Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “insomnia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1997

Risk factors for late-life insomnia in a representative general practice sample.

BACKGROUND: Insomnia is widely reported and widely treated in general practice, yet relatively little research has focused on the natural history of the condition in primary care settings. As a result, there is at present little information to enable clinicians to assess insomnia risk, or anticipate outcomes in older general practice populations. AIM: To estimate, using 8-year longitudinal data, the risk of insomnia onset associated with selected health and lifestyle factors. METHOD: Survivors from a nationally representative sample (n = 1042) of elderly people originally interviewed in 1985 were reassessed in 1989 (n = 690) and 1993 (n = 410). At the first follow up in 1989, 84 new cases of insomnia were identified (a weighted incidence rate per person per year at a risk of 3.1%; 95% CI = 2.7-3.5). In logistic regression analyses controlling for age and sex, the risk of insomnia onset was then assessed in relation to the selected factors. RESULTS: Three factors assessed in 1985 were significantly and independently related to incident insomnia: psychometric ratings consistent with depressed mood odds ratio (OR) = 4.41; 95% CI = 3.32-5.43); health index scores indicating lower physical health status (OR = 1.19; 95% CI = 1.06-1.31 per unit change in scale score); and moderate and low levels of physical activity (OR = 1.91 and 2.14; 95% CI = 1.91-3.62 and 2.14-3.64 respectively). However, although depressed mood represented a major risk factor, the most likely source of risk was physical rather than mental ill-health. CONCLUSIONS: Psychiatric, somatic and lifestyle factors significantly and independently increase the risk of insomnia in older general practice patients. In predicting incident sleep disturbance, these factors exceed in importance the age and sex of patients.

Aged↗
PubMed1997

A population study on risk factors for insomnia among adult Japanese women: a possible effect of road traffic volume.

In an effort to identify risk factors for insomnia and determine the contribution of nightime road traffic volume to insomnia in the general population, a questionnaire survey was carried out among 3,600 adult Japanese women living in eight urban residential areas. The crude prevalence rate of insomnia was 11.2%. Multivariate analysis revealed that aging, living with a child/children aged six or younger, undergoing medical treatment, experiencing major life events, having an irregular bedtime, having a sleep apnealike symptom, and living near a road with a heavy volume of traffic are risk factors for insomnia. Taking into account other risk factors, there was a level-response relationship between the nighttime traffic volume of main roads and the risk of insomnia in the subjects living in the zones 0-20 m from these roads. These results suggest that road traffic noise raises the sound level in bedrooms in such zones, and consequently the prevalence rate of insomnia among the residents, and that noise-induced insomnia is an important public health problem, at least in highly urbanized areas. To confirm this, a further study on noise exposure is needed.

Adult↗
PubMed2001

Epidemiology of severe insomnia and its consequences in Germany.

This is the first nation-wide face-to-face survey on the prevalence of well-defined severe insomnia and its impact on quality of life in the general population of Germany. The survey was part of an international epidemiological study, which was also conducted in Belgium, Great Britain, Ireland and Sweden. A representative sample of 1913 adults aged 18 years and over were interviewed in all parts of Germany according to the quota method. Subjects with symptomatic insomnia were identified using an algorithm compatible with the principal criteria for severe insomnia defined in the fourth revision of the Diagnostic and Statistical Manual of Mental Diseases (DSM-IV). Subjects provided data on quality of life using the Short Form 36 Health Survey (SF-36) questionnaire and on health care consumption. Prevalence of severe insomnia in Germany was found to be 4%, which was lower than in other European countries (6-22%). Severe insomnia was more prevalent among women, the unemployed, those living alone after divorce or separation, and those in large cities, but not more frequently in the elderly (aged 65 years and over). The majority of subjects had chronic complaints, with 74 % of them suffering from severe sleep problems for over a year's duration (average 56+/-23 months). Consultations with general physicians, medication usage, medical tests and hospitalisation were greater among severe insomniacs compared to subjects who had no sleep complaints. The question regarding overall appreciation of quality of life was rated as bad in 22% and good in 28% of severe insomniacs compared to 3% (bad) and 68 % (good) in subjects with no sleep complaints. Despite this, only 55% of severe insomniacs had ever discussed their sleep problem with a doctor and the proportion who consulted their doctor specifically regarding sleep problems in the previous 12 months was even lower (36%). The vast majority (73%) was not taking hypnotic or sedative medications. In conclusion, insomnia, even when severe, is a common and a chronic complaint in Germany. This trial suggests that while, on the one hand, sleep disorders have a significant impact on patient's quality of life and consumption of health care, it is, on the other hand, a condition that is poorly recognised and for which patients are, for unknown reasons, reluctant to seek treatment.

