Subclinical anxiety symptoms, sleep, and daytime dysfunction in older adults with primary insomnia.
Abstract
Both insomnia complaints and anxiety disorders are common in older adults, and are associated with poor daytime functioning. The present study investigated whether subclinical levels of anxiety were associated with sleep disturbance and daytime functioning in older adults who met diagnostic criteria for primary insomnia, and therefore did not meet criteria for depression or an anxiety disorder. After adjustment for depressive symptoms, elevated state anxiety was associated with higher levels of wake after sleep onset (measured by both actigraphy and sleep log) and shorter sleep onset latency (measured by sleep log). Higher levels of trait anxiety were associated with greater wake after sleep onset (measured by sleep log). Elevated state and trait anxiety were associated with worse social functioning, and higher levels of trait anxiety were associated with worse role functioning. Thus, subclinical anxiety symptoms may be an important target for clinical intervention to improve sleep and functioning in older adults with primary insomnia.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Sub-clinical, "healthy" samples often report meaningful anxiety symptoms that impact well-being and quality of life.
“sub-clinical, “healthy” samples often report meaningful anxiety symptoms that impact one’s well-being and quality of life (59–63)”
From Decreases in State and Trait Anxiety Post-psilocybin: A Naturalistic, Observational Study Among Retreat Attendees (2022) · cites this paper as [62]
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
(1992) · PubMed · Cited by 33,716 · see citing works
(1970) · Cited by 24,983 · see citing works
Development and validation of a geriatric depression screening scale: a preliminary report
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982) · Journal of Psychiatric Research · doi:10.1016/0022-3956(82)90033-4 · Cited by 15,025 · see citing works
Self-citationThe International Classification of Sleep Disorders
Daroff, R. B. (1991) · Neurology · doi:10.1212/wnl.41.1.160 · Cited by 5,023 · see citing works
Insomnia and Its Treatment: Prevalence and Correlates
Mellinger, G. D. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790260019002 · Cited by 1,071 · see citing works
Kushida, C. A., Chang, A., Patil, C. G., Guilleminault, C., Carrillo, O., & Dement, W. C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00098-8 · Cited by 997 · see citing works
American drinking practices : a national study of drinking behavior and attitudes
Cahalan, D., Cisin, I. H., & Crossley, H. M. (1969) · Medical Entomology and Zoology · Cited by 628 · see citing works
Bedside Assessment of Executive Cognitive Impairment: The Executive Interview
Royall, D. R., Mahurin, R. K., & Gray, K. F. (1992) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1992.tb03646.x · Cited by 595 · see citing works
American Drinking Practices: A National Study of Drinking Behavior and Attitudes
Goodwin, D. W. (1970) · JAMA · doi:10.1001/jama.1970.03170260064028 · Cited by 232 · see citing works
The Prevalence and Correlates of Anxiety Symptoms in Older Adults
Himmelfarb, S., & Murrell, S. A. (1984) · The Journal of Psychology · doi:10.1080/00223980.1984.9923632 · Cited by 208 · see citing works
Assessment of Anxiety in Older Adults
Kogan, J. N., Edelstein, B. A., & McKee, D. R. (2000) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(99)00044-4 · Cited by 160 · see citing works
Nonpharmacological treatment of late-life insomnia
Morin, C. M., Mimeault, V., & Gagné, A. (1999) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(98)00077-4 · Cited by 136 · see citing works
Wetherell, J. L., Le Roux, H., & Gatz, M. (2003) · Psychology and Aging · doi:10.1037/0882-7974.18.3.622 · Cited by 103 · see citing works
Anxiety disorders in the elderly: DSM-IV and other barriers to diagnosis and treatment
Palmer, B. W., Jeste, D. V., & Sheikh, J. I. (1997) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)00146-8 · Cited by 96 · see citing works
Self-citationPrimary versus secondary insomnia in older adults: Subjective sleep and daytime functioning.
Lichstein, K. L., Durrence, H. H., Riedel, B. W., & Bayen, U. J. (2001) · Psychology and Aging · doi:10.1037/0882-7974.16.2.264 · Cited by 50 · see citing works
Psychophysiological arousal in older adults: a critical review
Lau, A. W., Edelstein, B. A., & Larkin, K. T. (2001) · Clinical Psychology Review · doi:10.1016/s0272-7358(00)00052-0 · Cited by 41 · see citing works
Classification, Etiological Factors and Associated Disturbances
Roth, M., Noyes, R., & Burrows, G. D. (1989) · Medical Entomology and Zoology · Cited by 10 · see citing works
Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam
Beekman (1998) · Pure Amsterdam UMC · doi:10.1002/(sici)1099-1166(1998100)13:10 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Eadie, J., van de Water, A. T., Lonsdale, C., Tully, M. A., van Mechelen, W., Boreham, C. A., Daly, L., McDonough, S. M., & Hurley, D. A. (2013) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2013.04.017 · Cited by 83 · see citing works
Kiraga, M. K., Kuypers, K. P. C., Uthaug, M. V., Ramaekers, J. G., & Mason, N. L. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.883869 · Cited by 26 · see citing works
- Authors
- Spira, A. P., Friedman, L., Aulakh, J. S., Lee, T., Sheikh, J. I., & Yesavage, J. A.
- Affiliations
- San Francisco VA Medical Center (US)
- Stanford Medicine (US)
- VA Palo Alto Health Care System (US)
- Corresponding author
- Spira, Adam P.
- Venue
- Journal of Geriatric Psychiatry and Neurology
- Publisher
- SAGE Publications
- Published
- 2008-06
- Volume
- 21
- Issue
- 2
- Pages
- 149-153
- ISSN
- 0891-9887 (ISSN-L)
- 1552-5708
- OpenAlex
- W2102144916
- Cited by
- 45
- References
- 19
- Citations by year
- 2026: 2 · 2024: 1 · 2022: 5 · 2021: 2 · 2020: 5 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 5 · 2012: 1
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Geriatric Psychiatry and Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG-12914, R01AG012914)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- subclinical anxiety, primary insomnia, older adults, state anxiety, trait anxiety, wake after sleep onset, sleep latency, daytime functioning, social functioning, role functioning, actigraphy, sleep diary, depressive symptoms
- MeSH terms
- Aged, Anxiety Disorders, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Personality Inventory, Phototherapy, Sleep, Social Adjustment, Wakefulness, Comorbidity, Polysomnography
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
