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PubMed2001

Insomnia in men-a 10-year prospective population based study.

STUDY OBJECTIVES: to prospectively analyze changes in the prevalence of insomnia and the relationship between insomnia, aging, lifestyle, and medical disorders DESIGN: a longitudinal population survey. PARTICIPANTS: a randomly selected population sample of 2,602 men (age 30-69 years) from Uppsala in Sweden. INTERVENTION: all participants answered a questionnaire on sleep disturbances, lifestyle factors, and medical disorders in 1984 and again in 1994. MEASUREMENTS AND RESULTS: The prevalence of INSOMNIA was 10.3% in 1984 and 12.8% in 1994. No significant correlation was found between age and insomnia in any of the two time periods. Insomnia in 1994 was independently related to having insomnia in 1984 (OR=6.45), being over-weight (BMI> 27 kg/m2) (OR=1.35), physical inactivity (OR=1.42), alcohol dependence (OR=1.75), psychiatric disorders (OR=8.27) and joint/low back disorders (OR=2.95). The number of subject with reported insomnia in 1984 but not 1994 was 149. Subjects that quit smoking during the time period had an increased likeliness of remission (OR=2.70) while men who were overweight were less likely to remit (OR=0.43). CONCLUSIONS: We conclude that in men insomnia is related to lifestyle factors such as obesity, physical inactivity and alcohol dependency but not to aging. Medical disorders such as joint and low back disorders and psychiatric illnesses also increase the risk of reporting insomnia. This study demonstrates the close relationship between quality of sleep and overall health status.

Adult↗
PubMed2006

Psychological and behavioral treatment of insomnia:update of the recent evidence (1998-2004).

BACKGROUND: Recognition that psychological and behavioral factors play an important role in insomnia has led to increased interest in therapies targeting these factors. A review paper published in 1999 summarized the evidence regarding the efficacy of psychological and behavioral treatments for persistent insomnia. The present review provides an update of the evidence published since the original paper. As with the original paper, this review was conducted by a task force commissioned by the American Academy of Sleep Medicine in order to update its practice parameters on psychological and behavioral therapies for insomnia. METHODS: A systematic review was conducted on 37 treatment studies (N = 2246 subjects/patients) published between 1998 and 2004 inclusively and identified through Psyclnfo and Medline searches. Each study was systematically reviewed with a standard coding sheet and the following information was extracted: Study design, sample (number of participants, age, gender), diagnosis, type of treatments and controls, primary and secondary outcome measures, and main findings. Criteria for inclusion of a study were as follows: (a) the main sleep diagnosis was insomnia (primary or comorbid), (b) at least 1 treatment condition was psychological or behavioral in content, (c) the study design was a randomized controlled trial, a nonrandomized group design, a clinical case series or a single subject experimental design with a minimum of 10 subjects, and (d) the study included at least 1 of the following as dependent variables: sleep onset latency, number and/or duration of awakenings, total sleep time, sleep efficiency, or sleep quality. RESULTS: Psychological and behavioral therapies produced reliable changes in several sleep parameters of individuals with either primary insomnia or insomnia associated with medical and psychiatric disorders. Nine studies documented the benefits of insomnia treatment in older adults or for facilitating discontinuation of medication among chronic hypnotic users. Sleep improvements achieved with treatment were well sustained over time; however, with the exception of reduced psychological symptoms/ distress, there was limited evidence that improved sleep led to clinically meaningful changes in other indices of morbidity (e.g., daytime fatigue). Five treatments met criteria for empirically-supported psychological treatments for insomnia: Stimulus control therapy, relaxation, paradoxical intention, sleep restriction, and cognitive-behavior therapy. DISCUSSION: These updated findings provide additional evidence in support of the original review's conclusions as to the efficacy and generalizability of psychological and behavioral therapies for persistent insomnia. Nonetheless, further research is needed to develop therapies that would optimize outcomes and reduce morbidity, as would studies of treatment mechanisms, mediators, and moderators of outcomes. Effectiveness studies are also needed to validate those therapies when implemented in clinical settings (primary care), by non-sleep specialists. There is also a need to disseminate more effectively the available evidence in support of psychological and behavioral interventions to health-care practitioners working on the front line.

Adult↗
PubMedDate not supplied

Insomnia in patients with traumatic brain injury: frequency, characteristics, and risk factors.

