Risk Of Insomnia Research Articles

Association between gynecological disorders and insomnia and depression trajectories: a longitudinal study of middle-aged women

BackgroundInsomnia and depression often receive inadequate attention regarding their association with common menopausal gynecological disorders (GDs), and there is a lack of longitudinal epidemiological evidence. Furthermore, the specific disorders that exhibit the strongest correlation with depression, as well as the potential mediating role of insomnia, remain poorly understood.MethodsUsing data from the Study of Women’s Health Across the Nation (SWAN) spanning 1996 to 2008, this study analyzed a sample of 2217 racially diverse premenopausal women (aged 42 to 53 at baseline). Longitudinal trajectory analysis, employing latent class mixture models (LCMM), was used to identify optimal patterns for insomnia and depression. Logistic regression explored associations between pelvic pain, pelvic prolapse or relaxation, abnormal bleeding, and insomnia/depression trajectories. A causal mediation model investigated whether insomnia mediated the link between gynecological disorders and depression.ResultsThe analysis included 2217 participants for insomnia trajectories and 1767 for depression trajectories. Insomnia and depression showed similar patterns, with a single high and low trajectory and minimal fluctuations. Logistic regression revealed a significant positive correlation between pelvic pain, abnormal bleeding, number of GDs, and an increased risk of high insomnia and depression trajectories. Insomnia trajectories mediated 23.6%, 14.3%, and 11.9% of the association between pelvic pain, abnormal bleeding, and number of GDs, respectively, with depression trajectories.ConclusionsThis study found the significant associations between pelvic pain, abnormal bleeding, and comorbidity with an elevated risk of insomnia and depression during the menopausal transition.

Brief, Family-Centered, Videoconference-Based Behavioral Insomnia Program in Elementary School-Aged Pediatric Cancer Survivors: A Proof-of-Concept Study.

Pediatric cancer survivors are at heightened risk for insomnia. Though behavioral interventions are the recommended approach, there are not enough trained clinicians. No known published trials have been conducted among school-aged survivors, despite them having unique age-related sleep issues. Here, we tested a videoconference-based behavioral insomnia intervention program enrolling 15 caregivers of cancer survivors (5-12years) with insomnia. Staff without prior sleep education/training delivered intervention sessions providing evidence-based strategies tailored to family needs. Self-report measures were collected before intervention and approximately 2weeks post intervention. Caregivers reported significant sleep and quality-of-life improvements. Thus, we show preliminary support for a brief intervention that does not require significant resources or clinical expertise.

Associations between Insomnia Severity, Perceived Stress, Mental Toughness, Dark Triad Traits, and Organizational Citizenship Behavior among Cadets of the Swiss Armed Forces

ABSTRACT Background Compared to the general population, military personnel are at increased risk for insomnia and poor psychological well-being. The present study: (1) compared categories of insomnia severity between cadets of the Swiss Armed Forces (SAF) and previously published norms and (2) investigated the associations between insomnia and psychological well-being related to perceived stress, mental toughness, dark triad traits, and organizational citizenship behavior (OCB). Methods A total of 216 cadets of the SAF (mean age: 20.80 years) completed self-rating questionnaires covering sociodemographic information, insomnia, perceived stress, mental toughness, dark triad, and organizational citizenship behavior. Data on insomnia sum scores and categories of historical samples (862 young adults and 533 police and emergency response service officers) were used for comparison. Results Cadets of the SAF reported higher insomnia sum scores and insomnia severity categories, compared to young adults and police officers. Higher scores for insomnia were associated with higher scores for stress, dark triad traits, and with lower scores for mental toughness and OCB. Categories of low, medium, and high stress moderated the association between insomnia and dark triad traits. Conclusions Compared to norms of the general population, cadets of the SAF reported a higher insomnia severity. Given that standardized treatment programs for insomnia, mental toughness, and above all for coping with stress are available, such interventions might be promising avenues to improve a cadet’s overall sleep, psychological well-being, and behavior.

