Health, Social, and Lifestyle Factors Related to Combined Alcohol and Sleep Problems: Investigating Risks of Chronic Pain, Welfare Benefits, Divorce, Smoking, and Low Physical Activity in Relation to Alcohol and Sleep Problems

The purpose of the study was to uncover whether there are increased risks associated to having combined alcohol and sleep problems in association to health, social, and lifestyle factors. This in comparison to having either alcohol and sleep problems, as opposed to having neither alcohol nor sleep problems. This study investigates potential risks in association to chronic pain, reception of welfare benefits, divorce, smoking, and physical activity. This was investigated by using data collected from the sixth Tromsø study, Tromsø 6. Results show that combined alcohol and sleep problems are associated to risks in chronic pain, welfare benefits, and smoking among men, and only smoking among women. For the same factors it seems that sleep is the decisive factor among women. This study has recognised some associations in combined problems and other factors, future studies are needed to decide the causality of the associations

The Utilization of Health Services and Self-Care by Older Women With Sleeping Problems: Results From a Nationally Representative Sample of 9,110 Women.

OBJECTIVE: This research aims to investigate the health service use-including complementary and alternative medicine (CAM)-and self-care by women aged 62 to 67 with sleeping problems. METHOD: In total, 9,110 participants (99.6%) responded to questions about sleeping problems, health service utilization and self-care (e.g., herbal medicines and vitamins), demographics, and chronic illnesses. RESULTS: In all, 48.2% ( n = 4,394) women indicated that they had a sleeping problem. Women with sleeping problems consulted a general practitioner (GP) more frequently (odds ratio [OR] = 1.72; 95% confidence interval [CI] = [1.36, 2.17]; p < .005) and were more likely to be using herbal medicines (OR = 1.24; 95% CI = [1.13, 1.36]; p < .005) than women without sleeping problems. DISCUSSION: Health professionals, particularly GPs, may need to actively inquire with older patients in their care with sleeping problems about the use of herbal medicines, to ensure their sleeping problems are being directly and effectively treated, particularly in light of increased risks associated with sleeping problems for this age cohort

The Epidemiology of Insomnia and Sleep Duration Across Mental and Physical Health: The SHoT Study

Objective: Numerous epidemiological studies have been conducted to examine the prevalence and comorbidities of insomnia and document sleep duration, but a common limitation in many studies is the lack of use of agreed-upon definitions of insomnia, as well as insufficient statistical power to examine comorbid mental and physical disorders/conditions. Aim: To examine the prevalence of insomnia operationalized according to formal DSM-5 criteria and differences in mean sleep duration across a wide range of mental and physical disorders, examining men and women separately. Materials and Methods: Data stem from the SHoT study (Students’ Health and Wellbeing Study), a national survey of all college and university students in Norway. In all, 162,512 students aged 18–35 received an invitation to participate, of whom 50,054 students completed the internet-based survey (attendance rate: 30.8%). Insomnia was defined according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria and sleep duration was calculated separately for weekdays and weekends. Self-reported mental and physical disorders/conditions were assessed using a pre-defined list modified to fit this age group. Pearson chi-squared tests were used to examine the prevalence of insomnia across the various mental and physical disorders/conditions in men and women separately, and log-link binomial regression analysis were used to calculate effect-sizes, adjusting for age. Results: The prevalence of insomnia in both sexes was significantly higher across all mental disorders compared with a healthy reference group. Among females, the prevalence of insomnia ranged from 61.3% for comorbid depression (adj. RR = 2.49, 95% CI: 2.40) to 83.3% for comorbid schizophrenia (adj. RR = 3.37, 95% CI: 2.61–4.35). For males, the insomnia prevalence ranged from 32.3% for comorbid autism/Asperger (adj. RR = 2.02, 95% CI: 1.39–2.92) to 74.2% for comorbid eating disorder (adj. RR = 4.51, 95% CI: 3.87–5.27). The overall prevalence of insomnia was also significantly higher across most physical conditions compared with the healthy reference group, although generally lower compared to the mental disorders. For females, the insomnia prevalence ranged from 25% for comorbid multiple sclerosis (not significant) to 65.4% for comorbid chronic fatigue syndrome/ME (adj. RR = 2.66, 95% CI: 2.44–2.89). For males, the insomnia prevalence ranged from 20% for both comorbid cancer and diabetes (not significant) to 74.2% for comorbid fibromyalgia (adj. RR = 4.35, 95% CI: 2.96–6.39). Similar patterns were observed for sleep duration, with a significantly shorter sleep duration for across many physical disorders, but especially mental disorders. Conclusion: Insomnia and short sleep duration are strongly associated with a range of different disorders and conditions. Insomnia is most strongly associated with mental disorders, and physical conditions characterized by some level of psychological or psychosomatic properties.publishedVersio