OBJECTIVES: To document the frequency of insomnia (according to DSM-IV and ICSD criteria), to describe its sociodemographic and clinical characteristics, and to identify potential predictors of insomnia in persons with traumatic brain injury (TBI). PARTICIPANTS AND PROCEDURE: Four hundred fifty-two participants aged 16 years and older with minor to severe TBI answered a questionnaire pertaining to quality of sleep and fatigue. MAIN OUTCOME MEASURES: Proportion of participants fulfilling criteria for insomnia symptoms or syndrome. Validated measures of insomnia severity, fatigue level, and psychologic distress. Results of a logistic regression analysis. RESULTS: Overall, 50.2% of the sample reported insomnia symptoms and 29.4% fulfilled the diagnostic criteria for an insomnia syndrome. For the latter participants, insomnia was a severe and chronic condition remaining untreated in almost 60% of cases. Risk factors associated with insomnia were milder TBIs, and higher levels of fatigue, depression, and pain. CONCLUSION: Insomnia is a prevalent condition after TBI requiring more clinical and scientific attention as it may have important repercussions on rehabilitation.

Adult↗
PubMedDate not supplied

Major depression and insomnia in chronic pain.

OBJECTIVES: Insomnia and depression are common problems for people with chronic pain, and previous research has found that each is correlated with measures of pain and disability. The goal of this study was to examine the combined impact of major depression and insomnia on individuals with chronic pain. METHODS: The participants were patients with chronic musculoskeletal pain who underwent evaluation at an interdisciplinary treatment center. On the basis of semistructured interviews, participants were classified in three groups depending on whether they: (1) met criteria for major depression with insomnia (n = 38); (2) had insomnia without major depression (n = 58); or (3) had neither insomnia nor major depression (n = 47). The groups were then compared on self-report measures that included the McGill Pain Questionnaire, the Beck Depression Inventory, and the Multidimensional Pain Inventory. RESULTS: Participants with major depression and insomnia reported the most difficulty on measures of affective distress, life control, interference, and pain severity, although the insomniac patients without major depression also had elevated scores on some measures. In regression analyses, insomnia severity ratings did not contribute uniquely to the prediction of psychosocial problems when depression was controlled, but they did contribute to the prediction of pain severity. CONCLUSIONS: These results suggest that patients with chronic pain and concurrent major depression and insomnia report the highest levels of pain-related impairment, but insomnia in the absence of major depression is also associated with increased pain and distress.

Adult↗
PubMedDate not supplied

Stress exposure, psychological distress, and physiological stress activation in midlife women with insomnia.

OBJECTIVE: The objective of this study was to describe perceived and polysomnograhic (PSG) sleep patterns and determine whether stress exposure, psychological distress, and physiological stress activation differed among midlife women with psychophysiologic-type (PP-type) or subjective only-type (SO-type) insomnia or no insomnia. METHODS: Women had their sleep monitored, collected urine samples, and completed questionnaires in a week-long field study, and 53 women met criteria for insomnia types or no insomnia based on reported sleep quality and PSG sleep efficiency. RESULTS: As expected, women with PP-type insomnia were found to have the lowest sleep efficiency, took longer to fall asleep, had more wakefulness after sleep onset, and had more fragmented sleep. Perceptions of stress exposure, either for major or minor events, did not differ among groups. Despite there being no differences in perceived stress exposure, women with both types of insomnia scored higher on psychological distress (SCL-90R), especially on the somatization subscale, than women with no insomnia. Of the physiological stress activation indicators tested, a morning-to-evening difference in urinary cortisol statistically differed across the groups (p <.005). Women in the PP-type insomnia group had the highest levels of urinary cortisol in an early morning urine sample. CONCLUSIONS: These data provide support for the hypothesis that, in midlife women, cognitive or emotional arousal with chronic stress neuroendocrine activation underlies chronic insomnia, particularly the PP-type.

Body Mass Index↗
PubMed2002

Insomnia in diabetic hemodialysis patients. Prevalence and risk factors by a multicenter study.

