Insomnia and Impaired Quality of Life in the United States
Abstract
OBJECTIVE: This analysis characterizes the individual-level and population-level burden of insomnia in relation to other medical conditions and describes the comorbidity of insomnia with other medical conditions, including the dependence of these comorbidities on pain, life events, and mental disorders. METHODS: Information from 34,712 adults in the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013) was analyzed. Quality-adjusted life-years (QALYs) were measured with the SF-6D, a 6-dimensional health state classification derived from the Short-Form-12, version 2. RESULTS: In the last 12 months, 27.3% of adults reported insomnia. The US annual loss of QALYs associated with insomnia (5.6 million; 95% CI, 5.33-5.86 million) was significantly larger than that associated with any of the other 18 medical conditions assessed, including arthritis (4.94 million; 95% CI, 4.62-5.26 million), depression (4.02 million; 95% CI, 3.87-4.17 million), and hypertension (3.63 million; 95% CI, 3.32-3.93 million). After control for demographic factors, all conditions examined from obesity (adjusted odds ratio [aOR] = 1.25) to mania (aOR = 5.04) were associated with an increased risk of insomnia. Further controlling for pain, stressful life events, and mental disorders decreased the odds of the co-occurrence of insomnia with these conditions. The decrease in insomnia comorbidity associated with pain was greatest for fibromyalgia (31.8%) and arthritis (20.1%); the decrease in insomnia comorbidity associated with life events was greatest for mania (13.4%) and drug use disorders (11.2%); and the decrease in insomnia comorbidity associated with mental disorders was greatest for peptic ulcer disease (11.2%) and liver diseases (11.1%). CONCLUSIONS: Insomnia is prevalent and associated with substantial population-level burden in self-assessed health. The co-occurrence of insomnia with common medical conditions is differentially related to pain and to a lesser extent to stressful life events and mental disorders.
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Insomnia is a common problem among cancer patients, potentially devastatingly impacting their quality of life.
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- Authors
- Olfson, M., Wall, M., Liu, S.-M., Morin, C. M., & Blanco, C.
- Affiliations
- New York State Psychiatric Institute (US)
- Université Laval (CA)
- National Institute on Drug Abuse (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2018-09-11
- Volume
- 79
- Issue
- 5
- ISSN
- 0160-6689 (ISSN-L)
- 1555-2101
- OpenAlex
- W2892179388
- Cited by
- 147
- References
- 1
- Citations by year
- 2026: 12 · 2025: 23 · 2024: 20 · 2023: 25 · 2022: 25 · 2021: 22 · 2020: 15 · 2019: 4
- FWCI
- 13.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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, quality-adjusted life years, disease burden, comorbidities, pain, life events, mental illness, fibromyalgia, arthritis, depression, mania, drug use disorders, obesity, peptic ulcer, liver disease, health-related quality of life
- MeSH terms
- Adolescent, Adult, Aged, Mental Disorders, Disease, Female, Health Surveys, Humans, Sleep Initiation and Maintenance Disorders, Life Change Events, Male, Middle Aged, Pain, Quality of Life, United States, Comorbidity, Quality-Adjusted Life Years, Young Adult
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