β-Blockers and risk of neuropsychiatric disorders: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the association between β-blocker use and neuropsychiatric adverse events, specifically focusing on short-term outcomes. A comprehensive literature search identified studies reporting neuropsychiatric outcomes in patients using β-blockers, including randomized controlled trials and observational studies. Relative risks (RR) and 95% confidence intervals (CIs) were calculated for outcomes such as dizziness, insomnia, nightmares, drowsiness and delirium. Our analysis revealed that β-blocker use was significantly associated with an increased risk of dizziness (RR 1.72, 95% CI [1.39-2.14]; I2 = 1%, 14 studies) compared to placebo. Lipophilic β-blockers, especially propranolol, showed an even greater risk of dizziness (RR 3.13, 95% CI [1.44-6.84]; I2 = 0%, three studies). Propranolol was also associated with increased insomnia risk compared to placebo (RR 1.13, 95% CI [1.00-1.28]; I2 = 0%, five studies). Our data did not show statistically significant increases in the reports of nightmares and somnolence. Other adverse effects, including drowsiness, sleep disturbances, hallucinations and delirium, were noted. Our findings suggest a significant association between β-blocker use and an increased risk of neuropsychiatric adverse events, particularly insomnia and dizziness with higher risks associated with lipophilic β-blocker use. Given the ambiguity surrounding dizziness and its classification as a neuropsychiatric effect, our findings are exploratory, and we cannot exclude a potential cardiovascular origin for dizziness. Most studies (75%) were published before the CONSORT statement in 1996, indicating potential reporting limitations and a lack of recent research. Additionally, 60% of studies had a high risk of bias, underscoring the need for more rigorous and contemporary investigations into the neuropsychiatric implications of β-blocker use.

Elevated C-reactive protein levels and cardiovascular risk in prurigo nodularis patients with sleep disturbance: a multi-center cohort study.

Patients with prurigo nodularis (PN) present with pruritus which may lead to sleep disturbances and systemic comorbidities. The objective of our study was to determine the risk of sleep disorders in PN and its association with systemic inflammation and adverse cardiovascular outcomes. We conducted a retrospective population-level cohort using a global health records database to analyze the development of sleep disorders, C-reactive protein (CRP) levels, and risk of cardiovascular disease and mortality in PN compared to controls. PN patients had increased risk of general sleep disorders (RR 1.47, 95%CI 1.42-1.52, obstructive sleep apnea (1.61, 1.54-1.69), insomnia (1.37, 1.29-1.45), hypersomnia (1.47, 1.32-1.64), and restless legs syndrome (1.45, 1.28-1.65). Additionally, PN with sleep disorders had higher CRP levels than PN without sleep disorders (16.2mg/L vs. 10.6mg/L). PN patients with sleep disorders were more likely to develop cardiovascular comorbidities, including type 2 diabetes mellitus (RR 2.45, 95%CI 2.25-2.66), metabolic syndrome (4.16, 3.31-5.22), myocardial infarction (2.87, 2.52-3.22), venous thromboembolism (2.93, 2.55-3.39), and greater mortality (HR 1.47, 95%CI 1.34-1.62) compared to PN patients without sleep disorders. Our findings suggest that PN patients are at greater risk of developing various sleep disorders that are associated with adverse cardiovascular outcomes.

Sleep Treatment Education Program for Cancer Survivors: Protocol for an Efficacy Trial.