Adolescent↗
PubMed2026

Effectiveness of Wearable Digital Therapeutics in Improving Sleep Outcomes Among Individuals With Insomnia: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Wearable devices are increasingly used for sleep monitoring and as adjunctive treatment. Existing meta-analyses mostly pool composite digital therapies and rarely isolate stand-alone wearables or distinguish between objective and subjective end points. Whether stand-alone wearable interventions improve sleep outcomes in adults with insomnia, and which factors moderate treatment heterogeneity, remains unclear. OBJECTIVE: This study aims to evaluate the effectiveness of wearable digital interventions on sleep outcomes in adults with insomnia versus control strategies and explore moderators of effectiveness, including device-wearing position, intervention duration, and control type, using meta-regression. METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‑Analyses) 2020 statement and the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta‑Analyses Literature Search Extension) guideline. Five electronic databases and clinical trial registries were searched from inception to May 18, 2026. Eligible studies were randomized controlled trials (RCTs) evaluating wearable digital interventions in adults with insomnia compared with sham, waitlist, usual care, or active control conditions and had an intervention duration of at least 1 week. Study screening, data extraction, and risk-of-bias assessment were carried out independently by 2 reviewers. Pooled estimates were calculated using a restricted maximum likelihood random-effects model with the Hartung-Knapp-Sidik-Jonkman correction. Heterogeneity was assessed using the I² statistic, and 95% prediction intervals (PIs) were calculated for the primary analyses. The certainty of evidence was rated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. RESULTS: Sixteen RCTs (N=910) were included. Wearable digital interventions were associated with a significant reduction in objective sleep-onset latency (SOL; mean difference [MD] -4.52, 95% CI -8.38 to -0.67, PI -9.52 to 0.47 min) and a significant improvement in subjective sleep efficiency (SE; MD 2.00%, 95% CI 1.90%-2.11%, PI 1.85%-2.15%). Subjective total sleep time (TST) also showed a significant increase (MD 19.11, 95% CI 2.98-35.24, PI -16.20 to 54.43 minutes). Meta-regression showed that control type, intervention duration, and device location did not explain the heterogeneity of the insomnia severity index (ISI) (R²=0). Sensitivity analysis confirmed the robustness of pooled ISI estimates, and an Egger test indicated no small-study effects (P=.07). Certainty of evidence ranged from moderate to high. CONCLUSIONS: Wearable digital interventions provide selective benefits for objective SOL, subjective SE, and subjective TST in adults with insomnia, with no improvement in overall ISI. Despite statistically significant effects on several sleep parameters, wide PIs, substantial heterogeneity, and limited study numbers indicate preliminary, nonconclusive findings. Wearables should be viewed as affordable adjunctive tools requiring further validation, not substitutes for first-line cognitive behavioral therapy for insomnia. Large-scale, long-term RCTs with standardized protocols and patient-level external validation are required to consolidate the evidence base.

Humans↗
PubMed2001

Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial.

