Sleep problems, comorbid mental disorders, and role functioning in the national comorbidity survey replication
Open accessAbstract
Background Little is known about the population prevalence of sleep problems or whether the associations of sleep problems with role impairment are due to comorbid mental disorders.Methods The associations of four 12-month sleep problems (difficulty initiating or maintaining sleep, early morning awakening, nonrestorative sleep) with role impairment were analyzed in the National Comorbidity Survey Replication controlling 12-month DSM-IV anxiety, mood, impulse-control, and substance disorders. The WHO Composite International Diagnostic Interview was used to assess sleep problems and DSM-IV disorders. The WHO Disability Schedule-II (WHO-DAS) was used to assess role impairment.Results Prevalence estimates of the separate sleep problems were in the range 16.4-25.0%, with 36.3% reporting at least one of the four. Mean 12-month duration was 24.4 weeks. All four problems were significantly comorbid with all the 12-month DMS-IV disorders assessed in the survey (median OR: 3.4; 25(th)-75(th) percentile: 2.8-3.9) and significantly related to role impairment. Relationships with role impairment generally remained significant after controlling comorbid mental disorders. Nonrestorative sleep was more strongly and consistently related to role impairment than were the other sleep problems.Conclusions The four sleep problems considered here are of public health significance because of their high prevalence and significant associations with role impairment.
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When more rigorous insomnia criteria (DSM IV) are used, the prevalence of insomnia in adults decreases to 6-10%.
“when more rigorous insomnia criteria are used to determine insomnia rates (i.e., diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders IV; DSM IV), the prevalence in adults decreases to 6–10% [38,39].”
From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [39]
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The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review
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- Authors
- Roth, T., Jaeger, S., Jin, R., Kalsekar, A., Stang, P. E., & Kessler, R. C.
- Affiliations
- Henry Ford Hospital (US)
- Harvard University (US)
- Eli Lilly (United States) (US)
- West Chester University (US)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2006-12
- Volume
- 60
- Issue
- 12
- Pages
- 1364-1371
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC1894656
- OpenAlex
- W2021912704
- Cited by
- 422
- References
- 30
- Citations by year
- 2026: 15 · 2025: 21 · 2024: 34 · 2023: 19 · 2022: 23 · 2021: 25 · 2020: 32 · 2019: 27 · 2018: 19 · 2017: 20 · 2016: 28 · 2015: 29 · 2014: 16 · 2013: 18 · 2012: 24
- FWCI
- 12.98
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Robert Wood Johnson Foundation (044708)
- National Institute of Mental Health (U01-MH60220)
- John W. Alden Trust
- National Institute on Drug Abuse
- Eli Lilly and Company
- Substance Abuse and Mental Health Services Administration
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep disorders, comorbid mental disorders, role impairment, non-restorative sleep, early morning awakening, sleep initiation and maintenance, anxiety disorders, mood disorders, substance use disorders, impulse control disorders, disability
- MeSH terms
- Activities of Daily Living, Adult, Affect, Aged, Anxiety, Mental Disorders, Female, Health Surveys, Humans, Impulsive Behavior, Sleep Initiation and Maintenance Disorders, Interview, Psychological, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Regression Analysis, Sleep Wake Disorders, Socioeconomic Factors, United States, Comorbidity, Multivariate Analysis, Epidemiologic Studies, Substance-Related Disorders
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