Prevalence Of Chronic Insomnia Research Articles

Meal-timing patterns and chronic disease prevalence in two representative Austrian studies

PurposeThis study aimed at describing meal-timing patterns using cluster analysis and explore their association with sleep and chronic diseases, before and during COVID-19 mitigation measures in Austria.MethodsInformation was collected in two surveys in 2017 (N = 1004) and 2020 (N = 1010) in representative samples of the Austrian population. Timing of main meals, nighttime fasting interval, last-meal-to-bed time, breakfast skipping and eating midpoint were calculated using self-reported information. Cluster analysis was applied to identify meal-timing clusters. Multivariable-adjusted logistic regression models were used to study the association of meal-timing clusters with prevalence of chronic insomnia, depression, diabetes, hypertension, obesity and self-rated bad health status.ResultsIn both surveys, median breakfast, lunch and dinner times on weekdays were 7:30, 12:30 and 18:30. One out of four participants skipped breakfast and the median number of eating occasions was 3 in both samples. We observed correlation between the different meal-timing variables. Cluster analysis resulted in the definition of two clusters in each sample (A17 and B17 in 2017, and A20 and B20 in 2020). Clusters A comprised most respondents, with fasting duration of 12–13 h and median eating midpoint between 13:00 and 13:30. Clusters B comprised participants reporting longer fasting intervals and later mealtimes, and a high proportion of breakfast skippers. Chronic insomnia, depression, obesity and self-rated bad health-status were more prevalent in clusters B.ConclusionsAustrians reported long fasting intervals and low eating frequency. Meal-timing habits were similar before and during the COVID-19-pandemic. Besides individual characteristics of meal-timing, behavioural patterns need to be evaluated in chrono-nutrition epidemiological studies.

Prevalence of chronic insomnia in patients with obstructive sleep apnea.

Objectives:To investigate the prevalence of and factors associated with chronic insomnia and obstructive sleep apnea (CIOSA) comorbidity in obstructive sleep apnea (OSA) patients.Methods:Between March 2014 and March 2015, we conducted a prospective, cross-sectional study of 238 adults diagnosed with OSA according to polysomnography and International Classification of Sleep Disorders-Third Edition criteria.Results:The prevalence of CIOSA was 29%. There was a trend towards older age in the CIOSA group. Sex was not associated with CIOSA. Sleep-maintenance and sleep-onset insomnia predominated in the sample. Beck’s depression and anxiety inventory scores were higher in the CIOSA group. Both depression and anxiety symptoms were associated with CIOSA. The arousal and apnea-hypopnea indices were lower in the CIOSA group. CIOSA was also associated with age ≥ 60 years and current tobacco use. Severe OSA and alcohol use were negatively associated with CIOSA.Conclusions:Chronic insomnia is prevalent among OSA patients. Our study highlights the need for detailed evaluation of patients with sleep breathing disorders to diagnose other important sleep and mood disorders (such as depression and anxiety), given their frequent association.

Effect of Continuous Positive Airway Pressure on Symptoms and Prevalence of Insomnia in Patients With Obstructive Sleep Apnea: A Longitudinal Study.

ObjectiveObstructive sleep apnea (OSA) and insomnia are the two most common sleep disorders. Continuous positive airway pressure (CPAP) is considered first-line treatment for OSA. In the present study, we assess the effect of CPAP on symptoms and prevalence of insomnia in patients with OSA. We hypothesized a decrease in insomnia symptoms from CPAP initiation to follow-up, and that this decrease would depend on CPAP adherence.Materials and methodsThe sample included 442 patients diagnosed with OSA [mean age 54.9 years (SD = 12.1), 74.4% males] who started treatment with CPAP at a university hospital. OSA was diagnosed according to standard respiratory polygraphy. Mean apnea-hypopnea index (AHI) was 30.1 (SD = 21.1) at baseline. Insomnia was assessed prior to CPAP treatment (baseline) and at follow-up after a median of 19.9 weeks (range 6–52 weeks) with the Bergen Insomnia Scale (BIS). CPAP adherence was defined as an average use of ≥ 4 h per night, whereas non-adherence was defined as < 4 h per night.ResultsThere was a significant decrease in BIS scores from baseline (mean = 18.8, SD = 9.8) to follow-up (mean = 12.9, SD = 9.9), p < 0.001. Cohen’s d(0.65) indicated a moderate effect size. The reduction in BIS scores was depending on CPAP adherence (interaction effect F(1,440) = 12.4, p < 0.001), with larger reduction in the adherent group than in the non-adherent group. The proportion of patients with chronic insomnia was significantly reduced from 51.1% at baseline to 33.0% at follow-up (p < 0.001).ConclusionOverall, there was a significant reduction in insomnia symptoms from baseline to follow-up. The improvement was significant in both adherence groups, but the degree of improvement was larger among patients who were adherent to CPAP. Furthermore, there was a significant reduction in the prevalence of chronic insomnia at follow-up compared to baseline. This suggests that CPAP effectively reduces both the presence of insomnia and the severity of insomnia symptoms in some patients with OSA.