CONTEXT: Use of nonpharmacological behavioral therapy has been suggested for treatment of chronic primary insomnia, but well-blinded, placebo-controlled trials demonstrating effective behavioral therapy for sleep-maintenance insomnia are lacking. OBJECTIVE: To test the efficacy of a hybrid cognitive behavioral therapy (CBT) compared with both a first-generation behavioral treatment and a placebo therapy for treating primary sleep-maintenance insomnia. DESIGN AND SETTING: Randomized, double-blind, placebo-controlled clinical trial conducted at a single academic medical center, with recruitment from January 1995 to July 1997. PATIENTS: Seventy-five adults (n = 35 women; mean age, 55.3 years) with chronic primary sleep-maintenance insomnia (mean duration of symptoms, 13.6 years). INTERVENTIONS: Patients were randomly assigned to receive CBT (sleep education, stimulus control, and time-in-bed restrictions; n = 25), progressive muscle relaxation training (RT; n = 25), or a quasi-desensitization (placebo) treatment (n = 25). Outpatient treatment lasted 6 weeks, with follow-up conducted at 6 months. MAIN OUTCOME MEASURES: Objective (polysomnography) and subjective (sleep log) measures of total sleep time, middle and terminal wake time after sleep onset (WASO), and sleep efficiency; questionnaire measures of global insomnia symptoms, sleep-related self-efficacy, and mood. RESULTS: Cognitive behavioral therapy produced larger improvements across the majority of outcome measures than did RT or placebo treatment. For example, sleep logs showed that CBT-treated patients achieved an average 54% reduction in their WASO whereas RT-treated and placebo-treated patients, respectively, achieved only 16% and 12% reductions in this measure. Recipients of CBT also showed a greater normalization of sleep and subjective symptoms than did the other groups with an average sleep time of more than 6 hours, middle WASO of 26.6 minutes, and sleep efficiency of 85.1%. In contrast, RT-treated patients continued to report a middle WASO of 43.3 minutes and sleep efficiency of 78.8%. CONCLUSIONS: Our results suggest that CBT represents a viable intervention for primary sleep-maintenance insomnia. This treatment leads to clinically significant sleep improvements within 6 weeks and these improvements appear to endure through 6 months of follow-up.

Adult↗
PubMed2004

Variations in sleep hygiene practices of women with and without insomnia.

Sleep hygiene education is a basic component of behavioral treatment for chronic insomnia, yet the actual sleep hygiene practices of people with insomnia have not been well documented. In this descriptive secondary analysis, midlife women ages 41-55 years with either chronic insomnia (n = 92) or good sleep (n = 29) kept diaries of sleep perceptions and sleep hygiene practices during 6 nights of somnographic monitoring at home. In both groups few reported smoking cigarettes (<10%), most drank caffeine (>80%), and many averaged 30 min of exercise per day ( approximately 50%). Very few in either group (<10%) had regular (<30 min variation) bedtimes or getting-up times. Compared to women with good sleep, those with insomnia reported drinking less caffeine per day, being more abstinent from alcohol, and having smaller variations in day-to-day alcohol intake and bedtimes. Although some women with insomnia limit or refrain from caffeine and alcohol intake, many have not optimized behaviors believed to help prevent or modulate insomnia.

Adult↗
PubMed2005

Insomnia in men treated with radical prostatectomy for prostate cancer.

This study assessed the prevalence, clinical characteristics and risk factors for insomnia in patients treated with radical prostatectomy for prostate cancer. A total of 327 patients completed a battery of questionnaires assessing sleep and related issues (i.e. anxiety, depression, fatigue, quality of life). Results indicated that 31.5% of the patients currently reported non-specific sleep difficulties, while 18% met specific criteria for an insomnia syndrome. In most of these latter cases (95%), the insomnia was chronic (duration of 6 months or more). Nearly half of patients with an insomnia syndrome reported that the onset of their sleep difficulties followed the cancer diagnosis. A similar proportion had no comorbid clinical levels of anxiety or depression. Risk factors for the presence of an insomnia syndrome included a younger age, a worse prognosis, and the presence of intestinal, pain, depressive, and androgen blockade-related symptoms. Thus, insomnia is a frequent problem associated with prostate cancer, that often occurs independently of anxiety and depression, but seems to be influenced by the presence of physical and psychological symptoms associated with prostate cancer and its treatment.

