Over one quarter of adults (27 percent) in the U.S. experience insomnia, the problem of falling or staying asleep, according to a new study conducted by researchers at Columbia University Mailman School of Public Health and Columbia University Irving Medical Center. Often unrecognized clinically by a health care professional, insomnia exacts a heavy burden on quality of life, and frequently is related to co-occurring medical conditions. The national burden of insomnia on loss of quality of life exceeded 18 other medical conditions that were assessed in the study. The findings are published in the Journal of Clinical Psychiatry.
The risk of insomnia has been linked to musculoskeletal, respiratory, digestive, and pain conditions. In particular the researchers found strong correlations between insomnia and several medical conditions. Over half of adults with angina, peptic ulcer disease, or fibromyalgia reported insomnia and over of third of those with arthritis, chronic pulmonary disease, or cancer reported insomnia.
“Our findings highlight the considerable degree to which insomnia adversely affects the lives of U.S. adults,” said Dr. Mark Olfson, professor of epidemiology at Columbia University Mailman School of Public Health and professor of psychiatry at Columbia Vagelos College of Physicians and Surgeons. “We knew that poor-quality sleep was common and could interfere with a person’s sense of well-being and increase the risk of accidents one’s quality of life, but we were surprised to discover that at a population level insomnia accounts for a significantly greater loss of quality of life than common medical conditions such as obesity or mental health conditions.”
Using data from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions the research team examined the prevalence of insomnia, estimated its national health burden in relation to other common medical conditions, and assessed patterns of comorbidity between insomnia and other conditions as well as dependence of these comorbidities on pain, stressful life events, and mental disorders.
One of the key methods in the paper was the use of measure of quality adjusted life years or QALYs which permits comparisons across people with different health conditions. The study is believed to be the first to estimate QALYs lost each year in the United States to insomnia.
Consistent with prior research, Insomnia was more commonly reported by women than men, older than younger adults, and people who were non-Hispanic white than other racial and ethnic groups. The odds of insomnia were also increased among adults who were unemployed, had a lower family income, and were not currently married or cohabiting. As compared to adults aged 18 to 29 years, those who were 65 years of age or older had nearly three times the adjusted odds of reporting clinically recognized insomnia.
“Improving the management of insomnia offers opportunities to reduce its public health burden,” noted Olfson. “The empirical evidence also supports the sustained efficacy of cognitive-behavioral therapy for insomnia to reduce severity, improve sleep quality, and overall sleep time.”
Co-authors of “Insomnia and Impaired Quality of Life in the United States” are Dr. Melanie Wall, Columbia Public Health; Ms. Shang-Min Liu, CUIMC; Dr. Charles Morin, Laval University; and Dr. Carlos Blanco, National Institute on Drug Abuse.
The research was supported by the National Institutes of Health, grants DA019606 and MH 107452; New York State Psychiatric Institute; and the National Institute on Drug Abuse.