Association between report of insomnia and daytime functioning

doi:10.1016/j.sleep.2009.07.009

Sleep Medicine

Volume 11, Issue 1, January 2010, Pages 65-68

https://doi.org/10.1016/j.sleep.2009.07.009 Get rights and content

Abstract

Objectives

The relationship between reports of insomnia and daytime functioning was investigated using hierarchical regression. The presence or absence of a report of insomnia was the predictor of primary interest. A number of covariates were included in the model: demographic variables, health variables, and quantitative sleep parameters.

Methods

Data were collected from a community sample in the Memphis, Tennessee area. Data from 734 volunteers, ranging in age from 20 to 96 years were analyzed. The sample included 235 individuals who reported having chronic insomnia and 499 individuals who reported no sleep problems. Participants completed a 2-week sleep diary, a battery of daytime functioning questionnaires, and a medical disorders checklist. Demographic information was also collected. The daytime functioning assessment included the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Epworth Sleepiness Scale, the Insomnia Impact Scale, and the Fatigue Severity Scale. The hierarchical regression model included four sets. The first three sets consisted of 18 variables capturing demographic, health, and sleep diary parameters. The fourth set included a single dichotomous variable representing the presence or absence of a report of insomnia.

Results

Reports of insomnia were a significant predictor of all five daytime functioning measures, which is consistent with previous research. We also showed that reports of insomnia were able to uniquely explain a significant amount of variability in self-reported daytime functioning after controlling for demographics, health, and sleep diary variables. The pattern of individual variables that reached significance in the first three sets varied depending on which daytime functioning measure was predicted, however, age, the presence of pain, the presence of mental health problems, SOL, and WASO were the most commonly significant predictors of poor daytime functioning from these sets across measures.

Conclusions

Individuals’ perceptions of their sleep are related to differences in their reported daytime functioning, which are not accounted for by demographic factors, health surveys, or quantitative sleep assessments. Reports of insomnia may be related to a set of common cognitive factors among individuals who report having insomnia which cause them to be distressed with their sleep and increase their dissatisfaction with daytime functioning. Relevance of the findings to insomnia research and clinical management are discussed.

Section snippets

Objective

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV) [1] and the International Classification of Sleep Disorders: Diagnostic and Coding Manual (ICSD) [2] define insomnia as persistent difficulty initiating or maintaining sleep, which is associated with daytime functioning deficits. Furthermore, an individual must perceive his/her sleep as impaired and report insomnia to be diagnosed. It is unclear, however, how sleep disruption and daytime

Participants and procedures

The analyses were conducted using archival data from an epidemiological survey of sleep and daytime functioning collected in Shelby County in the Memphis, Tennessee area between the years 1997 and 1999. The current study was supported by the Institutional Review Board of the University of Alabama. Random digit dialing was used to recruit 772 participants with equal representation in each age decade from 20–29 years to 89+ years. Participants were recruited until data from 50 men and women in each

Sample demographics

Data from 734 individuals were analyzed. The gender distribution was 48.6% male and 51.4% female with 97 males and 138 females who reported insomnia and 260 males and 239 females who reported no sleep problems. A χ² test revealed that females were significantly more likely to report insomnia, χ² (1) = 7.50, p = .006. The age representation ranged from 20 to 96 years of age with a mean of 53.8(19.9) years. The mean age for individuals reporting insomnia was 59.0(19.4) and 51.3(19.6) for those

Conclusions

Individuals who reported insomnia also reported greater daytime functioning impairment, which is consistent with previous studies [7], [8], [10], [22]. This study expands on previous research by demonstrating that the presence or absence of an insomnia report was related to daytime functioning after controlling for demographics, health status, and quantitative sleep parameters. This finding suggests that perceptions of sleep are tied to meaningful differences in reported depression, anxiety,

Acknowledgements

This research was supported by National Institute on Aging Grants AG12136 and AG14738 awarded to the second author.

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To identify factors that most saliently characterize the profile of individuals who complain of chronic insomnia, with or without quantitative sleep impairment.
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Shelby County in the Memphis, TN, area.
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Original ArticleAssociation between report of insomnia and daytime functioning

Abstract

Objectives

Methods

Results

Conclusions

Section snippets

Objective

Participants and procedures

Sample demographics

Conclusions

Acknowledgements

Sleep Med Rev

J Psychosom Res

Behav Res Ther

J Psychosom Res

Behav Res Ther

Behav Res Ther

Behav Res Ther

Psychosomatics

Behav Res Ther

How is good and poor sleep in older adults and college students related to daytime sleepiness, fatigue, and ability to concentrate?

J Psychosom Res

Daytime consequences and correlates of insomnia in the United States: results from the 1991 National Sleep Foundation Survey II

Sleep

An epidemiological study of insomnia among the Japanese general population

Sleep

Poor sleepers who do not complain of insomnia: Myths and realities about psychological and lifestyle characteristics of older good and poor sleepers

J Behav Med

Original Article
Association between report of insomnia and daytime functioning