Lena Mallon

Relationship Between Insomnia, Depression, and Mortality: A 12-Year Follow-Up of Older Adults in the Community

The purpose of the study was to investigate the natural history of insomnia and its association with depression and mortality. In 1983, 1,870 randomly selected subjects aged 45-65 years answered a questionnaire on sleep and health. Of the 1,604 survivors in 1995, 1,244 (77.6%) answered a new questionnaire with almost identical questions. Mortality data were collected for the 266 subjects that had died during the follow-up period. Chronic insomnia was reported by 36.0% of women and 25.4% of men (chi2 = 9.7; p < .01). About 75% of subjects with insomnia at baseline continued to have insomnia at follow-up. Insomnia in women predicted subsequent depression (odds ratio [OR] = 4.1; 95% confidence interval [CI] 2.1-7.2) but was not related to mortality. In men, insomnia predicted mortality (OR = 1.7; 95% CI 1.2-2.3), but after adjustment for an array of possible risk factors, this association was no longer significant. Men with depression at baseline had an adjusted total death rate that was 1.9 times higher than in the nondepressed men (95% CI: 1.2-3.0).

A Survey of Sleep Habits and Sleeping Difficulties in an Elderly Swedish Population

A random sample of 876 subjects aged 65-79 years were investigated by means of a questionnaire concerning sleep and related factors. Sleep problems were reported by 23.8% of females and 13.3% of males. Moderate or major complaints of maintaining sleep were reported by 43.5% of subjects, early morning awakening 33.4% and difficulties falling asleep 31.4%. Daytime sleepiness was more common among males, and a relationship between daytime sleepiness and perceived poor sleep was found. Daytime napping was common, but not related to poor sleep. The prevalence of regular sleeping pill users was 7.6% for females and 3.0% for males and a relationship between sleep problems, sleeping pill usage and psychiatric symptoms was established. Among the regular sleeping pill users 39.1% had possible depression (PD) and 63.0% had possible anxiety disorder (PA). Among respondents with sleep complaints 29.8% had PD and 48.7% had PA. Sleep problems were also related to impaired physical health. Various medical illnesses contributed to sleep complaints among males, and depression affected sleep the most among females.

Restless legs syndrome and its relationship with insomnia symptoms and daytime distress: Epidemiological survey in Sweden

To investigate prevalence estimates of restless legs syndrome (RLS) in relation to insomnia complaints and daytime distress a questionnaire was sent to a randomly selected sample of 1962 inhabitants of Uppsala, Sweden. The questionnaire included questions about sleep and daytime distress and the standardized four‐question set for epidemiological settings recommended by the International RLS Study Group. A positive diagnosis of RLS was established in 18.8% of all responders. When the optional question about frequency was applied 5.8% reported frequent symptoms. Insomnia symptoms and daytime distress were significantly associated with the frequency of RLS symptoms.

Restless legs symptoms with sleepiness in relation to mortality : 20-year follow-up study of a middle-aged Swedish population

Aim:  The aim of the present study was to investigate restless legs symptoms with concomitant daytime sleepiness as a risk factor for mortality in a middle‐aged population.

The Minimal Insomnia Symptom Scale (MISS) : A Brief Measure of Sleeping Difficulties

To evaluate basic psychometric properties and obtain normative values for a novel 3-item scale, the Minimal Insomnia Symptom Scale (MISS), a sleep questionnaire was sent out to a randomly selected sample of the general population, aged 20-64 years. Responses were obtained from 1075 subjects corresponding to a response rate of 78%. Results showed that MISS possessed satisfactory reliability and validity. Women scored significantly higher than men while there was no age relationship. A receiver operating characteristic curve analysis revealed that MISS was able to distinguish subjects with a clinical insomnia according to ICD-10 research criteria. The main advantage of MISS over other insomnia instruments is its brevity and ease of use. Evidence was provided for the utility of MISS in epidemiological settings. MISS also showed promise as a convenient ultra-short screening measure of insomnia in health care settings.

Insomnia in sweden: a population-based survey.

Aims. Estimate the prevalence of insomnia and examine effects of sex, age, health problems, sleep duration, need for treatment, and usage of sleep medication. Methods. A sample of 1,550 subjects aged 18–84 years was selected for a telephone interview. The interview was completed by 1,128 subjects (72.8%). Results. 24.6% reported insomnia symptoms. Insomnia disorder, that is, insomnia symptoms and daytime consequences, was reported by 10.5%. The prevalence was similar among all age groups, with the exception of women aged 40–49 years who demonstrated a significantly higher prevalence, 21.6%. Having at least one physical or psychiatric disorder was reported by 82.8% of subjects with insomnia disorder. Mean sleep duration for subjects with insomnia disorder was 5.77 hours on weeknights and 7.03 hours on days off/weekends. The corresponding figures for subjects without insomnia disorder were 7.04 hours and 7.86 hours, respectively. Among those with insomnia disorder 62.5% expressed a need for treatment, and 20.0% used prescribed sleep medication regularly. Conclusions. Insomnia disorder is highly prevalent in the population. There are significant associations between insomnia disorder and physical and psychiatric disorders. A majority of subjects with insomnia disorder expressed a need for treatment, indicating a public health problem.