Cancer survivors are at increased risk for chronic insomnia, even years after treatment completion. As insomnia is associated with a variety of long-term health consequences, access to insomnia treatment is critically important for the survivor population. Cognitive behavioral therapy for insomnia (CBTI) is the recommended first-line treatment for insomnia but remains largely unavailable to survivors. Treatment barriers include geographic limitations, a shortage of trained providers, and demanding treatment regimens. Designed with these limitations in mind, the Sleep Treatment Education Program (STEP-1) delivers components of CBTI in a low-intensity educational intervention delivered online. This is a phase II pilot randomized controlled trial. The primary aims are to test the efficacy of STEP-1 to improve (1) insomnia symptoms and (2) mood in cancer survivors compared to a control condition. The secondary aims will (1) explore participant factors associated with clinically significant response, (2) evaluate acceptability of the control intervention, (3) explore feasibility of delivering individualized coaching sessions for participants who do not have a significant response to STEP-1, and (4) describe participants' satisfaction with STEP-1 and suggestions for improvement. This 2-arm randomized controlled trial enrolled 70 off-treatment cancer survivors aged 40-89 years with clinically significant insomnia. Participants are randomized to receive either the STEP-1 intervention or control condition (relaxation education); interventions are delivered in one-on-one, synchronous, virtual videoconference sessions by trained interventionists. The STEP-1 intervention presents educational information on the development of insomnia after cancer and offers suggestions for improving insomnia symptoms based on the CBTI elements of sleep hygiene, stimulus control, and cognitive restructuring. With the interventionist, participants review the suggestions and develop a personalized sleep action plan for implementation. The relaxation education session provides information on the potential benefits of relaxation and how to independently access online relaxation exercises. The Insomnia Severity Index is used to measure insomnia symptoms, and the Profile of Mood States Short Form is used to measure mood at baseline and 4 and 8 weeks after intervention. The primary end point is change in the Insomnia Severity Index score at 8 weeks, and the secondary end point is change in mood symptoms (Profile of Mood States Short Form) at 8 weeks. This trial was funded in July 2022. Enrollment and data collection began in February 2023 and concluded in October 2024, with 70 participants enrolled. The analysis will begin in fall 2024, and the results are expected in winter 2025. Trial results will determine if STEP-1 effects go beyond those that could be attributed to placebo and other nonspecific treatment factors. Should results support the efficacy of STEP-1 to improve mood and insomnia symptoms, we anticipate developing efficacy and implementation trials of STEP-1 in larger and more diverse samples. ClinicalTrials.gov NCT05519982; https://clinicaltrials.gov/study/NCT05519982. DERR1-10.2196/60762.

8. INSOMNIA AND RELATED FACTORS AMONG THE ELDERLY LIVED IN TAN VINH COMMUNE, LUONG SON DISTRICT, HOA BINH PROVINCE, 2024

Objective: This study aims to assess the prevalence of insomnia and its associated factors among the elderly in Tan Vinh, Luong Son District, Hoa Binh Province, in 2024. Subject Methods: A cross-sectional design was conducted in 255 elderly lives in Tan Vinh, Luong Son District, Hoa Binh Province from March to August 2024. Insomnia Severity Index was used to collect the data. Results: 77.3% of participants reported insomnia; among them, 11.6% were classified as severe insomnia. Individuals who were unmarried, divorced, or widowed were found to be 2.9 times more likely to experience insomnia compared to married participants. Additionally, those who consumed stimulants late in the evening faced a staggering 12.1-fold increased risk of insomnia. Furthermore, elderly individuals who napped for more than 30 minutes had a 3.9 times higher likelihood of insomnia compared to those who napped for less than 30 minutes. Conclusion: The study indicated a high prevalence of insomnia among participants that highlight the needs for interventions to improve sleep quality among participants.

Treatment Preferences of Physicians Treating Adult Patients with Attention-Deficit/Hyperactivity Disorderin the United States and Canada: A Discrete Choice Experiment.

Factors influencing attention-deficit/hyperactivity disorder (ADHD) treatment preferences have been studied among patients but not physicians in the United States (US) and Canada. This study assessed treatment preferences of physicians treating adult patients with ADHD in both countries. An online discrete choice experiment (DCE) was conducted (October 4-20, 2023) among physicians from Dynata's US and Canadian panel who treated adult patients with ADHD. Preference weights for efficacy (improvement in ADHD symptoms) and safety [risks of adverse events (AEs)] attributes were estimated using a conditional logistic regression model, and were used to calculate the willingness to trade-off and relative importance of the attributes. Among 510 US and 347 Canadian physicians (64.1% and 69.2% male, respectively), improvement in ADHD symptoms had a significant positive impact, and the risks of AEs (except the risk of feeling jittery in Canada) had a significant negative impact on physician preferences for ADHD treatments. US physicians were willing to tradeoff 0.44, 0.35, 0.20, 0.17, and 0.17 percentage points of improvement in ADHD symptoms to avoid a one-percentage-point risk of insomnia, nausea, feeling jittery, anxiety, and dry mouth, respectively; among Canadian physicians, these were 0.31, 0.21, 0.12, 0.20, and 0.07, respectively. The relative importance of the efficacy versus safety attributes (i.e., the risks of AEs included in the DCE taken together) was 45.5% versus 54.5% in the US and 56.3% versus 43.7% in Canada. Efficacy was the most important single attribute for physicians treating adult patients with ADHD in both the US and Canada; however, the risks of AEs taken together had greater relative importance than efficacy alone among US but not Canadian physicians. These findings highlight potential discrepancies in physician and patient preferences based on existing evidence and underscore the importance of shared decision-making, which may in turn increase patients' treatment satisfaction.