Aged↗
PubMed1989

The Zurich Study. VII. Insomnia: symptoms, classification and prevalence.

This study describes sleep behaviour and insomnia in a representative cohort of a Swiss population. Interviews were carried out prospectively from age 20-21 to 27-28 years, starting with 292 males and 299 females. Females usually go to bed earlier and sleep 30 min longer than males. Taking into account length and periodicity of insomnia we can distinguish occasional insomnia (OI), repeated brief insomnia (RBI), and continued insomnia (CI), defined by operational criteria. The prevalence of sleep problems is stable from age 21-28, at 36%-40%. CI (prevalence 8%-10%) and RBI (13%-19%) are both medical problems in terms of treatment by professionals (10%-17%) or self-medication (7%-12%). The majority of insomniacs cope with sleep problems in various other ways. Frequency and patterns of symptoms of insomnia are described.

Adult↗
PubMed1992

Rebound insomnia and hypnotic self administration.

Twenty-one (three groups of seven), men and women, 25-50 years of age were studied to determine whether or not rebound insomnia would increase the likelihood of self administering a benzodiazepine (triazolam 0.25 mg) hypnotic. The groups compared were patients with insomnia and disturbed sleep, insomnia and normal sleep, and healthy normals. Rebound insomnia, by both subjective and polysomnographic assessment, was induced. The experience of rebound insomnia did not increase the likelihood of self administering a benzodiazepine hypnotic in any of the groups. There were clear group differences in pill self administration with normals rarely and insomnia patients frequently, but not differentially (placebo versus active drug) self administering pills.

Adult↗
PubMed2003

[Non-restorative sleep and insomnia. Diagnostic and therapeutic options for psychiatry and psychotherapy].

Over the last few years, a shift in paradigm has taken place in the diagnosis and therapy of insomnia. Traditionally, treatment focused on improving night sleep, i.e. shortening sleep latency and prolonging total sleep time. Modern approaches aim at improving or restoring the recuperative value of sleep and ensuring daytime functioning on a social, psychological and professional level. Based on the guidelines "Non-restorative Sleep" of the German Society of Sleep Research and Sleep Medicine, this article presents a clinical algorithm for the diagnosis and therapy of non-restorative sleep with predominant insomnia. The term "non-restorative sleep" permits us to view the restorative value of sleep and the resulting daytime functioning of the individual afflicted with insomnia as the focus for the diagnosis of and therapy for insomnia. This algorithm is suitable for the clinical practice of outpatient psychiatric and psychotherapeutic services as well as for psychiatric inpatients. The main features for psychiatrists and psychotherapists in the diagnosis and therapy of non-restorative sleep are underlying psychiatric-psychological factors or secondary psychiatric sequelae of chronic primary insomnias. For primary, organic and psychiatric insomnias, a broad spectrum of psychopharmacological and cognitive behavioral methods can be applied either alone or in combination.

Algorithms↗
PubMed2004

Treatment of chronic insomnia with yoga: a preliminary study with sleep-wake diaries.

