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[Prevalence of insomnia in adults aged 18 to 60 years and exposure to electromagnetic fields in households of Barranquilla, Colombia]
Abstract
Introduction:
Insomnia, a sleep disorder that affects both individual and public health, has not been studied in Barranquilla. Prior studies about the effects of exposure to electromagnetic fields on sleep disorders are controversial.
Objective:
To estimate the prevalence of insomnia symptoms in adults aged 18 to 60 years and its relation to the presence and intensity of electromagnetic fields in two neighborhoods of Barranquilla, Colombia.
Materials and methods:
A cross-sectional study was carried out in 220 households located in two neighborhoods of Barranquilla, one with high exposure to radio and cell phone antennas and the other one with low exposure. After informed consent, a survey was applied among adults residing in 220 households to investigate the presence of insomnia symptoms, socio-demographic data and intake of medicines. When it was allowed, electromagnetic fields were measured with teslameters in bedrooms. The database was created in Excel™ and the data analysis was done with SPSS™, version 18.
Results:
Insomnia, mainly of the mild type, was present in 74.5% of the total study population while 25.5% reported a normal sleep pattern. According to the sleeping test score we found a higher prevalence of insomnia in the neighborhood with greater exposure to radio antennas and cell towers (85.4%) than in the one with lower exposure (63.3%), prevalence ratio 1.34 (CI 95% 1.14-1.57).
Conclusions:
This study suggests a higher prevalence of insomnia among persons living in areas with higher exposure to electromagnetic fields where the number of radio antennas and cell towers was greater.
... Santini had showed that people living in the zone of 300 m from a base station complained significantly more often of some symptoms (till 300 m for tiredness, 200 m for headache, sleep disturbance, discomfort and 100 m for irritability, depression, loss of memory, dizziness, libido decrease). Another study on adults suggests a higher prevalence of insomnia among persons living in areas with higher exposure to electromagnetic fields where the number of radio antennas and cell towers was higher [41]. In the present study we found increased risks of visual disturbances, arrhythmia, sensitivity towards sounds, hearing difficulties in significant relation with proximity to base stations [17]. ...
Abstract Background Health outcomes of electromagnetic fields (EMF) from mobile phones and their base stations are of concern. Conducting multidisciplinary research, targeting children and exploring dose-response are recommended. Our objectives were to describe the mobile phone usage characteristics of high school students and to explore the association between mobile phone usage characteristics, high school EMF levels and self-reported symptoms. Methods This cross-sectional study’s data were collected by a survey questionnaire and by measuring school EMF levels between November 2009 and April 2011. A sample size of 2530 was calculated from a total of 20,493 students in 26 high schools and 2150 (85.0%) were included in the analysis. The frequencies of 23 symptoms were questioned and analysed according to 16 different aspects of mobile phone use and school EMF levels, exploring also dose-response. School EMF levels were measured with Aaronia Spectran HF-4060 device. Chi square and trend tests were used for univariate and logistic regression was used for multivariate analyses. Results Among participants, 2021 (94.0%) were using mobile phones and 129 (6.0%) were not. Among users, 49.4% were speaking
Sleep is a fascinating physiological process, only recently some of the mysteries about its origin, physiology and biological functions have been clarified; however, much remains to be studied. Research on sleep biology and the clinical consequences of sleep disorders has made clear that sleep is a vital process for the full health of human beings. Nevertheless, according to some studies, worldwide population tends to reduce total sleep time, which is reflected in the increasing incidence of sleep disorders. In this sense, young people are particularly prone to the development of sleep disorders, mainly due to external factors (social and environmental), and other habits that can influence the quality of sleep (alcohol, tobacco, caffeine, etc.). This article aims at providing an updated review about sleep neurobiology and related aspects of practical interest for university students, such as: the role of sleep in learning and memory processes, as well as the effects produced by several substances, commonly used in this population, on the sleep process; finally emphasizing the importance of appropriate sleep hygiene practices for human health.