Diabetes distress and depression in type 2 diabetes. A cross-sectional study in 18,000 individuals in the Central Denmark region.

Type 2 diabetes is linked to psychological distress and a doubled risk of depression. This study aims to characterize individuals with type 2 diabetes experiencing diabetes distress and/or depression in relation to lifestyle and metabolic outcomes. A population-based survey in 2020 targeted individuals with type 2 diabetes (aged 18-75 years) in the Central Denmark Region. This cross-sectional study assessed diabetes distress (using Problem-Area-in-Diabetes-scale) and depression (via hospital diagnosis and prescribed medication) as exposures. Logistic regression, adjusting for potential confounders, compared exposed and non-exposed groups on lifestyle habits, metabolic factors and medication usage related to cardio-metabolic risks. Of 18,222 respondents with type 2 diabetes (46% response rate), 11% had depression, 14% had diabetes distress and 4% had both. Compared to those with neither condition, those with depression were more often smokers (OR: 2.0, 95% CI: 1.8; 2.3) and sedentary in leisure time (OR: 2.0, 95% CI: 1.8; 2.2). Diabetes distress was associated with elevated HbA1c (OR: 1.8, 95% CI: 1.5; 2.0) and treatment with insulin (OR: 1.8, 95% CI: 1.6; 2.0). Half with diabetes distress displayed stable blood glucose levels. Those with both conditions had a higher risk of sedentary behaviour (OR: 2.7, 95% CI: 2.3; 3.2), clinical insomnia (OR: 6.5, 95% CI: 5.5; 7.7) and low self-rated health (OR: 7.5, 95% CI: 6.3; 9.0) than those with either psychological condition in isolation. This study emphasizes the importance of recognizing distinct features and risk factors associated with diabetes distress and depression in individuals with type 2 diabetes. Tailored care strategies for comorbid mental health issues are crucial for comprehensive management.

Screen time and insomnia among college students: the moderating effect of loneliness

Objective: Insomnia is detrimental to college student health. The purpose of this study was to examine the interaction between two risk factors of insomnia—screen time use and loneliness—in college students. Participants: Respondents were 1,001 (M age = 19.9 [SD = 2.3]) college undergraduates. Methods: Self-reported demographic information, daily screen time (social, nonsocial, or productivity), loneliness, and insomnia were collected. Analyses examined the interaction of screen time and loneliness on insomnia. Results: Insomnia significantly correlated with loneliness and total, social, and nonsocial screen time. Less lonely students had an increase in insomnia symptoms with increased total and social screen time. However, lonelier students had greater insomnia symptoms than less lonely students, regardless of screen time. Greater than 8 h of total screen time per day elevated the risk for insomnia. Conclusion: Screen time was associated with insomnia symptoms; however, loneliness better predicted insomnia among college students.

Proposal for Managing Cancer-Related Insomnia: A Systematic Literature Review of Associated Factors and a Narrative Review of Treatment.

