![]() Insomnia is a highly prevalent condition in the general population 1, 2 and a common complaint in clinical practice. Considering the long-term adverse outcomes associated with persistent insomnia, these findings may have important implication for the prognosis and management of insomnia. Similarly, those with an insomnia syndrome at any given assessment were more likely (adjusted odds ratio, 1.60 95% CI, 1.19-2.60) to remain in that status (persistence) than to improve (remittance) at the next assessment even among those who improved, the odds of relapse were greater (adjusted odds ratio, 2.04 95% CI, 1.23-3.37) than those to improve in the following year.Ĭonclusions and Relevance The findings suggest that insomnia is often a persistent condition. Yearly trajectories showed that individuals who were good sleepers at baseline were 4.2 (95% CI, 3.51-4.89) times more likely to stay good sleepers in the subsequent year, but once they developed insomnia, they were equally likely to report symptoms (47% probability) than to return to a good sleeper status (53% probability) 1 year later. 5%) of initial good sleepers developed an insomnia syndrome during the 5-year follow-up period, and incidence rates were higher among women than among men (17.6% vs 10.1% vs 14.0% ), 3 years (62.7% vs 27.6% ), and 5 years (73.6% vs 40.9% ). Results The sample included 3073 adults (mean age, 48.1 years range, 18.0-95.0 years 1910 female). All inferential analyses were weighted according to normalized sampling weights. Sleep trajectories were examined by looking at year-person transitions between each consecutive year summed over the 5-year follow-up period. Main Outcomes and Measures Survival analyses were used to derive incidence rates of new insomnia among the subgroup of good sleepers at baseline and persistence and remission rates among those with insomnia at baseline. Participants completed an annual survey about their sleep and health status for 5 consecutive years.Įxposure Using validated algorithms, participants were classified at each assessment as being good sleepers (n = 1717), having an insomnia disorder (n = 538), or having subsyndromal insomnia (n = 818). Objective To assess the incidence, persistence, and remission rates of insomnia over a 5-year naturalistic follow-up period.ĭesign, Setting, and Participants This cohort study included participants with and without sleep problems selected from the adult population in Canada from August 2007 to June 2014. Importance Insomnia is a significant public health problem, but there is little information on its natural history. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.ICD-10 insomnia disorder has the lowest prevalence, perhaps because excessive concern and preoccupation, one of its diagnostic criteria, is not always present in people with insomnia.ĭSM-5 DSM-IV-TR ICD-10 ICSD-2 Insomnia Prevalence.Ĭopyright © 2014 Elsevier B.V. The prevalence is reduced by half from DSM-IV to DSM-5. The weighted prevalence of DSM-IV, ICD-10, ICSD-2, and any of the three insomnia disorders was 22.1%, 4.7%, 15.1%, and 22.1%, respectively for DSM-5 insomnia disorder, it was 10.8%.Ĭompared with 22.1%, 3.9%, and 14.7% for DSM-IV, ICD-10, and ICSD-2 in the AIS, cross-cultural difference in the prevalence of insomnia disorder is less than what is expected. When quantitative criteria were included, the prevalence dropped the most from 39.9% to 8.4% for non-restorative sleep, and the least from 14.0% to 12.9% for difficulty falling asleep. The weighted prevalence of difficulty falling asleep, difficulty staying asleep, waking up too early, and non-restorative sleep that occurred ≥3 days per week was 14.0%, 28.3%, 32.1%, and 39.9%, respectively. Population-based epidemiological survey respondents (n = 2011) completed the Brief Insomnia Questionnaire (BIQ), a validated scale generating DSM-IV, DSM-5, ICD-10, and ICSD-2 insomnia disorder. To compare the prevalence of insomnia according to symptoms, quantitative criteria, and Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th Edition (DSM-IV and DSM-5), International Classification of Diseases, 10th Revision (ICD-10), and International Classification of Sleep Disorders, 2nd Edition (ICSD-2), and to compare the prevalence of insomnia disorder between Hong Kong and the United States by adopting a similar methodology used by the America Insomnia Survey (AIS). ![]()
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