration or sleep quality. The present study explored how the timing of wakefulness was associated with suicidal ideation for weekdays and weekends. Methods Data were collected from N=888 adults aged 22 to 60 as part of the Sleep and Healthy Activity, Diet, Environment, and Socialization study. Suicidal ideation was measured by the Patient Health Questionnaire – 9, while timing of wakefulness was estimated from the Sleep Timing Questionnaire. Binomial logistic regressions estimated the association between nocturnal (11pm-5am) and morning (5am-11am) wakefulness and suicidal ideation. Results Nocturnal wakefulness was positively associated with suicidal ideation on weekdays (OR: 1.44 [1.28-1.64] per hour awake between 23:00 to 05:00, p<0.0001) and weekends (OR: 1.22 [1.08-1.39], p=0.0018). Morning wakefulness was negatively associated with suicidal ideation on weekdays (OR: 0.82 [0.72-0.92] per hour awake between 05:00 to 11:00, p=0.0008) and weekends (OR: 0.84 [0.75-0.94], p=0.0035). These associations remained significant when adjusting for sociodemographic factors. Additionally, nocturnal wakefulness on weekdays was associated with suicidal ideation when accounting for insomnia, sleep duration, sleep quality, and chronotype (OR 1.25 [1.09-1.44] per hour awake, p=0.002). Conclusion Wakefulness at night was consistently associated with suicidal ideation. Additionally, morning wakefulness was negatively associated with suicidal ideation in some models. Although these findings are drawn from a non-clinical sample, larger longitudinal studies in the general population are needed to confirm these results.

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A. (2020) Onset insomnia and insufficient sleep duration are associated with suicide ideation in university students and athletes.