Cranial electrotherapy stimulation is a prescriptive medical device that delivers a mild form of electrical stimulation to the brain for the treatment of anxiety, depression, and insomnia. It is supported by more than 40 years of research demonstrating its effectiveness in several mechanistic studies and greater than 100 clinical studies. Adverse effects are rare (<1%), mild, and self-limiting, consisting mainly of skin irritation under the electrodes and headaches. Often used as a stand-alone therapy, because results are usually seen from the first treatment, cranial electrotherapy stimulation may also be used as an adjunctive therapy.
A health survey was carried out in Murcia, Spain, in the vicinity of a Cellular Phone Base Station working in DCS‐1800 MHz. This survey contained health items related to “microwave sickness” or “RF syndrome.” The microwave power density was measured at the respondents' homes. Statistical analysis showed significant correlation between the declared severity of the symptoms and the measured power density. The separation of respondents into two different exposure groups also showed an increase of the declared severity in the group with the higher exposure.
Background
Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) remains a complex and unclear phenomenon, often characterized by the report of various, non-specific physical symptoms (NSPS) when an EMF source is present or perceived by the individual. The lack of validated criteria for defining and assessing IEI-EMF affects the quality of the relevant research, hindering not only the comparison or integration of study findings, but also the identification and management of patients by health care providers. The objective of this review was to evaluate and summarize the criteria that previous studies employed to identify IEI-EMF participants.
Methods
An extensive literature search was performed for studies published up to June 2011. We searched EMBASE, Medline, Psychinfo, Scopus and Web of Science. Additionally, citation analyses were performed for key papers, reference sections of relevant papers were searched, conference proceedings were examined and a literature database held by the Mobile Phones Research Unit of King’s College London was reviewed.
Results
Sixty-three studies were included. “Hypersensitivity to EMF” was the most frequently used descriptive term. Despite heterogeneity, the criteria predominantly used to identify IEI-EMF individuals were: 1. Self-report of being (hyper)sensitive to EMF. 2. Attribution of NSPS to at least one EMF source. 3. Absence of medical or psychiatric/psychological disorder capable of accounting for these symptoms 4. Symptoms should occur soon (up to 24 hours) after the individual perceives an exposure source or exposed area. (Hyper)sensitivity to EMF was either generalized (attribution to various EMF sources) or source-specific. Experimental studies used a larger number of criteria than those of observational design and performed more frequently a medical examination or interview as prerequisite for inclusion.
Conclusions
Considerable heterogeneity exists in the criteria used by the researchers to identify IEI-EMF, due to explicit differences in their conceptual frameworks. Further work is required to produce consensus criteria not only for research purposes but also for use in clinical practice. This could be achieved by the development of an international protocol enabling a clearly defined case definition for IEI-EMF and a validated screening tool, with active involvement of medical practitioners.
Increasing evidence suggests an association between both short and long duration of habitual sleep with adverse health outcomes.
To assess whether the population longitudinal evidence supports the presence of a relationship between duration of sleep and all-cause mortality, to investigate both short and long sleep duration and to obtain an estimate of the risk.
We performed a systematic search of publications using MEDLINE (1966-2009), EMBASE (from 1980), the Cochrane Library, and manual searches without language restrictions. We included studies if they were prospective, had follow-up >3 years, had duration of sleep at baseline, and all-cause mortality prospectively. We extracted relative risks (RR) and 95% confidence intervals (CI) and pooled them using a random effect model. We carried out sensitivity analyses and assessed heterogeneity and publication bias.
Overall, the 16 studies analyzed provided 27 independent cohort samples. They included 1,382,999 male and female participants (followup range 4 to 25 years), and 112,566 deaths. Sleep duration was assessed by questionnaire and outcome through death certification. In the pooled analysis, short duration of sleep was associated with a greater risk of death (RR: 1.12; 95% CI 1.06 to 1.18; P < 0.01) with no evidence of publication bias (P = 0.74) but heterogeneity between studies (P = 0.02). Long duration of sleep was also associated with a greater risk of death (1.30; [1.22 to 1.38]; P < 0.0001) with no evidence of publication bias (P = 0.18) but significant heterogeneity between studies (P < 0.0001).