Insomnia is common in patients with cancer. It has a multifactorial etiology that may include the disease process, adverse effects of anticancer therapies, and/or an association with other comorbidities. The purpose of this review was to identify risk factors for insomnia and suggest optimal management strategies. We conducted a systematic literature review to elucidate the risk factors for insomnia and sleep disturbances in patients with solid tumors. The effects of sleep medications in this population were also described. A total of 75 publications were evaluated, including those on breast, lung, gynecologic, brain, head and neck, gastrointestinal, prostate, thyroid, and mixed cancers. We classified the factors related to insomnia or sleep disturbance in cancer into four categories: (1) patient demographic characteristics (e.g., age, marital or socioeconomic status); (2) mental state (e.g., depression or anxiety); (3) physical state (e.g., fatigue, pain, or restless legs syndrome); and (4) anticancer treatment-related (e.g., use of chemotherapy, opioids, or hormone therapy). Overall, literature on the pharmacologic treatment of insomnia is extremely limited, although some efficacy data for zolpidem and melatonin have been reported. Demographic characteristics, physical and mental distress, and anticancer treatments are all risks for insomnia in patients with cancer. The limited evidence base for pharmacologic therapy in this patient population means that healthcare professionals need to implement a comprehensive and multidisciplinary pathway from screening to management.

Do Children With Accidental Gunshot-related Fractures Experience Greater Risk of Mental Illness and Psychiatric Disorders? A Propensity-matched Study.

Firearm violence is the leading cause of death and is a major source of morbidity for children in the United States. While gunshot wounds (GSWs) are known to cause lasting psychological repercussions beyond physical injury, these effects are not well documented compared with the physical implications. Our study explores the association between accidental gunshot-related fractures in children and subsequent psychiatric outcomes. Relative to non-GSW-related fractures, do children sustaining an accidental GSW-related fracture experience higher risk of mental illness and psychiatric disorders? This study utilized the TriNetX US Collaborative Network as it provides comprehensive inpatient and outpatient data, longitudinal follow-up, and complete medical records across different facilities, closely reflecting real-world patient outcomes in orthopaedic practice. We retrospectively evaluated children diagnosed with an accidental GSW-related fracture and compared mental health diagnoses to children who experienced non-GSW-related fractures. Between January 1, 2003, and March 1, 2023, a total of 5071 children in the United States without preexisting anxiety, mood, psychotic, substance use, or insomnia disorders were reported to have experienced an accidental GSW-related fracture. Among these patients, 55% (2773) had a follow-up period of at least 1 year and met the inclusion criteria for the exposure cohort. In the non-GSW-related fracture cohort, a total of 61% (985,070) of children among 1,613,891 without the preexisting aforementioned conditions had a minimum follow-up period of 1 year and met the inclusion criteria. A total of 2769 children were successfully matched in each cohort using a greedy nearest neighbor propensity score-matching algorithm. Matching was based on age, gender, race, fracture location, and BMI, as these characteristics were identified through a regression analysis as potentially associated with psychiatric outcomes (p < 0.01). The mean ± SD age was 15 ± 4 years, and 16% (451) in the GSW cohort were girls. In the non-GSW cohort 17% (474) were girls. With respect to race and ethnicity, 62% (1709 in the GSW cohort; 1679 in the non-GSW cohort) were Black and 14% (384 in the GSW cohort; 386 in the non-GSW cohort) were Hispanic. Outcomes of interest were recorded for up to 3 years after the index event. The accidental GSW-related fracture cohort experienced a greater hazard of developing anxiety disorders (HR 3.8 [95% confidence interval (CI) 3.2 to 4.6]; p < 0.001), substance use disorders (HR 3.6 [95% CI 3.0 to 4.2]; p < 0.001), mood disorders (HR 2.4 [95% CI 1.9 to 3.1]; p < 0.001), non-mood psychotic disorders (HR 2.4 [95% CI 1.5 to 3.9]; p < 0.001), and insomnia (HR 1.8 [95% CI 1.4 to 2.3]; p < 0.001). Orthopaedic surgeons should implement early psychiatric screenings and integrate mental health support for children with gunshot-related fractures to address elevated risk of anxiety disorders, psychotic disorders, mood disorders, substance abuse, and insomnia. Future studies should focus on identifying effective interventions that mitigate these long-term psychological outcomes, with an emphasis on practical, targeted approaches in clinical care. Level III, prognostic study.