Anxiety and Depression Symptom Level and Psychotherapy Use among Music and Art Students Compared to the General Student Population

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Insomnia – A Heterogenic Disorder Often Comorbid With Psychological and Somatic Disorders and Diseases: A Narrative Review With Focus on Diagnostic and Treatment Challenges

Patients with insomnia complain of problems with sleep onset or sleep maintenance or early morning awakenings, or a combination of these, despite adequate opportunity and circumstances for sleep. In addition, to fulfill the diagnostic criteria for insomnia the complaints need to be associated with negative daytime consequences. For chronic insomnia, the symptoms are required to be present at least 3 days per week for a duration of at least 3 months. Lastly, for insomnia to be defined as a disorder, the sleep complaints and daytime symptoms should not be better explained by another sleep disorder. This criterion represents a diagnostic challenge, since patients suffering from other sleep disorders often complain of insomnia symptoms. For instance, insomnia symptoms are common in e.g., obstructive sleep apnea and circadian rhythm sleep-wake disorders. It may sometimes be difficult to disentangle whether the patient suffers from insomnia disorder or whether the insomnia symptoms are purely due to another sleep disorder. Furthermore, insomnia disorder may be comorbid with other sleep disorders in some patients, e.g., comorbid insomnia and sleep apnea (COMISA). In addition, insomnia disorder is often comorbid with psychological or somatic disorders and diseases. Thus, a thorough assessment is necessary for correct diagnostics. For chronic insomnia disorder, treatment-of-choice is cognitive behavioral therapy, and such treatment is also effective when the insomnia disorder appears comorbid with other diagnoses. Furthermore, studies suggest that insomnia is a heterogenic disorder with many different phenotypes or subtypes. Different insomnia subtypes may respond differently to treatment, but more research on this issue is warranted. Also, the role of comorbidity on treatment outcome is understudied. This review is part of a Research Topic on insomnia launched by Frontiers and focuses on diagnostic and treatment challenges of the disorder. The review aims to stimulate to more research into the bidirectional associations and interactions between insomnia disorder and other sleep, psychological, and somatic disorders/diseases.publishedVersio

Insomnia Symptoms, Sleep Duration, and Disability Pensions: a Prospective Study of Swedish Workers.

BACKGROUND: Previous studies have found insomnia and long sleep duration to be independently associated with subsequent disability pension (DP). However, the issue of a possible gender-based pattern in this context has received little attention. PURPOSE: This study aims to assess the impact of insomnia symptoms and sleep duration on the DP rates among Swedish women and men during a 12-year follow-up period. METHOD: The participants, from the general population of Malmö, Sweden, were enrolled from 1992 to 1994 (n = 4,319; participation rate 41 %), aged 45-64, healthy, and employed ≥30 h per week. Baseline inquiry data concerning psychosocial circumstances and self-reported sleep habits were compared with official register-based DP rates. RESULTS: Five hundred and nine persons were granted a DP. Insomnia symptoms, affirmed by 33 % of the men and 41 % of the women, were associated with receiving a DP; the hazard ratios in the fully adjusted model were 1.4 for both men [95 % confidence interval (CI) 1.1, 1.9] and women (95 % CI 1.1, 1.7). The fully adjusted hazard ratio for women sleeping ≥9 h was 7.8 (95 % CI 3.7, 16.6) for DP due to a mental disorder. In the age-adjusted analyses, the sub-domain "difficulties falling asleep" was related to DP due to mental disorders in men and DP due to cardiovascular diseases in women. CONCLUSION: The findings suggest that preventing and treating insomnia symptoms could reduce DP and that disease mechanisms linking sleep disturbances to DP may differ by gender