Both short and long duration of sleep are significant predictors of death in prospective population studies.
There is presently an intense discussion if electromagnetic field (EMF) exposure has consequences for human health. This include exposure to structures and appliances that emit in the extremely low frequency (ELF) range of the electromagnetic spectrum, as well as emission coming from communication devices using the radiofrequency part of the spectrum. Biological effects of such exposures have been noted frequently, although the implication for specific health effects is not that clear. The basic interaction mechanism(s) between such fields and living matter is unknown. Numerous hypotheses have been suggested, although none is convincingly supported by experimental data. Various cellular components, processes, and systems can be affected by EMF exposure. Since it is unlikely that EMF can induce DNA damage directly, most studies have examined EMF effects on the cell membrane level, general and specific gene expression, and signal transduction pathways. In addition, a large number of studies have been performed regarding cell proliferation, cell cycle regulation, cell differentiation, metabolism, and various physiological characteristics of cells. Although 50/60 Hz EMF do not directly lead to genotoxic effects, it is possible that certain cellular processes altered by exposure to EMF indirectly affect the structure of DNA causing strand breaks and other chromosomal aberrations. The aim of this article is to present a hypothesis of a possible initial cellular event affected by exposure to ELF EMF, an event which is compatible with the multitude of effects observed after exposure. Based on an extensive literature review, we suggest that ELF EMF exposure is able to perform such activation by means of increasing levels of free radicals. Such a general activation is compatible with the diverse nature of observed effects. Free radicals are intermediates in natural processes like mitochondrial metabolism and are also a key feature of phagocytosis. Free radical release is inducible by ionizing radiation or phorbol ester treatment, both leading to genomic instability. EMF might be a stimulus to induce an "activated state" of the cell such as phagocytosis, which then enhances the release of free radicals, in turn leading to genotoxic events. We envisage that EMF exposure can cause both acute and chronic effects that are mediated by increased free radical levels: (1) Direct activation of, for example macrophages (or other cells) by short-term exposure to EMF leads to phagocytosis (or other cell specific responses) and consequently, free radical production. This pathway may be utilized to positively influence certain aspects of the immune response, and could be useful for specific therapeutic applications. (2) EMF-induced macrophage (cell) activation includes direct stimulation of free radical production. (3) An increase in the lifetime of free radicals by EMF leads to persistently elevated free radical concentrations. In general, reactions in which radicals are involved become more frequent, increasing the possibility of DNA damage. (4) Long-term EMF exposure leads to a chronically increased level of free radicals, subsequently causing an inhibition of the effects of the pineal gland hormone melatonin. Taken together, these EMF induced reactions could lead to a higher incidence of DNA damage and therefore, to an increased risk of tumour development. While the effects on melatonin and the extension of the lifetime of radicals can explain the link between EMF exposure and the incidence of for example leukaemia, the two additional mechanisms described here specifically for mouse macrophages, can explain the possible correlation between immune cell system stimulation and EMF exposure.
In this study, we investigated subjective and objective effects of mobile phones using a Wideband Code Division Multiple Access (W-CDMA)-like system on human sleep. Subjects were 19 volunteers. Real or sham electromagnetic field (EMF) exposures for 3 h were performed before their usual sleep time on 3 consecutive days. They were exposed to real EMF on the second or third experimental day in a double-blind design. Sleepiness and sleep insufficiency were evaluated the next morning. Polysomnograms were recorded for analyses of the sleep variables and power spectra of electroencephalograms (EEG). No significant differences were observed between the two conditions in subjective feelings. Sleep parameters including sleep stage percentages and EEG power spectra did not differ significantly between real and sham exposures. We conclude that continuous wave EMF exposure for 3 h from a W-CDMA-like system has no detectable effects on human sleep. Bioelectromagnetics. 9999:1-10, 2013. © 2013 Wiley Periodicals, Inc.
