Posted by Phillipa on May 23, 2009, at 0:12:45
Not that we didn't know this but insomnia linked to depression especially with alchohol. Phillipa
APA 2009: New NHANES Data Show 15% of Americans Meet Criteria for Insomnia
Susan Jeffrey
Read more May 19, 2009 A new analysis of the first National Health and Nutrition Examination Survey (NHANES) to ask about sleep patterns in Americans shows that insomnia is a common problem in the United States.
Dr. Tuan-Anh Ngyen
"Fifteen percent of Americans meet the definition for insomnia by [Diagnostic and Statistical Manual of Mental Disorders, 4th ed] DSM-IV criteria in the past month; that's a lot of people," lead author Tuan-Anh Nguyen, MD, from the department of psychiatry at Maricopa Integrated Health System, in Phoenix, Arizona, told Medscape Psychiatry.Women, along with those who are divorced, those who are obese, and those living in poverty, are at increased risk for sleep disturbance, they find, and insomnia is strongly linked to depression and to alcohol abuse, cigarette smoking, and the use of illicit drugs.
The new analysis was presented here at the American Psychiatric Association 162nd Annual Meeting.
National Picture of Sleep
The NHANES annual survey is carried out by the National Center for Health Statistics and uses probability sampling techniques and weighted analyses to produce national estimates of health information. For this analysis, the researchers used data from NHANES 20042005, the last survey for which data are available.
A total of 6127 participants aged 20 to 85 years took part in the 20042005 survey. Each was interviewed and underwent a standardized health examination.
"This is the first time NHANES ever had a survey about sleep patterns in the US population," Dr. Nguyen.
Overall, 15% of respondents met DSM-IV criteria for insomnia in the past month. Of those with insomnia, 16% reported initial insomnia or trouble falling asleep, 20% reported frequent wakening, 27% complained of not feeling rested in the morning, and 18% had excessive daytime sleepiness.
Some 8.6% of overall respondents reported they had taken sleeping pills often, Dr. Nguyen said. White respondents were more likely than Hispanics or African Americans to report having used sleeping pills in the past month, but there was no difference in the rates of insomnia by age or race.
In terms of sleep duration, 57% of respondents reported sleeping between 7 and 8 hours per night, 13% reported sleeping less than 6 hours, and 8% reported sleeping more than 9 hours per night.
Of the total sample, 23% reported issues with sleeping to their doctor. "It's interesting that women were more likely than men to have reported trouble sleeping to their doctor, but they are not more likely than men to be diagnosed with a sleeping disorder," Dr. Nguyen noted. The researchers found that 28% of women reported seeing their doctor about sleep complaints vs 19% of men, but in the end, 7% of both women and men were diagnosed with a sleep disorder.
Rates of insomnia were higher in women, seen in 19% vs 12% of men. Other groups with a high risk for insomnia were those who are obese (18%), those living under the poverty level (23%), and those who are abusing alcohol (18%), smoking cigarettes (22%), or using illegal drugs (21%). Divorced respondents also had a higher rate of insomnia, at 20%, than those who are married (14%) or single (15%).
Link to Depression
Finally, there was a close relationship between depression and insomnia; among those who met DSM IV criteria for major depressive disorder, 52% met diagnostic criteria for insomnia. Among those with insomnia, 47% met criteria for major depressive disorder.
"I think from the results of this study, primary-care physicians should know that if a patient is coming in and reporting sleeping problems, they should screen for depression, because 47% of those with insomnia have major depressive disorder," Dr. Nguyen suggested.
The presence of insomnia, the researchers conclude, should alert clinicians to the need to determine an underlying etiology.
Discouraging Data
Asked for comment on these findings, Donna Arand, PhD, clinical director of the Kettering Sleep Disorders Center, in Ohio, said this study supports previous findings of a high prevalence of insomnia in the population, as well as the strong associations between insomnia and depression and insomnia and drug and alcohol abuse.
The data are interesting, though, for the finding that 23% of respondents talked to their doctor about sleep problems, but only 7% were diagnosed with a sleep disorder. "This suggests that physicians are not pursuing workups for the various underlying causes of insomnia in most patients," Dr. Arand said.
Further, the fact that 8.6% of respondents report using sleeping pills frequently suggests that many patients with insomnia are being treated symptomatically, she added.
"These are discouraging data, suggesting that despite the large number of patients with insomnia and its negative impact on quality of life, most patients are not worked up for an underlying cause, many are being treated symptomatically, and some are not receiving any medical treatment," Dr. Arand concluded.
American Psychiatric Association 162nd Annual Meeting: Abstract NR3-009. Presented May 17, 2009.
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