BACKGROUND: Insomnia is one of the most common problems in dialysis patients, and likely to contribute impairment in quality of life, which has a positive correlation with patients' survival. In diabetic patients, morbidity and mortality are substantially higher than in the nondiabetic counterparts, and also the incidence of sleep disturbances. However, there is no means to predict sleep disturbance in the dialysis patients especially in diabetics. To define the prevalence and risk factors for insomnia in diabetic patients on hemodialysis, we undertook a cross-sectional multicenter study. METHODS: Eighty-two diabetic patients (50 men/32 women, aged 58.7 +/- 9.23 years) on maintenance hemodialysis for more than 6 months from 12 different hospitals were enrolled. The demographic data, subjective symptoms, depression scale, and insomnia were assessed by questionnaires, and lean body mass, BMI, Kt/V, subjective global assessment, nursing assessment score (NAS), and biochemical parameters were examined. RESULTS: The number of patients with and without insomnia were 56 and 26, respectively, which amounted to 68.2% for insomnia. NAS (28.1 +/- 3.81 vs. 30.8 +/- 2.88, p = 0.002), serum albumin concentration (3.82 +/- 0.44 vs. 4.09 +/- 0.36 g/dl, p = 0.008), and depression scale (25.2 +/- 12.1 vs. 18.9 +/- 10.3, p = 0.025) were significantly different between them. Patients with insomnia were older (60.5 +/- 9.0 vs. 56. 1 +/- 9.60 years, p = 0.053) and felt pain (38.5 vs. 15.3%, p = 0.06) more frequently than those without insomnia. The scale of depression was correlated with NAS (r = -0.455, p < 0.001) and the serum albumin concentration was correlated with NAS (r = 0.337, p = 0.002). NAS, age, and serum albumin concentration were the major risk factors for insomnia in logistic regression analysis. CONCLUSION: The prevalence of insomnia in diabetic hemodialysis patients was 68.2%. Age, nutritional status, and depression were the major risk factors for sleep disturbance in diabetic patients.

Adult↗
PubMed1991

Subtyping DSM-III-R primary insomnia: a literature review by the DSM-IV Work Group on Sleep Disorders.

OBJECTIVE: The authors review the usefulness, reliability, and validity of recently proposed subtypes of primary insomnia. DSM-III uses "primary insomnia" to indicate chronic insomnia not associated with other diagnosable mental or medical disorders, whereas the International Classification of Sleep Disorders (ICSD) recognizes three subtypes: psychophysiological insomnia, idiopathic insomnia, and sleep state misperception. METHOD: After reviewing all of the primary source references for each insomnia disorder in the ICSD and all of the additional primary sources cited in each of these, the authors conducted an automated literature search using Medline. Of the 48 primary sources located, the authors selected 27 studies that were reported in peer-reviewed journals, had the largest available subject groups, used diagnostic reliability procedures, and included control groups. RESULTS: The studies reviewed contained limited empirical support for the proposed distinction between idiopathic and psychophysiological insomnia. Sleep state misperception appears, however, to be a highly prevalent feature of chronic insomnia generally, rather than only a specific disorder per se. CONCLUSIONS: The authors conclude that there is not yet sufficient empirical evidence to warrant the abandonment of DSM-III-R "primary insomnia" and the adoption of the ICSD subtypes in DSM-IV. However, they affirm the heuristic value of the ICSD subtypes and the need for field trials to compare the performance characteristics of the DSM-III-R and ICSD systems with respect to 1) interrater reliability, 2) effects of rater expertise (generalist versus specialist) on rates of agreement, and 3) effects of polysomnographic data on rates of agreement.

Humans↗
PubMed1999

Evaluation of severe insomnia in the general population: results of a European multinational survey.

The epidemiology of severe insomnia and its effect on quality of life and healthcare consumption was assessed in a survey of the general population of five northern European countries. Applying established consumer sampling techniques, insomnia sufferers were selected from the general population using a questionnaire, conducted by face-to-face interview, and severity of insomnia was ranked (severe, mild/moderate, no sleep complaint) using a specific algorithm. Population samples were matched according to case control methodology for age, gender and geographical region. A second questionnaire gathered information on sleep problems, quality of life (SF-36 scores) and healthcare consumption. The prevalence of severe insomnia ranged from 4% to 22%, was higher in females than in males, but did not increase significantly with age. Patients with severe insomnia had been experiencing sleeping problems for a median of 2-6 years. In all countries, insomnia had a negative impact on quality of life, and the degree of impairment in quality of life was directly related to the severity of insomnia. Individuals with severe insomnia also showed a higher level of healthcare consumption. Despite this, severe insomnia did not appear to feature prominently in the doctor-patient relationship.

Adult↗
PubMed2004

Precipitating factors of insomnia.