Application of Mendelian randomization to explore the genetic association between drinking habits of different beverages and sleep disorder

IntroductionThis study aims to provide genetic evidence linking Drinking Habits of Different Beverages (DHDB) to Sleep Disorder Liability (SDL), potentially informing clinical treatments to improve lifestyle factors.Material and methodsA two-sample Mendelian randomization (MR) method was employed to explore the genetic associations between DHDB and SDL. The DHDB variables studied encompassed Alcohol Intake (ALI), Alcohol Intake Frequency (ALF), High-Frequency Drinking with Meals (HAL), Tea Intake (TEAI), Coffee Intake (COFI), and Red Wine Intake (RWI). The SDL variables analyzed were Insomnia (INS), Inhibit Excitability (IE), and Sleep Duration (SD).ResultsThe MR analysis identified genetic links between ALI and INS, ALF and IE, ALF and SD, HAL and INS, HAL and IE, HAL and SD, TEAI and IE, TEAI and SD, and COFI and IE (P(IVW)&lt;0.05). Nonetheless, no significant genetic links were detected between ALI and IE, ALI and SD, ALF and INS, TEAI and INS, COFI and INS, COFI and SD, RWI and INS, RWI and IE, or RWI and SD (P(IVW)&gt;0.05).ConclusionsAlcohol intake may elevate insomnia risk without affecting daytime sleepiness or sleep duration. Frequent alcohol consumption may lead to daytime sleepiness and reduced sleep duration but not insomnia. Alcohol with meals might reduce insomnia and daytime sleepiness while improving sleep duration. Tea appears unlinked to insomnia and may reduce daytime drowsiness. Coffee may alleviate daytime drowsiness without causing insomnia, and red wine shows no significant association with sleep disorders. Reverse MR suggests potential links between sleep disorders and alcohol or caffeine intake.

Bidirectional influence between benign prostatic hyperplasia, prostate cancer, and prostatitis and mental disorders: two-sample and multivariate mendelian randomization analyses

Background We aimed to use Mendelian randomization (MR) to determine the causality between fifteen major mental disorders (MDs) and benign prostatic hyperplasia (BPH), prostate cancer (PCa), and prostatitis. Methods The main MR analysis was performed using the inverse variance-weighted (IVW) method. Results The study found that insomnia (odds ratio [OR], 1.6190; p = .0017) was significantly associated with an increased risk of BPH, and mood disorders (OR, 1.1590; p = .0221) was nominally associated with an increased risk of BPH. Conversely, BPH was suggestively associated with a low epilepsy risk (OR, 0.9988; p = .0043), and was nominally associated with an increased risk of insomnia (OR, 1.0061; p = .0291). Furthermore, attention deficit hyperactivity disorder (ADHD) was suggestively associated with a low PCa risk (OR = 0.9474; p = .0058). However, no causal relationship was observed between PCa and MDs. Finally, anorexia nervosa (OR, 1.1686; p = .0248) and depression (OR, 336.5383; p = .0308) were nominally positively correlated with prostatitis. Prostatitis was suggestively associated with increased risk of ADHD (OR, 1.0868; p = .0413). Conclusion Our findings provide clinicians with a basis for developing programs to prevent or treat MDs and prostatic diseases.

Analysis of migraine characteristics in postmenopausal women

Objective: to identify characteristics of migraine in women in postmenopause (PM) by analyzing the frequency, duration and intensity of migraine attacks, assessment of quality of life, anxiety, depression and sleep disturbances in patients in the reproductive phase (RP) and in the PM.Material and methods. The study comprised 60 migraine patients (30 patients in the RP, 30 patients in the PM). During the personal interview, age, migraine type, frequency and duration of attacks and headache (HA) intensity on the visual analogue scale (VAS) were recorded. The patients then completed the questionnaires: HIT-6, MIBS-4, HURT, Migraine- ACT, MIDAS, SF-36, HADS, ISQ. The statistical analysis was performed in Microsoft Office Excel 2021.Results. The risk of high intensity HA (≥8 points on the VAS) was significantly higher in patients in the PM than in patients in the RP [p&lt;0.05; relative risk (RR) 1.77]. The risk of necessity of a revision of therapy of attacks was higher in the PM than in the RP (p=0.004; RR=2.2). The risk of insomnia was higher in the PM than in the RP (p=0.004; RR=4.67). The risk of severe headache impact (HIT-6) and high migraine burden (MIBS-4) was higher in patients in the PM than in the RP (ORHIT6=1.7; ORMIBS4=1.78). All indicators of SF-36 quality of life questionnaire were significantly lower in patients in the PM group than in the RP group (p&lt;0.05). The risk of subclinical and clinical anxiety (p&lt;0.05; RR=4.33) and depression (p&lt;0.05; RR=2.75) was significantly higher in the PM than in the RP.Conclusion. Migraine attacks in women in the PM are more intense than in women in the RP, quality of life is lower, and revision of therapy for attacks is required more frequently. Patients with migraine in the PM are more likely to suffer from anxiety, depression and insomnia. Further research is needed to determine the causes of the observed phenomena and to develop migraine therapy in patients in the PM.

