Hierarchy of insomnia criteria based on daytime consequences
Open accessAbstract
Objectives To explore how insomnia symptoms are hierarchically organized in individuals reporting daytime consequences of their sleep disturbances.Methods This is a cross-sectional study conducted in the general population of the states of California, New York, and Texas. The sample included 8937 individuals aged 18 years or older representative of the general population. Telephone interviews on sleep habits and disorders were managed with the Sleep-EVAL expert system and using DSM-IV and ICSD classifications. Insomnia symptoms and global sleep dissatisfaction (GSD) had to occur at least three times per week for at least three months.Results A total of 26.2% of the sample had a GSD. Individuals with GSD reported at least one insomnia symptom in 73.1% of the cases. The presence of GSD in addition to insomnia symptoms considerably increased the proportion of individuals with daytime consequences related to insomnia. In the classification trees performed, GSD arrived as the first predictor for daytime consequences related to insomnia. The second predictor was nonrestorative sleep followed by difficulty resuming sleep and difficulty initiating sleep.Conclusions Classification trees are a useful way to hierarchically organize symptoms and to help diagnostic classifications. In this study, GSD was found to be the foremost symptom in identifying individuals with daytime consequences related to insomnia.
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For insomnia, predictive items rank as follows: dissatisfaction with sleep, non-restorative sleep complaints, trouble resuming or maintaining sleep, and trouble falling asleep.
“These predictive items show the following hierarchical order: self-reported dissatisfaction with sleep, complaints of non-restorative sleep, difficulty resuming or maintaining sleep, and difficulty initiating sleep (Ohayon et al, 2012).”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Ohayon et al, 2012
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- Authors
- Ohayon, M. M., Riemann, D., Morin, C., & Reynolds, C. F.
- Affiliations
- Stanford Medicine (US)
- University Medical Center Freiburg (DE)
- Université Laval (CA)
- University of Pittsburgh (US)
- Corresponding author
- Ohayon, Maurice M.
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2012-01
- Volume
- 13
- Issue
- 1
- Pages
- 52-57
- ISSN
- 1389-9457 (ISSN-L)
- PMC
- PMC3249005
- OpenAlex
- W2120136983
- Cited by
- 49
- References
- 24
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 5 · 2021: 6 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 2 · 2016: 5 · 2015: 6 · 2014: 5 · 2013: 5 · 2012: 2
- FWCI
- 4.93
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000005)
- National Institute of Neurological Disorders and Stroke (R01NS044199)
- National Center for Advancing Translational Sciences
- 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
- insomnia, non-restorative sleep, sleep onset difficulty, sleep initiation difficulty, classification trees, diagnostic classification, sleep disorders
- MeSH terms
- Adolescent, Adult, Affect, Aged, Aged, 80 and over, Arousal, California, Cognition, Cross-Sectional Studies, Female, Humans, Sleep Initiation and Maintenance Disorders, Interviews as Topic, Male, Middle Aged, New York, Sleep, Texas, Prevalence, Young Adult
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