Background:
In recent years, by tremendous use of mobile phone telecommunication, a growing concern about the possible health hazards has increased greatly among public and scientists. The mobile phone exposure has been shown to have many effects upon the immune functions, stimulating hormones, mammalian brain, sperm motility and morphology, and neurological pathologies syndrome. The aim of this study was to find out the psychological and psychobiological reactions of the people who are living near mobile phone base transceiver stations (BTS) antenna, in Isfahan, Iran.
Materials and methods:
A cross-sectional study on 250 randomly selected inhabitants (133 women and 117 men) was performed in October 2012 till November 2012. The inhabitants were requested to complete a standardized questionnaire that focused on the relevant psychological and psychobiological reactions parameters. A computer program (SPSS version16.0, Chicago, IL) was used for statistical analysis using the Chi-square test with Yates correction. All the data were tested using a criterion level of p = 0.05.
Results:
The results showed that most of the symptoms such as nausea, headache, dizziness, irritability, discomfort, nervousness, depression, sleep disturbance, memory loss and lowering of libido were statistically significant in the inhabitants living near the BTS antenna (<300 m distances) compared to those living far from the BTS antenna (>300 m).
Conclusion:
It is suggested that cellular phone BTS antenna should not be sited closer than 300 m to populations to minimize exposure of neighbors.
Sleep disorders often remain undiagnosed. Untreated sleep disorders among police officers may adversely affect their health and safety and pose a risk to the public.
To quantify associations between sleep disorder risk and self-reported health, safety, and performance outcomes in police officers.
Cross-sectional and prospective cohort study of North American police officers participating in either an online or an on-site screening (n=4957) and monthly follow-up surveys (n=3545 officers representing 15,735 person-months) between July 2005 and December 2007. A total of 3693 officers in the United States and Canada participated in the online screening survey, and 1264 officers from a municipal police department and a state police department participated in the on-site survey.
Comorbid health conditions (cross-sectional); performance and safety outcomes (prospective).
Of the 4957 participants, 40.4% screened positive for at least 1 sleep disorder, most of whom had not been diagnosed previously. Of the total cohort, 1666 (33.6%) screened positive for obstructive sleep apnea, 281 (6.5%) for moderate to severe insomnia, 269 (5.4%) for shift work disorder (14.5% of those who worked the night shift). Of the 4608 participants who completed the sleepiness scale, 1312 (28.5%) reported excessive sleepiness. Of the total cohort, 1294 (26.1%) reported falling asleep while driving at least 1 time a month. Respondents who screened positive for obstructive sleep apnea or any sleep disorder had an increased prevalence of reported physical and mental health conditions, including diabetes, depression, and cardiovascular disease. An analysis of up to 2 years of monthly follow-up surveys showed that those respondents who screened positive for a sleep disorder vs those who did not had a higher rate of reporting that they had made a serious administrative error (17.9% vs 12.7%; adjusted odds ratio [OR], 1.43 [95% CI, 1.23-1.67]); of falling asleep while driving (14.4% vs 9.2%; adjusted OR, 1.51 [95% CI, 1.20-1.90]); of making an error or safety violation attributed to fatigue (23.7% vs 15.5%; adjusted OR, 1.63 [95% CI, 1.43-1.85]); and of exhibiting other adverse work-related outcomes including uncontrolled anger toward suspects (34.1% vs 28.5%; adjusted OR, 1.25 [95% CI, 1.09-1.43]), absenteeism (26.0% vs 20.9%; adjusted OR, 1.23 [95% CI, 1.08-1.40]), and falling asleep during meetings (14.1% vs 7.0%; adjusted OR, 1.95 [95% CI, 1.52-2.52]).