Maternal early pregnancy body mass index and risk of insomnia in the offspring.

To investigate the association between maternal early pregnancy body mass index (BMI) and risk of offspring insomnia. We conducted a nationwide cohort study among 3,281,803 singleton live births in Sweden born 1983-2015. Using national registries with prospectively recorded information, we followed participants for an insomnia diagnosis from 2 to up to 35 years of age. We compared insomnia risks by early pregnancy BMI categories using hazard ratios (HR) with 95% confidence intervals (CI) from adjusted Cox models. To assess unmeasured shared familial confounding, we conducted sibling-controlled analyses among 1,724,473 full siblings and studied the relation of maternal full sisters' BMI and insomnia risk in 1,185,998 offspring. There were 7,154 insomnia diagnoses over a median follow-up age of 17.9 years. Compared with women with normal BMI, adjusted HR (95% CI) of offspring insomnia for early pregnancy BMI categories overweight, obesity class I, and obesity classes II or III were, respectively, 1.22 (1.14, 1.30), 1.60 (1.45, 1.77), and 2.11 (1.83, 2.45). Corresponding adjusted HR (95% CI) in sibling comparisons were, respectively, 1.32 (1.05, 1.65), 1.48 (1.03, 2.14), and 1.56 (0.91, 2.65). Associations with maternal sisters' BMI were attenuated, suggesting a weak role for unmeasured shared factors. Other pregnancy, birth, and neonatal complications were associated with risk of insomnia in offspring but did not substantially mediate the association. The dose-response relation between maternal overweight and obesity severity with offspring insomnia risk is not fully explained by shared familial factors.

Mediating Role of Burnout on the Association Between Work-Related Boredom and Insomnia Among Korean Wage Workers.

This cross-sectional study aimed to determine the mediating role of burnout in the relationship between work-related boredom and insomnia among Korean workers. Data from 30,992 wage workers in the sixth Korean Working Conditions Survey were analyzed. The odds ratio and 95% confidence interval for insomnia according to work-related boredom were estimated using a survey-weighted logistic regression model. A mediation analysis was performed with burnout as the mediator. The survey-weighted logistic regression model revealed that work-related boredom was significantly associated with an increased risk of insomnia. In the mediation model, both the total and direct association of work-related boredom on insomnia were statistically significant. Moreover, the indirect association, mediated by burnout, was also significant, accounting for 23.38% of the total association. Our findings burnout may play a mediating role between work-related boredom and insomnia.

Insomnia and sleep apnea in the entire population of US Army soldiers: Associations with deployment and combat exposure 2010-2019, a retrospective cohort investigation

ObjectivesThis retrospective cohort study examined clinically diagnosed insomnia and sleep apnea and analyzed associations with deployment and combat exposure in active-duty soldiers (n=1,228,346) from 2010 to 2019. MethodsRetrospective data were obtained from the Soldier Performance, Health, and Readiness database. ResultsOverseas soldier deployments peaked in 2010, decreasing thereafter as soldiers were withdrawn from Iraq and Afghanistan. From 2010 to 2012 insomnia incidence increased at a rate of 6.7 cases/1000 soldier-years, then decreased after 2012 at 5.3 cases/1000 soldier-years. Sleep apnea increased 2010-2016 at 1.9 cases/1000 soldier-years and generally declined thereafter. Risk of insomnia increased with deployment (hazard ratio=1.51; 95% confidence interval=1.49-1.52) and combat exposure (hazard ratio=1.15; 95% confidence interval=1.13-1.17). Risk of sleep apnea was increased by deployment (hazard ratio=1.89; 95% confidence interval, 1.86-1.92) and combat exposure (hazard ratio=1.09; 95% confidence interval, 1.07-1.11). Most relationships remained after accounting for other factors in multivariable analyses, except that the association between sleep apnea and combat exposure was reduced (hazard ratio=0.94; 95% confidence interval=0.92-0.97). ConclusionsInsomnia risk decreased in the period nearly in parallel with a reduction in the number of deployments; nonetheless deployment and combat exposure increased insomnia risk in the period examined. Risk of sleep apnea increased in the period and was related to deployment but not combat exposure after accounting for demographics and comorbid conditions. Despite reductions in insomnia incidence and a slowing in sleep apnea incidence, sleep disorders remain highly prevalent, warranting continued emphasis on sleep-disorder screening and improving the soldier sleep habits.