Insomnia is a prevalent health complaint whose onset is precipitated by a variety of factors. There is an important need to identify and describe these factors to improve our understanding of risk factors and the natural history of insomnia. This article is aimed at identifying and describing the types of precipitating factors related to the onset of insomnia. A total of 345 patients evaluated for insomnia at a sleep-disorders clinic completed a sleep survey and underwent a semistructured clinical interview. As part of the evaluation, the specific precipitating events related to the onset of insomnia were identified. Subsequently, these factors were categorized (work-school, family, physical or psychological health, or indeterminate), and their affective valence (negative, positive, or indeterminate) was coded. The most common precipitating factors of insomnia were related to family, health, and work-school events. Sixty-five percent of precipitating events had a negative valence. These events differed with the age of onset of insomnia but not with the gender of participants. These findings are useful to identify potential risk factors for insomnia and improve our understanding of the natural history of insomnia.

Adolescent↗
PubMed2002

The relationship between insomnia and health-related quality of life in patients with chronic illness.

OBJECTIVES: To determine the association between insomnia and health-related quality of life (HRQOL) in patients with chronic illness after accounting for the effects of depression, anxiety, and medical comorbidities. STUDY DESIGN: We used a cross-sectional analysis of Medical Outcomes Study (MOS) data. POPULATION: The sample consisted of 3445 patients who completed a self-administered questionnaire and who were given a diagnosis of 1 or more of 5 chronic medical and psychiatric conditions by an MOS clinician. Patients were recruited from the offices of clinicians practicing family medicine, internal medicine, endocrinology, cardiology, and psychiatry in 3 US cities. OUTCOMES MEASURED: Outcomes were sleep items, health-related quality of life as measured by the Medical Outcomes Study Short Form Health Survey (SF-36), chronic medical comorbidity, depression, and anxiety. Insomnia was defined as the complaint of difficulty initiating or maintaining sleep. RESULTS: Insomnia was severe in 16% and mild in 34% of study patients. Patients with insomnia demonstrated significant global decrements in HRQOL. Differences between patients with mild insomnia versus no insomnia showed small to medium decrements across SF-36 subscales ranging from 4.1 to 9.3 points (on a scale of 0 to 100); the corresponding decrements for severe insomnia (versus no insomnia) ranged from 12.0 to 23.9 points. CONCLUSIONS: Insomnia is independently associated with worsened HRQOL to almost the same extent as chronic conditions such as congestive heart failure and clinical depression.

Adult↗
PubMed2002

NREM sleep EEG frequency spectral correlates of sleep complaints in primary insomnia subtypes.

STUDY OBJECTIVES: To determine whether the frequency spectrum of the sleep EEG is a physiologic correlate of 1) the degree to which individuals with persistent primary insomnia (PPI) underestimate their sleep time compared with the traditionally scored polysomnogram (PSG) and 2) the sleep complaints in PPI subjects who have relatively long traditionally scored PSG sleep times and relatively greater underestimation of sleep time. DESIGN: We compared EEG frequency spectra from REM and NREM sleep in PPI subjects subtyped as subjective insomnia sufferers (those with relatively long total sleep time and relative underestimation of sleep time compared with PSG), and objective insomnia sufferers (those with relatively short PSG total sleep time) with EEG frequency spectra in normals. We also studied the correlation between these indices and the degree of underestimation of sleep. Further, we determined the degree to which sleep EEG indexes related to sleep complaints. SETTING: Duke University Medical Center Sleep Laboratory. PARTICIPANTS: Normal (N=20), subjective insomnia (N=12), and objective insomnia (N=18) subjects. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Lower delta and greater alpha, sigma, and beta NREM EEG activity were found in the patients with subjective insomnia but not those with objective insomnia, compared with the normal subjects. These results were robust to changes in the subtyping criteria. No effects were found for REM spectral indexes. Less delta non- REM EEG activity predicted greater deviation between subjective and PSG estimates of sleep time across all subjects. For the subjective insomnia subjects, diminished low-frequency and elevated higher frequency non- REM EEG activity was associated with their sleep complaints. CONCLUSIONS: NREM EEG frequency spectral indexes appear to be physiologic correlates of sleep complaints in patients with subjective insomnia and may reflect heightened arousal during sleep.

Adult↗
PubMed2004

Clinical and socioeconomic correlates of insomnia.