There is good evidence for cognitive and physiological arousal in chronic insomnia. Accordingly, clinical trial studies of insomnia treatments aimed at reducing arousal, including relaxation and meditation, have reported positive results. Yoga is a multicomponent practice that is also known to be effective in reducing arousal, although it has not been well evaluated as a treatment for insomnia. In this preliminary study, a simple daily yoga treatment was evaluated in a chronic insomnia population consisting of sleep-onset and/or sleep-maintenance insomnia and primary or secondary insomnia. Participants maintained sleep-wake diaries during a pretreatment 2-week baseline and a subsequent 8-week intervention, in which they practiced the treatment on their own following a single in-person training session with subsequent brief in-person and telephone follow-ups. Sleep efficiency (SE), total sleep time (TST), total wake time (TWT), sleep onset latency (SOL), wake time after sleep onset (WASO), number of awakenings, and sleep quality measures were derived from sleep-wake diary entries and were averaged in 2-week intervals. For 20 participants completing the protocol, statistically significant improvements were observed in SE, TST, TWT, SOL, and WASO at end-treatment as compared with pretreatment values.

Adult↗
PubMed2004

Nasal dilator strip therapy for chronic sleep maintenance insomnia: a case series.

Sleep-disordered breathing (SDB) is a salient factor in chronic sleep maintenance insomnia. However, many insomnia patients with comorbid SDB may not be interested initially in receiving treatment with continuous positive airway pressure or oral appliance therapy. As an interim pathway, we used Breathe Right nasal dilator strip (NDS) therapy to introduce these patients to the relationship between insomnia and SDB. We hypothesized that NDS-associated improvements might motivate patients to pursue comprehensive SDB therapies. In this open label trial, three men with chronic sleep maintenance insomnia were treated with an educational session about SDB coupled with nightly NDS therapy. At 4-week follow-up, global insomnia severity, difficulty staying asleep, difficulty falling back asleep when awakened, total number of awakenings, and wake time after sleep onset systematically improved. Following NDS therapy, all three insomnia patients elected to pursue comprehensive SDB treatment at local sleep centers.

Case-Control Studies↗
PubMed1994

Insomnia in relation to depression and anxiety: epidemiologic considerations.

Epidemiologic studies show that psychopathology is a very powerful risk factor for the occurrence of insomnia. Depression and/or anxiety are quite prevalent among insomniacs, while insomnia is more than twice as prevalent in depressed than in non-depressed individuals. Moreover, recent data support a strong causal link of insomnia to both depression and anxiety. An exact cause-and-effect relationship between insomnia and psychopathology, however, has not as yet been definitively established. This is probably due to methodological differences across studies, related to design characteristics and the ways insomnia as well as various dimensions of psychopathology have been defined and detected. Thus, more refined psychometric techniques and multivariate methods of analysis should be utilized to elucidate the etiologic interface of insomnia and psychopathology.

Anxiety Disorders↗
PubMed2005

Prevalence of insomnia and its associated factors in elderly long-term care residents.

Insomnia is a significant problem that may jeopardize elderly residents' quality of life in long-term care settings. However, there are only a few studies dealing with sleeping disturbances among nursing home residents. The goal of this study was to determine the prevalence of insomnia and its associated factors in nursing home residents. A cross-sectional study (n=2332) was conducted among seniors living in long-term care facilities. The findings indicate that 144 (6.2%) participants had an insomnia disorder according to DSM-IV criteria, 17% displayed at least one symptom of insomnia, and more that half of the subjects were benzodiazepine users. According to multivariate analysis, psychological distress (adjusted odds ratio=1.51) and disruptive behaviors (adjusted odds ratio=2.10) were the only factors associated with an insomnia disorder among this population. In conclusion, insomnia is a fairly important problem, as a symptom or a syndrome, among elderly people and deserves attention from caregivers. Alternative interventions to benzodiazepine drugs, which are suited to long-term care residents while tailored to these specific care settings, should be developed.

Aged↗
PubMed2006

Interpretive biases in chronic insomnia: an investigation using a priming paradigm.