Help-seeking behavior of young and middle-aged Austrians with chronic insomnia: Results from the 2017 national sleep survey

Chronic insomnia is highly prevalent and associates with poor physical and mental health, leading to high societal cost. Data on insomnia from Austria, including help-seeking behaviour, are currently lacking. In 2017 we conducted an online survey in Austrian adults aged between 18 and 67 years. Chronic insomnia was defined based on the 3rd edition of the diagnostic criteria of the International Classification of Sleep Disorders (ICSD-III) using an exact and a broad definition. Daytime functioning had to be affected “much” to “very much” for the exact (chronic insomnia) and “somewhat” for the broad (chronic insomnia symptoms) definition, respectively. We evaluated the distribution of sociodemographic characteristics, sleep problems overall and stratified by help-seeking behaviour. A total of 1004 participants (50.4% female, age 42 ± 13 years) completed the survey. In 8.9 % sleep problems were classified as chronic insomnia symptoms (broad definition) and in 7.8% as chronic insomnia (exact definition). Among participants with chronic insomnia symptoms and chronic insomnia, 26% and 53% respectively, reported active help-seeking behavior for their sleep problems. In conclusion, the prevalence of chronic insomnia appears comparable to that of other European countries with a higher proportion of people with chronic insomnia symptoms not fulfilling current diagnostic criteria. The low rates of active help-seeking behavior in both groups warrant more attention to public health initiatives regarding patient education and early treatment of insomnia.

Prevalencia y persistencia del insomnio crónico

Introducción: el insomnio, especialmente cuando se cronifica, se convierte en una patología con marcadas implicaciones en la salud física y mental. No obstante su importancia, en nuestro país existen pocos estudios poblacionales sobre su comportamiento epidemiológico. Estudios previos realizados en el departamento de Caldas mostraron una elevada prevalencia de insomnio global con cifras alrededor de 47%. &#x0D; Objetivo: establecer la frecuencia, características sociodemográficas y persistencia a dos años del insomnio crónico, en una muestra poblacional representativa de la ciudad de Manizales. Sujetos y métodos: estudio transversal mediante entrevista domiciliaria en diferentes estratos socioeconómicos en mayores de 18 años, con queja de insomnio en el estudio previo de trastornos de sueño en Caldas (2008), que incluyó 530 personas de las cuales 228 tenían insomnio (agudo o crónico), lo cual arrojó una prevalencia global de 43.9%. Para el análisis de la información se empleó el paquete estadístico Epiinfo 6.04d/. &#x0D; Resultados: el seguimiento a dos años se pudo realizar a 218 personas, y de éstas el insomnio continuaba en 175, lo cual indicó una prevalencia de insomnio crónico de 33% y una persistencia del mismo de 80.2%. Cuando sólo se estimó el insomnio con repercusión diurna la prevalencia fue de 10.9%. En más de la mitad de los individuos el insomnio había estado presente entre cinco y diez años. El aumento en edad fue el único factor asociado para una mayor frecuencia. A pesar de la persistencia y severidad del insomnio, sólo 18.3% lo habían informado al médico. &#x0D; Conclusiones: las prevalencias halladas de insomnio global, crónico y con repercusión diurna se encuentran entre los rangos mencionados en la literatura y se detectó una elevada persistencia y duración del insomnio crónico. Lo anterior, y dadas sus consecuencias negativas sobre individuos y comunidades, amerita una búsqueda activa de esta condición en la práctica clínica y medidas gubernamentales apropiadas para su prevención y manejo &#x0D;

Prévalence et facteurs sociodémographiques associés à l’insomnie et au temps de sommeil en France (15–85 ans)