Insomnia is characterized by difficulty falling asleep (sleep onset disturbance), difficulty staying asleep (sleep maintenance disturbance), or poor quality (nonrestorative) sleep, leading to impairment of next-day functioning, including psychological distress. Published prevalence estimates of insomnia vary considerably, very likely due to differences in definitions, study setting, and data collection methods. However, estimates based on large population-based surveys provide a rather constant prevalence rate for chronic insomnia in the United States of about 10% (approximately 25 million people). Chronic insomnia is associated with numerous physical and psychiatric conditions and is more common in women and the elderly. Although it is often perceived as a symptom of depression, insomnia is also a precursor of depression and is associated with a substantial increase in the relative risk of major depression. Chronic insomnia is correlated with impaired mood, subjective functioning, and quality of life and, in some cases, with increased daytime sleepiness and accident risk. Those reporting insomnia have higher rates of absenteeism and health care utilization. Direct costs of insomnia have been estimated to be $13.9 billion annually, with a large majority of costs attributable to nursing home care. Chronic insomnia is a common problem, often associated with negative waking mood or function. As such, heightened clinical attention and clinical research appear warranted.

Adolescent↗
PubMed2005

Insomnia.

OBJECTIVES: This article estimates the prevalence of insomnia among Canadians aged 15 or older, and factors related to it. Associations between insomnia and coping ability, work status, two-week disability days and life dissatisfaction are analyzed. DATA SOURCES: The data are from the 2002 Canadian Community Health Survey: Mental Health and Well-being. ANALYTICAL TECHNIQUES: Cross-tabulations were used to estimate the prevalence of insomnia by selected characteristics. Associations between these characteristics and insomnia, and between insomnia and selected negative situations, were examined in multivariate logistic regression models. MAIN RESULTS: In 2002, an estimated 3.3 million Canadians (13.4% of the household population aged 15 or older) had insomnia. Factors independently associated with insomnia included painful chronic conditions, activity limitations, mood and anxiety disorders, life stress, frequent use of alcohol or cannabis, obesity, and low education. Compared with those who did not have insomnia, people with insomnia were more likely to report negataive situations such as difficulty coping and not having a job.

Adaptation, Psychological↗
PubMed2006

[Monthly distribution of insomnia patients' birth].

OBJECTIVE: To investigate whether the monthly distribution of birth is associated with insomnia. METHODS: The monthly distribution of birth of 1020 consequent patients with insomnia who visited the Third Hospital of Peking University, 439 males and 581 females, aged 54 (22 - 86), was investigated and compared with that of 13254 cases of healthy newborn children born in the same hospital 1994 - 2004. RESULTS: 114 of the 1020 patients with insomnia were been born in January (11.2%), 90 in February (8.85%), 65 in March (6.4%), 67 in April (6.6%), 56 in May (5.5%), 56 in June (5.5%), 66 in July (6.5%), 78 in August (7.6%), 64 in September (6.3%), 91 in October (8.9%), 126 in November (12.4%), and 147 in December (14.4%). The structural ratio of the number of insomnia patients was the highest for those who were born in the months November, December, and January, and was the lowest for those who were born in May, June, and July. The number of insomnia patients who were born in the wintery months, November, December, and January, was 387 (37.9%), much more than those who were born in the May, June, and July (178 cases, 17.4%). The structural ratios of the insomnia patients who were born in different months were not significantly different between the 2 sexes (chi(2) = 12.769, P > 0.05). There was no significant differences in the structural ratios of the number of healthy newborn children who were born in different months. However, the monthly distribution of birth of the patients was statistically significantly different between the patients with insomnia and the healthy newborn children (chi(2) = 75.098, P < 0.01). CONCLUSION: Month of birth is associated with insomnia. Those born in November, December, and January are more susceptible to insomnia.

Adult↗
PubMedDate not supplied

[Pharmacological treatment of insomnia].

Sleep disturbances of insomnia type belong to the most common health problems of the modern society. Chronic insomnia, one that worsens daytime functioning and lasts over one month, occurs in 9 to 15% of the general population of developed countries. Further 15-20% of the population suffers from short term insomnia. When approaching a patient with insomnia, the physician should firstly regard sleep disturbances as a symptom related to other medical conditions. The most common causes of chronic insomnia include psychiatric disorders, addictions, somatic disorders and poor sleep habits. For successful treatment of insomnia it is most important to diagnose the cause of sleep problems properly. Such management of sleep disturbances allows treating insomnia causally. The symptomatic treatment of insomnia includes sleep hygiene and intermittent administration of sleep promoting drugs such as benzodiazepines, non-benzodiazepine hypnotics of second generation, antidepressants, antipsychotics, antihistaminics or herbal and over the counter agents. This article reviews the sleep promoting drugs and substances that can be used for treatment of chronic insomnia.

Anti-Anxiety Agents↗
PubMed2006

Practice parameters for the psychological and behavioral treatment of insomnia: an update. An american academy of sleep medicine report.