Among a group of North American police officers, sleep disorders were common and were significantly associated with increased risk of self-reported adverse health, performance, and safety outcomes.
Previous studies have observed increases in electroencephalographic power during sleep in the spindle frequency range (approximately 11-15 Hz) after exposure to mobile phone-like radio frequency electromagnetic fields (RF EMF). Results also suggest that pulse modulation of the signal is crucial to induce these effects. Nevertheless, it remains unclear which specific elements of the field are responsible for the observed changes. We investigated whether pulse-modulation frequency components in the range of sleep spindles may be involved in mediating these effects. Thirty young healthy men were exposed, at weekly intervals, to three different conditions for 30 min directly prior to an 8-h sleep period. Exposure consisted of a 900-MHz RF EMF, pulse modulated at 14 Hz or 217 Hz, and a sham control condition. Both active conditions had a peak spatial specific absorption rate of 2 W kg(-1) . During exposure subjects performed three different cognitive tasks (measuring attention, reaction speed and working memory), which were presented in a fixed order. Electroencephalographic power in the spindle frequency range was increased during non-rapid eye movement sleep (2nd episode) following the 14-Hz pulse-modulated condition. A similar but non-significant increase was also observed following the 217-Hz pulse-modulated condition. Importantly, this exposure-induced effect showed considerable individual variability. Regarding cognitive performance, no clear exposure-related effects were seen. Consistent with previous findings, our results provide further evidence that pulse-modulated RF EMF alter brain physiology, although the time-course of the effect remains variable across studies. Additionally, we demonstrated that modulation frequency components within a physiological range may be sufficient to induce these effects.
The goals of this study were to estimate the prevalence of insomnia symptomatology and diagnoses in the Spanish general population and to determine if certain sleep parameters were related to specific insomnia symptoms.
This is a cross-sectional telephone survey performed in the general population of Spain using a representative sample of 4065 individuals aged 15years or older. The participation rate was 87.5%. Interviews were conducted using the Sleep-EVAL system. The questions were related to sociodemographic characteristics, sleep-wake schedule, events occurring during sleep, insomnia symptoms, daytime consequences and DSM-IV diagnoses of sleep disorders.
Overall, 20.8% (95% C.I. 19.6-22.1%) of the sample reported at least one insomnia symptom occurring at least three nights/week. The prevalence was higher in women than in men (23.9% vs. 17.6%) and increased with age. Difficulty maintaining sleep at least three nights/week was the most prevalent symptom. DSM-IV insomnia disorder diagnoses were found in 6.4% (95% C.I. 5.6-7.1%) of the sample. Delayed bedtime and wake-up time, irregular bedtime hours and hypnagogic hallucinations were the most frequent in participants who had difficulty initiating sleep. Perception of light and "too short" sleep were the most frequent in participants who had early morning awakenings. Participants who had a non-restorative sleep were more likely to extend sleep on days off than other insomnia participants. Medical consultations in the previous year were more frequent in insomnia participants compared to participants without insomnia. One-fifth of insomnia participants were using sleep-promoting medication.
Insomnia is frequent in Spain, affecting up to one in five individuals. Results show that insomnia is multidimensional and needs to be assessed as such.
Although the epidemiology of insomnia in the general population has received considerable attention in the past 20 years, few studies have investigated the prevalence of insomnia using operational definitions such as those set forth in the ICSD and DSM-IV, specifying what proportion of respondents satisfied the criteria to reach a diagnosis of insomnia disorder.
This is a cross-sectional study involving 25,579 individuals aged 15 years and over representative of the general population of France, the United Kingdom, Germany, Italy, Portugal, Spain and Finland. The participants were interviewed on sleep habits and disorders managed by the Sleep-EVAL expert system using DSM-IV and ICSD classifications.
