0324 Protective and Risk Factors for Insomnia Over 5 Years in a Population-Based Sample of Adults

Abstract

Abstract Introduction Insomnia is a major public health concern and one of the most prevalent health issues among adults. Identifying protective and risk factors for insomnia could help identify vulnerable populations and design public health interventions to prevent some adverse medical and mental health consequences. The study objective was to identify protective and risk factors for insomnia in a population-based sample of adults. Methods Data is from a large epidemiological cohort study on the natural course of insomnia conducted in Canada before the COVID-19 pandemic. Insomnia and potential protective and risk factors for insomnia were measured annually over 5 years with validated questionnaires (e.g., Insomnia Severity Index, Pittsburgh Sleep Quality Index, State-Trait Anxiety Inventory, Beck Depression Inventory, Perceived Stress Scale, Coping Inventory for Stressful Situations, Ford Insomnia Response to Stress Test, Arousal Predisposition Scale, Life Experiences Survey). Risk factors for insomnia were divided as predisposing or precipitating factors. Results From a cohort of 3,413 participants 1,709 adults were identified as good sleepers at baseline and were included in the analyses. A total of 202 people developed an insomnia syndrome during the 5-year follow-up. Using survival analysis for discrete events, the following variables were significant predisposing factors for insomnia: anxiety (HR=1.037; p=0.018), depression (HR=1.082; p< 0.001), perceived stress (HR=1.073; p< 0.001), number of negative life events (HR=1.478; p=0.02), perceived worse general health (HR=1.606; p=0.006), pain (HR=1.475; p=0.002), vulnerability to stress (HR=1.089; p< 0.001), and maladaptive emotional coping (HR=1.044; p< 0.001). The following variables were identified as precipitating factors for insomnia: loss of income (HR=1.346; p=0.03), increased anxiety (HR=1.070, p< 0.001), depression (HR=1.119; p< 0.001) and perceived stress (HR=1.083; p=0.001), decline in perceived general health (HR=2.061; p=0.006), and increased pain (HR=1.353; p=0.013). Physical activity was not a significant protective factor for insomnia (p=0.54). Conclusion These results provide new information that could be helpful to prevent the onset and chronicity of insomnia by targeting specific precipitating factors, and people with predisposing factors for insomnia. This is important as insomnia tends to be a persistent condition and is known to increase adverse medical and mental health outcomes. Support (if any) This study was funded by the Canadian Institutes of Health Research.