The Course and Impact of Post-Stroke Insomnia in Stroke Survivors aged 18 to 65 years: results from the Psychosocial Outcomes in StrokE (POISE) study

BACKGROUND: Insomnia symptoms are common in the population and have negative psychosocial and functional sequelae. There are no prospective studies of the course of such symptoms and their impact, if any, in stroke survivors. This prospective cohort study investigated insomnia after stroke in working-age adults, and evaluated its impact on psychological and functional outcomes over the subsequent year. METHODS: We prospectively recruited 441 young (<65 years) consecutive stroke survivors from 20 public hospitals in the New South Wales Stroke Service network. Participants were assessed by self-report and interview at 28 days, six months and 12 months after stroke. Insomnia was defined using a common epidemiological measure of sleep disturbance and daytime consequences. Depression, anxiety, disability and return to work were assessed through standardized measures. RESULTS The point prevalence of insomnia at each time point in the year after stroke was stable at 30-37% and more common in females. 58 (16%) of all participants reported 'chronic' insomnia, with symptoms at both baseline and six months later. At 12 months this group was more likely to be depressed (OR 6.75, 95% CI 2.78-16.4), anxious (OR 3.31, 95% CI 1.54- 7.09), disabled (OR 3.60, 95% CI 2.07-6.25) and not have returned to work, compared to those without insomnia over the same period. CONCLUSIONS Chronic insomnia has a negative effect on disability and return to work one year after stroke even after adjusting for demographic, psychiatric and disability factors. Identifying and appropriately targeting insomnia through known effective treatments may improve functional outcomes after stroke

Poor sleep predicts symptoms of depression and disability retirement due to depression

BACKGROUND: Disturbed sleep is associated with mood disorders. Both depression and insomnia may increase the risk of disability retirement. The longitudinal links among insomnia, depression and work incapacity are poorly known. METHODS: We examined association of self-reported sleep quality with incident symptoms of depression and disability retirement due to depressive disorders in a longitudinal population-based sample of twins (n=12,063 individuals). These adults were categorized by their sleep quality in 1975 and 1981, excluding individuals with depressed mood in 1975/1981. The outcomes were the Beck Depression Inventory (BDItot) and its subscale Negative Attitudes Towards Self (BDINATS) in 1990 as dichotomized measures, and the incidence of disability retirement due to depressive disorder during 1991-2004. RESULTS: Onset of poor sleep between 1975 and 1981 predicted incident depression (BDItot OR=4.5, 95% CI: 2.7-7.4, BDINATS OR=2.0, 95% CI: 1.4-2.7), while persistent poor sleep showed somewhat weaker effects (BDItot; OR=2.5, 95% CI: 1.0-6.0, BDINATS OR=1.9, 95% CI: 1.1-3.3). Among those with few recent stressful life events, onset of poor sleep predicted strongly depression (BDINATS OR=9.5, 95% CI: 3.7-24.2). Likewise onset of poor sleep by 1981 increased the risk of disability retirement due to depression (OR=2.9, 95% CI: 1.8-4.9) with a similar risk among those with persistent poor sleep (OR=2.7, 95% CI: 1.3-5.7). LIMITATIONS: Lack of baseline diagnostic interviews; sleep quality based on self-report. CONCLUSIONS: Poor sleep is of importance in etiology of depression and disability retirement due to depression. This emphasizes the importance of early detection and treatment of sleep disturbances.Peer reviewe