Epidemiology of Insomnia

Abstract

This paper summarizes recent epidemiological evidence on insomnia, including its prevalence, incidence, and risk factors, as well as its course and consequences. There is now substantial evidence that insomnia is a significant public health problem. It is a highly prevalent condition, both as a symptom and a syndrome, and is often a persistent condition over time. Its persistence is associated with increased risk for mental (major depression), physical (hypertension), and occupational health problems (disability). Chronic insomnia also carries heavy economic burden, both in terms of direct healthcare costs and, more importantly, in terms of human resources loss due to the illness and lack of treatment. These findings have direct implications for community-based prevention and intervention programs and for future research including the need for: a) longitudinal, population-based studies aimed at evaluating whether we can prevent insomnia among at-risk individuals; b) clinical studies evaluating whether the morbidity associated with chronic insomnia is reversible; and c) prospective health economic evaluations of prevention programs using different dissemination technologies. Key Points• The epidemiology of insomnia has received increased attention in the last decade and investigators have moved from a purely cross-sectional approach to a more prospective and longitudinal approach.• Progress on the epidemiology of insomnia has been hampered by important methodological shortcomings including, but not limited to, the lack of a consistent case definition and standardized assessment procedures across studies.• Additional prospective and longitudinal studies are needed to identify early precursors of insomnia and factors moderating its trajectories over time.• A better understanding of how insomnia evolves over time and what factors trigger an episode or perpetuate it over time is critical for developing effective prevention and treatment programs. Outline• Introduction • Nature of insomnia complaints and updated diagnostic criteria • Prevalence and correlates of insomnia • Incidence and risk factors • Course of Insomnia -persistence, remission, relapse • Consequences and burden of insomnia

Heart rate variability in insomnia patients: A critical review of the literature

“…(16) With an estimated worldwide prevalence of 10%, insomnia is the most common sleep disorder. (15,17,18) Clinical diagnosis in accordance with the most recent diagnostic and statistical manual of mental disorders requires the patient to report difficulty initiating and/or maintaining sleep with subsequent daytime impairments greater than three nights per week and for at least three months.…”

Prevalence, associated factors and management of insomnia in prison populations: An integrative review

“…With regards to criminogenic factors, three studies examined unconvicted and sentenced prisoners, finding that insomnia tended to be more common in the former [22, 43,44]. Overall, insomnia symptoms prevalence was higher in a prison population than in the general population (30%e 36%) [8] with the exception of just two studies (10.9% and around 20%) [40,51]. The former study identified this figure based on whether the prisoner had been prescribed hypnotic medication only and not by prisoner self-report of insomnia symptoms.…”

“…This wide prevalence range reflects the differing definitions of insomnia and the variety of assessment tools adopted by different studies [8]. In terms of agreed definitions of insomnia, all three commonly used sleep classification manuals accept that the main symptoms of insomnia are a persistent problem initiating or maintaining sleep; experiencing early morning awakenings; and/or non-restorative sleep [9e11].…”

Investigating the Effects of the Unified Protocol on Common and Specific Factors in a Comorbid Insomniac Sample: A Single-Case Experimental Design

“…Insomnia, as a syndrome or symptom, is a widespread and persistent problem (1). People with insomnia experience a wide range of problems such as fatigue, irritability, difficulties in memorization and concentration, impairment of daily functions, and reduced quality of life (2).…”