The risk of insomnia by work schedule instability in Korean firefighters.

Firefighters are exposed to shift work, as well as unpredictable emergency calls and traumatic events, which can lead to sleep problems. This study aimed to investigate the risk of insomnia by work schedule instability in Korean firefighters. This study used the Insomnia Severity Index to assess the insomnia in firefighters. The work schedule stability was classified with the frequency of the substitute work and the timing of notification for work schedule changes. Logistic regression analysis was used to assess the adjusted odds ratio of insomnia by work schedule stability with covariates including sex, age, education, smoking, alcohol, caffeine intake, shift type, job, and underlying conditions. Of the 8,587 individuals, 751 (8.75%) had moderate to severe insomnia (Insomnia Severity Index ≥ 15). The prevalence of insomnia was statistically significantly higher as the frequency of substitute work increased: <1 time per month (6.8%), 1-2 times (9.5%), 3-5 times (13.4%), and more than 5 times (15.7%) (p < 0.001). Additionally, the prevalence of insomnia was statistically significantly higher when the timing of the schedule change notification was urgent or irregular: no change or several weeks before (5.4%), several days before (7.9%), one day before or on the day (11.2%), irregularly notification (11.6%) (p < 0.001). In comparison to the group with good frequency of the substitute work/good timing of schedule change notification group, the adjusted odds ratios of insomnia were 1.480 (95% confidence interval [CI]: 1.237-1.771) for Good/Bad group, 1.862 (95% CI: 1.340-2.588) for Bad/Good group, and 1.885 (95% CI: 1.366-2.602) for Bad/Bad group. Work schedule instability was important risk factor of insomnia in firefighters. It suggests that improving the stability of work schedules could be a key strategy for reducing sleep problems in this occupational group.

Insomnia in teachers at the time of resumption of in-person instruction at schools amidst the COVID-19 pandemic: A cross-sectional study.

The coronavirus (COVID-19) pandemic has affected people's economies, lifestyles, and physical, emotional, and sleep health. This research aimed to estimate the prevalence of insomnia and symptoms of stress, anxiety, and depression among teachers with the resumption of in-person instruction at schools following a hiatus after COVID-19 lockdowns in India. We also studied the association of teachers' insomnia with psychological symptoms and demographic variables. We conducted a cross-sectional survey between October -November 2021 after schools had reopened during the COVID-19 pandemic. Data was collected using standard questionnaires online among schoolteachers. We explored the association of insomnia with teachers' symptoms of stress, anxiety, depression, sex, school boards, and age groups. Of 124 schoolteachers surveyed, the prevalence of insomnia was 37.9% (subthreshold in 25% and clinical in 12.9%). The prevalence of stress, depression, and anxiety was 20.2%, 30.6%, and 45.2%, respectively. There was a significant association (p<0.001) of insomnia with symptoms of anxiety, stress, and depression in univariate analysis. On multivariate analysis, we found that those feeling stressed had a 6.4 times higher risk of insomnia (95% CI: 1.5-28.3, p - 0.01). There was no association of insomnia with age, sex, school educational boards, and type of institution. Over one-third (37.9%) of teachers reported having trouble sleeping when they returned to the school's typical face-to-face instruction modalities through COVID-19 times, and insomnia was more prevalent in those with stress.