At the complaint level, too short sleep (20.2%), light sleep (16.6%), and global sleep dissatisfaction (8.2%) were reported by 37% of the subjects. At the symptom level (difficulty initiating or maintaining sleep and non-restorative sleep at least 3 nights per week), 34.5% of the sample reported at least one of them. At the criterion level, (symptoms+daytime consequences), 9.8% of the total sample reported having them. At the diagnostic level, 6.6% satisfied the DSM-IV requirement for positive and differential diagnosis. However, many respondents failed to meet diagnostic criteria for duration, frequency and severity in the two classifications, suggesting that multidimensional measures are needed.
A significant proportion of the population with sleep complaints do not fit into DSM-IV and ICSD classifications. Further efforts are needed to identify diagnostic criteria and dimensional measures that will lead to insomnia diagnoses and thus provide a more reliable, valid and clinically relevant classification.
Epidemiologic studies have shown that sleep duration is associated with overall mortality. We conducted a systematic review of the associations between sleep duration and all-cause and cause-specific mortality. PubMed was systematically searched up to January, 2008 to identify studies examining the association between sleep duration and mortality (both all-cause and cause-specific) among adults. Data were abstracted serially in a standardized manner by two reviewers and analyzed using random-effects meta-analysis. Twenty-three studies assessing the associations between sleep duration and mortality were identified. All examined sleep duration measured using participant self-report. Among the 16 studies which had similar reference categories and reported sufficient data on short sleep and mortality for meta-analyses, the pooled relative risk (RR) for all-cause mortality for short sleep duration was 1.10 [95% confidence interval (CI): 1.06, 1.15]. For cardiovascular-related and cancer-related mortality, the RRs associated with short sleep were 1.06 (95% CI: 0.94, 1.18) and 0.99 (95% CI: 0.88, 1.13), respectively. Similarly, among the 17 studies reporting data on long sleep duration and mortality, the pooled RRs comparing the long sleepers with medium sleepers were 1.23 (95% CI: 1.17, 1.30) for all-cause mortality, 1.38 (95% CI: 1.13, 1.69) for cardiovascular-related mortality, and 1.21 (95% CI: 1.11, 1.32) for cancer-related mortality. Our findings indicate that both short sleepers and long sleepers are at increased risk of all-cause mortality. Further research using objective measures of sleep duration is needed to fully characterize these associations.
Epidemiologists have published more than 50 studies of insomnia based on data collected in various representative community-dwelling samples or populations. These surveys provide estimates of the prevalence of insomnia according to four definitions: insomnia symptoms, insomnia symptoms with daytime consequences, sleep dissatisfaction and insomnia diagnoses. The first definition, based on insomnia criteria as defined by the DSM-IV, recognizes that about one-third of a general population presents at least one of them. The second definition shows that, when daytime consequences of insomnia are taken into account, the prevalence is between 9% and 15%. The third definition represents 8-18% of the general population. The last definition, more precise and corresponding to a decision-making diagnosis, sets the prevalence at 6% of insomnia diagnoses according to the DSM-IV classification. These four definitions of insomnia have higher prevalence rates in women than in men. The prevalence of insomnia symptoms generally increases with age, while the rates of sleep dissatisfaction and diagnoses have little variation with age. Numerous factors can initiate or maintain insomnia. Mental disorders and organic diseases are the factors that have been the most frequently studied. The association between insomnia and major depressive episodes has been constantly reported: individuals with insomnia are more likely to have a major depressive illness. Longitudinal studies have shown that the persistence of insomnia is associated with the appearance of a new depressive episode. Future epidemiological studies should focus on the natural evolution of insomnia. Epidemiological genetic links of insomnia are yet to be studied.
Population-based studies of insomnia among older people residing in communities in developing countries are rare. The objectives of this population-based study were to determine the prevalence and factors associated with insomnia among older adults (60 years and over) living in a Brazilian town with 15,000 inhabitants (Bambuí MG).