IntroductionSleep is considered as a major protective factor for good health and quality of life. The epidemiology of chronic insomnia and other sleep disorders has recently been developed in France. The aim of this study was to evaluate total sleep time and the prevalence of chronic insomnia in the general population aged 15 to 85years. It was also to investigate factors associated with sleep disorders. MethodsWithin the framework of the Health Barometer 2010, a French general population survey, 27,653 15 to 85-year-old individuals were questioned about their health behaviors and attitudes, in particular about their sleeping time and habits. ResultsThe average sleeping time of the 15 to 85-year-old was 7hours 13minutes. It was higher for women than for men (7hours 18minutes vs 7hours 07minutes; P<0.001), whereas 15.8 % of the population presented criteria for chronic insomnia, 19.3 % of women and 11.9 % of men (P<0.001). The prevalence of chronic insomnia was stable with age among women, around 19 %, whereas it increased for men from 3 % in the 15–19-year age range to 18 % in the 45–54-year age range, before decreasing to 8 % beyond 65years. Chronic insomnia was also found to be related to precarious situations and to several difficult events of life such as violence or chronic alcohol abuse, whereas the relationship observed with tobacco smoking was no longer found after logistic regression adjustment for socio-demographic characteristics. Since the beginning of 1990s, a single-question inquiry on “sleeping problems present during the last 8days” has been asked in the Health Barometer. The rate of subjects concerned increased from 1995, with a prevalence stabilized at a high level since 2000. ConclusionsBased on these data, we think that the surveillance of sleep disorders is an important public health issue and that prevention and health educational initiatives should be launched in the general population to promote a better quality of sleep.

Management of Late-Life Insomnia

Insomnia is a common complaint that can have significant daytime consequences. The prevalence of chronic insomnia may increase with age. The management of late-life insomnia can be complicated because aging is associated with normal changes in sleep structure, continuity, and timing, as well as a higher rate of medical and psychiatric disorders. A thorough evaluation and conceptualization of patients’ problems should be conducted for effective treatment planning. Both non-pharmacological and pharmacological strategies have been proven effective in treating insomnia in elderly populations. Behavioral intervention and cognitive behavioral therapy for insomnia are recommended as first considerations. Light therapy may be administered for misalignment of the circadian phase. When necessary, hypnotic medications may be added with adequate safety precautions and consideration of comorbid conditions.

Longitudinal Course and Outcome of Chronic Insomnia in Hong Kong Chinese Children: A 5-Year Follow-Up Study of a Community-Based Cohort

There are limited data on the long-term outcome of childhood insomnia. We explored the longitudinal course, predictors, and impact of childhood insomnia in a community-based cohort. 5-year prospective follow-up. Community-based. 611 children (49% boys) aged 9.0 ± 1.8 years at baseline; 13.7 ± 1.8 years at follow-up. NA. Chronic insomnia was defined as difficulty initiating sleep, difficulty maintaining sleep and/or early morning awakening ≥ 3 times/week in the past 12 months. General health, upper airway inflammatory diseases, and behavioral problems in recent one year were assessed at both time points, while mental health and lifestyle practice were assessed at follow-up study. The questionnaires at baseline and follow-up were reported by parents/caretakers and adolescents themselves, respectively. The prevalence of chronic insomnia was 4.2% and 6.6% for baseline and follow-up, respectively. The incidence and persistence rates of chronic insomnia were 6.2% and 14.9%, respectively. New incidence of insomnia was associated with lower paternal education level, baseline factors of frequent temper outbursts and daytime fatigue as well as alcohol use and poor mental health at follow-up. Baseline chronic medical disorders, frequent temper outbursts, and poor mental health at follow-up were associated with the persistence of insomnia in adolescents. Baseline insomnia was associated with frequent episodes of laryngopharyngitis and lifestyle practice (coffee and smoking) at follow-up. Chronic insomnia is a common problem with moderate persistent rate in children. The associations of adverse physical and mental health consequences with maladaptive lifestyle coping (smoking and alcohol) argue for rigorous intervention of childhood insomnia.

Sleep problems in children with autism spectrum problems: a longitudinal population-based study

This study examined the prevalence and chronicity of sleep problems in children who manifest problems believed to be typical of Autism Spectrum Disorders (ASD). Using data from a longitudinal total population study, symptoms of ASD, insomnia and potential explanatory factors were assessed at ages 7-9 and 11-13. Children were included in a group defined as having Autism Spectrum Problems (ASP) if they scored above a strict threshold on the Autism Spectrum Screening Questionnaire (ASSQ). Twenty-eight (0.8%) of 3700 children fulfilled the selected criteria for ASP at both waves, and the prevalence of chronic insomnia was more than ten times higher in these children compared to the controls. Children with ASP developed more sleep problems over time, with an incidence rate at wave 2 of 37.5% compared to 8.6% in the controls. The sleep problems were more persistent over time, with a remission rate of 8.3% compared to 52.4% in the controls. ASP was a strong predictor of sleep problems at wave 2 (OR = 12.44), and while emotional and behavioural problems explained a large proportion of this association, the effect of ASP on insomnia remained significant in the fully adjusted model (OR = 3.25). These findings call for increased awareness of sleep problems in children with ASP.