Disorder-congruent interpretations of ambiguous stimuli characterize several psychological disorders and have been implicated in their maintenance. Models of insomnia have highlighted the importance of cognitive processes, but the possibility that biased interpretations are important has been minimally investigated. Hence, a priming methodology was employed to investigate the presence of an interpretive bias in insomnia. A sample of 78 participants, differing in the presence of a diagnosis of insomnia, severity of sleep disturbance, and sleepiness, was required to read ambiguous sentences and make a lexical decision about target words that followed. Sleepiness at the time of the experiment was associated with the likelihood with which participants made insomnia and threat consistent interpretations of ambiguous sentences. The results suggest that there is a general bias towards threatening interpretations when individuals are sleepy and suggests that cognitive accounts of insomnia require revision to include a role for interpretative bias when people are sleepy. Future research is required to investigate whether this interpretive bias plays a causal role in the maintenance of insomnia.

Adolescent↗
PubMed2005

Cognitive behavior therapy for chronic insomnia occurring within the context of medical and psychiatric disorders.

Insomnia is a pervasive problem for many patients suffering from medical and psychiatric conditions. Even when the comorbid disorders are successfully treated, insomnia often fails to remit. In addition to compromising quality of life, untreated insomnia may also aggravate and complicate recovery from the comorbid disease. Cognitive behavior therapy for insomnia (CBT-I) has an established efficacy for primary insomnia, but less is known about its efficacy for insomnia occurring in the context of medical and psychiatric conditions. The purpose of this article is to present a rationale for using CBT-I in medical and psychiatric disorders, review the extant outcome literature, highlight considerations for adapting CBT-I procedures in specific populations, and suggest directions for future research. Outcome studies were identified for CBT-I in mixed medical and psychiatric conditions, cancer, chronic pain, HIV, depression, posttraumatic stress disorder, and alcoholism. Other disorders discussed include: bipolar disorder, eating disorders, generalized anxiety, and obsessive compulsive disorder. The available data demonstrate moderate to large treatment effects (Cohen's d, range=0.35-2.2) and indicate that CBT-I is a promising treatment for individuals with medical and psychiatric comorbidity. Although the literature reviewed here is limited by a paucity of randomized, controlled studies, the available data suggest that by improving sleep, CBT-I might also indirectly improve medical and psychological endpoints. This review underscores the need for future research to test the efficacy of adaptations of CBT-I to disease specific conditions and symptoms.

Chronic Disease↗
PubMed2005

Treatment of insomnia in older adults.

Insomnia outcome studies from the last 15 years show consistent success for behavioral treatment with older adults. The present review of evaluation and treatment covers the effects of aging on ability to sleep, the insomnia classification system, the treatment efficacy database, and critical outcome research methodology. Clinical trial methodology with older adults includes familiar challenges; for example, the need for placebo controls, and frequent failures to document the adequacy of treatment implementation. Recommendations for improving methodology are offered. A new review of treatment for primary insomnia in older adults shows strong improvement and consistent results for popular behavioral treatments. Older adult clinical trials show proven efficacy of behavioral treatment for primary insomnia, efficacy for secondary insomnia, and efficacy for insomnia associated with hypnotic dependency.

Aged↗
PubMedDate not supplied

Correlates and consequences of chronic insomnia.

Approximately one half of patients with insomnia have a primary psychiatric disorder such as a depression or anxiety. Insomnia is associated with increased risk of new or recurrent psychiatric disorders, increased daytime sleepiness with consequent cognitive impairment, poorer prognoses, reduced quality of life and high healthcare-related financial burden. Emerging data suggest that resolution of insomnia may improve psychiatric outcomes, which underscores the importance of vigorous treatment. Unfortunately, only a small percentage of patients receive such care. An ideal monotherapeutic strategy would treat both depression and insomnia. There are, however, only a handful of modern antidepressants that objectively improve sleep maintenance problems, and none do so without causing adverse next-day effects such as sedation. Thus, a significant number of patients must take adjunctive hypnotic medications, even though longer-term efficacy has not been established. New and emerging anti-insomnia agents may prove useful in the long-term treatment of chronic insomnia. Further research is needed to establish the benefits of such treatment.

Age Factors↗