All 1742 residents in this age group were selected for a structured interview and blood tests. From these, 1516 (87.0%) participated in the study.
The prevalence of insomnia was 38.9%, being higher among women (45.3%) than among men (28.8%). The use of sleeping pills was reported by 380/1513 (25.1%) of the participants; 186 (49.0%) of these complained of insomnia, suggesting that their treatment should be reassessed. Factors independently associated with insomnia were: female sex (OR=1.78, 95% CI=1.41-2.24), dissatisfaction with free time arrangements (OR=1.88, 95% CI=1.28-2.77), self-rated health as reasonable or bad/very bad (OR=2.02, 95% CI=1.50-2.72 and OR=3.12, 95% CI=2.21-4.39, respectively), history of previous medical diagnosis of some chronic conditions (OR=1.38, 95% CI=1.10-1.73), inability to perform routine activities due to a health problem in the previous 2 weeks (OR=1.54, 95% CI=1.10-2.15), and staying in bed in the previous 2 weeks (OR=1.61, 95% CI=1.04-2.48).
The prevalence of insomnia was high, indicating that this was a public health problem for older adults living in the study community. Our results emphasize the necessity for further investigations about insomnia among older people living in small communities in Brazil and other developing countries.
To estimate the prevalence of insomnia symptoms and syndrome in the general population, describe the types of self-help treatments and consultations initiated for insomnia, and examine help-seeking determinants.
A randomly selected sample of 2001 French-speaking adults from the province of Quebec (Canada) responded to a telephone survey about sleep, insomnia, and its treatments.
Of the total sample, 25.3% were dissatisfied with their sleep, 29.9% reported insomnia symptoms, and 9.5% met criteria for an insomnia syndrome. Thirteen percent of the respondents had consulted a healthcare provider specifically for insomnia in their lifetime, with general practitioners being the most frequently consulted. Daytime fatigue (48%), psychological distress (40%), and physical discomfort (22%) were the main determinants prompting individuals with insomnia to seek treatment. Of the total sample, 15% had used at least once herbal/dietary products to facilitate sleep and 11% had used prescribed sleep medications in the year preceding the survey. Other self-help strategies employed to facilitate sleep included reading, listening to music, and relaxation.
These findings confirm the high prevalence of insomnia in the general population. While few insomnia sufferers seek professional consultations, many individuals initiate self-help treatments, particularly when daytime impairments such as fatigue become more noticeable. Improved knowledge of the determinants of help-seeking behaviors could guide the development of effective public health prevention and intervention programs to promote healthy sleep.
This study examined the relationship of psychological and health-related quality of life variables to insomnia in a population-based sample.
Data were derived from a longitudinal epidemiological study assessing the natural history of insomnia. The present results are based on the first of four postal evaluations conducted over a 2-year period. Participants (n=953) completed questionnaires assessing sleep, psychological and personality variables, and health-related factors. Participants were categorized into three sleep status subgroups using an algorithm based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and International Classification of Diseases, 10th Edition diagnostic criteria for insomnia: (1) insomnia syndrome (n=147), (2) insomnia symptoms (n=308), and (3) good sleepers (n=493).
Compared to individuals with insomnia symptoms and good sleepers, individuals with insomnia syndrome presented lower quality of life and higher scores on measures of depression, anxiety, neuroticism, extraversion, arousal predisposition, stress perception, and emotion-oriented coping. The same pattern was observed for individuals with insomnia symptoms in comparison with good sleepers. An ordinal logistic regression analysis showed that the presence of a past episode of insomnia, higher depressive symptoms, and lower scores on the 12-item Short Form Health Survey vitality and role physical subscales were the most useful variables to predict subgroups membership.
The findings indicate that insomnia is associated with increased psychological symptomatology and perceived stress, higher predisposition to arousal, and more impairment of health quality. Longitudinal follow-ups are now being conducted to assess the relative contribution of those variables in the development and natural course of insomnia.
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