Severe Hot Flashes Are Associated With Chronic Insomnia

Because hot flashes can occur during the night, their presence has been frequently associated with insomnia in women with symptoms of menopause. However, many factors other than hot flashes or menopause can be responsible for insomnia, and several factors associated with insomnia in the general population are also commonly observed in perimenopausal and postmenopausal women who have hot flashes. A random sample of 3243 subjects (aged > or =18 years) representative of the California population was interviewed by telephone. Included were 982 women aged 35 to 65 years. Women were divided into 3 groups according to menopausal status: premenopause (57.2%), perimenopause (22.3%), and postmenopause (20.5%). Hot flashes were counted if they were present for at least 3 days per week during the last month and were classified as mild, moderate, or severe according to their effect on daily functioning. Chronic insomnia was defined as global sleep dissatisfaction, difficulty initiating sleep, difficulty maintaining sleep, or nonrestorative sleep, for at least 6 months. Diagnoses of insomnia were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, classification. Prevalence of hot flashes was 12.5% in premenopause, 79.0% in perimenopause, and 39.3% in postmenopause. Prevalence of chronic insomnia was reported as 36.5% in premenopause, 56.6% in perimenopause, and 50.7% in postmenopause (P<.001). Prevalence of symptoms of chronic insomnia increased with the severity of hot flashes, reaching more than 80% in perimenopausal women and postmenopausal women who had severe hot flashes. In multivariate analyses, severe hot flashes were significantly associated with symptoms and a diagnosis of chronic insomnia. Poor health, chronic pain, and sleep apnea were other significant factors associated with chronic insomnia. Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.

Prevalence of Chronic Insomnia Among Adults and Associated Factors

Prevalence of Chronic Insomnia Among Adults and Associated Factors

Assessment of the Safety and Efficacy Data for the Hypnotic Halcion(R): Results of an Analysis by an Institute of Medicine Committee

Recent estimates indicate a 10% prevalence of chronic insomnia in the adult population of the United States, with an associated annual cost of more than $90 billion. Since its approval in 1982 for use in the treatment of insomnia, an estimated 11 billion prescriptions for Halcion(R) (triazolam) have been filled worldwide. Concerns about the safety of Halcion began to emerge when a Dutch psychiatrist reported a possible link between the drug and a syndrome that included depression, amnesia, hallucinations, and anxiety. Since that time, the United Kingdom, Brazil, Argentina, Norway, and Denmark removed Halcion from the market, and the manufacturer, Upjohn, withdrew Halcion from the market in The Netherlands. Other countries, including the United States and Canada, modified the labeling to reduce the recommended dose and duration of treatment and to heighten awareness regarding possible side effects affecting behavior and cognition. The labeling changes raised questions regarding the hypnotic effectiveness of these lower doses of Halcion. Based on a 1996 U.S. Food and Drug Administration (FDA) task force report, the Institute of Medicine (IOM) of the National Academy of Sciences assessed the adequacy, quality, and overall confidence in the data on the effectiveness and safety of Halcion at different doses and durations, including those specified in the current product labeling. This article provides a summary of the IOM report titled “Halcion: An Independent Assessment of Safety and Efficacy Data” and a more detailed overview of the statistical analysis that led to the committee's conclusions.

Report of the Institute of Medicine Committee on the Efficacy and Safety of Halcion.

Recent estimates indicate that there is a 10% prevalence of chronic insomnia in the adult population of the United States, with an associated annual cost of $90 to $107 billion. 1 Since its approval in 1982 for use in the treatment of insomnia, an estimated 11 billion prescriptions for Halcion (triazolam) have been filled worldwide. Halcion refers to the actual product that is manufactured and marketed by the Upjohn Co (hereinafter, Upjohn), Kalamazoo, Mich. Triazolam is the generic name of the pure active ingredient in Halcion. The committee uses the term Halcion in the text when it discusses clinical trials or events involving the actual product; otherwise, the committee uses the term triazolam.