Insomnia is highly prevalent, has associated daytime consequences which impair job performance and quality of life, and is associated with increased risk of comorbidities including depression. These practice parameters provide recommendations regarding behavioral and psychological treatment approaches, which are often effective in primary and secondary insomnia. These recommendations replace or modify those published in the 1999 practice parameter paper produced by the American Sleep Disorders Association. A Task Force of content experts was appointed by the American Academy of Sleep Medicine to perform a comprehensive review of the scientific literature since 1999 and to grade the evidence regarding non-pharmacological treatments of insomnia. Recommendations were developed based on this review using evidence-based methods. These recommendations were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. Psychological and behavioral interventions are effective in the treatment of both chronic primary insomnia (Standard) and secondary insomnia (Guideline). Stimulus control therapy, relaxation training, and cognitive behavior therapy are individually effective therapies in the treatment of chronic insomnia (Standard) and sleep restriction therapy, multicomponent therapy (without cognitive therapy), biofeedback and paradoxical intention are individually effective therapies in the treatment of chronic insomnia (Guideline). There was insufficient evidence to recommend sleep hygiene education, imagery training and cognitive therapy as single therapies or when added to other specific approaches. Psychological and behavioral interventions are effective in the treatment of insomnia in older adults and in the treatment of insomnia among chronic hypnotic users (Standard).

Adult↗
PubMed2004

Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison.

BACKGROUND: Chronic sleep-onset insomnia is a prevalent health complaint in adults. Although behavioral and pharmacological therapies have been shown to be effective for insomnia, no placebo-controlled trials have evaluated their separate and combined effects for sleep-onset insomnia. The objective of this study was to evaluate the clinical efficacy of behavioral and pharmacological therapy, singly and in combination, for chronic sleep-onset insomnia. METHODS: This was a randomized, placebo-controlled clinical trial that involved 63 young and middle-aged adults with chronic sleep-onset insomnia. Interventions included cognitive behavior therapy (CBT), pharmacotherapy, or combination therapy compared with placebo. The main outcome measures were sleep-onset latency as measured by sleep diaries; secondary measures included sleep diary measures of sleep efficiency and total sleep time, objective measures of sleep variables (Nightcap sleep monitor recorder), and measures of daytime functioning. RESULTS: In most measures, CBT was the most sleep effective intervention; it produced the greatest changes in sleep-onset latency and sleep efficiency, yielded the largest number of normal sleepers after treatment, and maintained therapeutic gains at long-term follow-up. The combined treatment provided no advantage over CBT alone, whereas pharmacotherapy produced only moderate improvements during drug administration and returned measures toward baseline after drug use discontinuation. CONCLUSIONS: These findings suggest that young and middle-age patients with sleep-onset insomnia can derive significantly greater benefit from CBT than pharmacotherapy and that CBT should be considered a first-line intervention for chronic insomnia. Increased recognition of the efficacy of CBT and more widespread recommendations for its use could improve the quality of life of a large numbers of patients with insomnia.

Adult↗
PubMed2006

Insomnia, trouble sleeping, and complementary and alternative medicine: Analysis of the 2002 national health interview survey data.

BACKGROUND: Insomnia and other disorders that result in trouble sleeping are common in the United States and are often associated with chronic health conditions. Some individuals with insomnia or trouble sleeping use complementary and alternative medicine (CAM) therapies to treat their condition, but the prevalence of such use and the most common types of CAM therapies selected are not known. METHODS: Prevalence of insomnia or trouble sleeping and of CAM use for treating such conditions was examined using the 2002 National Health Interview Survey. Logistic regression was used to examine associations between insomnia or trouble sleeping, comorbid conditions, and use of CAM treatments. RESULTS: The 12-month prevalence rate of insomnia or trouble sleeping was 17.4%. There was a strong positive association between adults who reported having insomnia or trouble sleeping and adults who reported 4 of 5 common conditions: obesity (adjusted odds ratio [OR], 1.15; 99% confidence interval [CI], 1.01-1.31), hypertension (OR, 1.32; 99% CI, 1.16-1.51), congestive heart failure (OR, 2.24; 99% CI, 1.60-3.14), and anxiety or depression (OR, 5.64; 99% CI, 5.07-6.29). Of those with insomnia or trouble sleeping, 4.5% used some form of CAM therapy to treat their condition. CONCLUSIONS: According to the National Health Interview Survey analysis, over 1.6 million civilian, noninstitutionalized adult US citizens use CAM to treat insomnia or trouble sleeping. The details of this analysis will serve as a guide for future research on CAM therapies for sleep disorders.

Adolescent↗