Findings Reveal Protective, Risk Factors Associated With Insomnia in Adults

Article

Over a 5-year period in a study, both insomnia protective and risk factors in adults were observed as significantly associated with the sleep disorder, offering valuable insights for prevention strategies.

Charles M. Morin, PhD, professor of psychology at Laval University

Charles M. Morin, PhD

In a recent population-based sample study, findings over the course of 5 years revealed a number of protective and risk factors, divided as predisposing or precipitating factors, that were significantly associated with insomnia in adults. As insomnia is a persistent condition with adverse health outcomes, these results provide new information that could be beneficial for preventing the onset and long-term occurrence of insomnia by targeting the specific precipitating factors and predisposing factors.1

In the survival analysis for discrete events, significant predisposing factors for insomnia included anxiety (HR, 1.037; P = .018), depression (HR, 1.082; P <.001), perceived stress (HR, 1.073; P <.001), and number of negative life events (HR, 1.478; P = .02). Also, perceived worse general health (HR, 1.606; P = .006), pain (HR, 1.475; P =.002), vulnerability to stress (HR, 1.089; P <.001), and maladaptive emotional coping (HR, 1.044; P <.001) were significant predisposing factors for insomnia.

“Insomnia is a major public health concern and one of the most prevalent health issues among adults. Identifying protective and risk factors for insomnia could help identify vulnerable populations and design public health interventions to prevent some adverse medical and mental health consequences,” lead author Charles M. Morin, PhD, professor of psychology at Laval University, and colleagues wrote.1

Presented at the 2023 SLEEP Annual Meeting, held June 3 to 7, in Indianapolis, Indiana, Morin and colleagues enrolled 3413 participants from a large epidemiological cohort study performed in Canada before the COVID-19 pandemic on the natural course of insomnia. The insomnia factors and potential insomnia factors were measured annually over the span of 5 years. The protective and risk factors were measured through questionnaires: Insomnia Severity Index, Pittsburgh Sleep Quality Index, State-Trait Anxiety Inventory, Beck Depression Inventory, Perceived Stress Scale, Coping Inventory for Stressful Situations, Ford Insomnia Response to Stress Test, Arousal Predisposition Scale, and Life Experiences Survey.

The variables identified as precipitating factors that were significant associated with insomnia included loss of income (HR, 1.346; P = .03), increased anxiety (HR, 1.070; P <.001), depression (HR, 1.119; P <.001), and perceived stress (HR, 1.083; P = .001), decline in perceived general health (HR, 2.061; P = .006), and increased pain (HR, 1.353; P = .013). Although these precipitating factors were significant, physical activity did not show significance as a protective factor for insomnia (P = .54).

In similar research, Morin and colleagues previously summarized the epidemiological evidence on insomnia, including prevalence, incidence, and risk factors, as well as its course and adverse health outcomes associated with it. According to the summary, approximately 10% of adults have a diagnosis of insomnia, and another 20% experiences occasional symptoms of insomnia. Notably over a 5-year period, insomnia had a 40% persistence rate in patients. All noted that the populations that are more vulnerable to insomnia are women, older adults, and people with socioeconomic hardship. The authors also noted that the condition poses a significant public health issue that should be addressed at the individual level and population level with appropriate clinical care and large-scale sleep health interventions.

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REFERENCES
1. Morin CM, Vézina-Im LA, Ivers H, LeBlanc M, Savard J. Protective and Risk Factors for Insomnia Over 5 Years in a Population-Based Sample of Adults. Presented at: 2023 SLEEP Annual Meeting; June 3-7; Indianapolis, Indiana. Abstract 0324.
2. Morin CM, Jarrin DC. Epidemiology of Insomnia: Prevalence, Course, Risk Factors, and Public Health Burden. Sleep Med Clin. 2022;17(2):173-191. doi:10.1016/j.jsmc.2022.03.003
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