Persistent Insomnia: the Role of Objective Short Sleep Duration and Mental Health
Open accessAbstract
STUDY OBJECTIVES: Few population-based, longitudinal studies have examined risk factors for persistent insomnia, and the results are inconsistent. Furthermore, none of these studies have examined the role of polysomnographic (PSG) variables such as sleep duration or sleep apnea on the persistence of insomnia. DESIGN: Representative longitudinal study. SETTING: Sleep laboratory. PARTICIPANTS: From a random, general population sample of 1741 individuals of the adult Penn State Cohort, 1395 were followed-up after 7.5 years. MEASUREMENTS: Individuals underwent one-night PSG and full medical evaluation at baseline and a telephone interview at follow-up. PSG sleep duration was analyzed as a continuous variable and as a categorical variable: < 6 h sleep (short sleep duration) and ≥ 6 h sleep (longer sleep duration). RESULTS: The rates of insomnia persistence, partial remission, and full remission were 44.0%, 30.0%, and 26.0%, respectively. Objective short sleep duration significantly increased the odds of persistent insomnia as compared to normal sleep (OR = 3.19) and to fully remitted insomnia (OR = 4.92). Mental health problems at baseline were strongly associated with persistent insomnia as compared to normal sleep (OR = 9.67) and to a lesser degree compared to fully remitted insomnia (OR = 3.68). Smoking, caffeine, and alcohol consumption and sleep apnea did not predict persistent insomnia. CONCLUSIONS: Objective short sleep duration and mental health problems are the strongest predictors of persistent insomnia. These data further support the validity and clinical utility of objective short sleep duration as a novel marker of the biological severity of insomnia.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Insomnia is a disorder while 'poor sleep' is a symptom of underlying physical or mental health problems.
“which indicates that insomnia is a disorder while “poor sleep” is a symptom of underlying physical or mental health problems(137, 138, 140).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [140]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., Lombardo, C., & Riemann, D. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.01.011 · Cited by 2,779 · see citing works
Vgontzas, A. N., Bixler, E. O., Lin, H.-M., Prolo, P., Mastorakos, G., Vela-Bueno, A., Kales, A., & Chrousos, G. P. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.8.7778 · Cited by 884 · see citing works
National Institutes of Health State of the Science Conference Statement
(2005) · Sleep · doi:10.1093/sleep/28.9.1049 · Cited by 745 · see citing works
Use of sleep hygiene in the treatment of insomnia
Stepanski, E. J., & Wyatt, J. K. (2003) · Sleep Medicine Reviews · doi:10.1053/smrv.2001.0246 · Cited by 733 · see citing works
Epidemiology of Insomnia: a Longitudinal Study in a UK Population
(2007) · Sleep · doi:10.1093/sleep/30.3.274 · Cited by 583 · see citing works
The Natural History of Insomnia: A Population-Based 3-Year Longitudinal Study
Morin, C. M., Bélanger, L., LeBlanc, M., Ivers, H., Savard, J., Espie, C. A., Mérette, C., Baillargeon, L., & Grégoire, J.-P. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.610 · Cited by 498 · see citing works
Relationship between reported and measured sleep times: the sleep heart health study (SHHS)
Silva, G. E., Goodwin, J. L., Sherrill, D. L., Arnold, J. L., Bootzin, R. R., Smith, T., Walsleben, J. A., Baldwin, C. M., & Quan, S. F. (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26974 · Cited by 295 · see citing works
Fernandez-Mendoza, J., Calhoun, S. L., Bixler, E. O., Karataraki, M., Liao, D., Vela-Bueno, A., Jose Ramos-Platon, M., Sauder, K. A., Basta, M., & Vgontzas, A. N. (2011) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181fe365a · Cited by 261 · see citing works
Self-citationShort sleep duration and obesity: the role of emotional stress and sleep disturbances
Vgontzas, A. N., Lin, H.-M., Papaliaga, M., Calhoun, S., Vela-Bueno, A., Chrousos, G. P., & Bixler, E. O. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.4 · Cited by 224 · see citing works
Self-citationInsomnia in central Pennsylvania
Bixler, E. O., Vgontzas, A. N., Lin, H.-M., Vela-Bueno, A., & Kales, A. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00450-6 · Cited by 205 · see citing works
Self-citationRodenbeck, A., Cohrs, S., Jordan, W., Huether, G., R�ther, E., & Hajak, G. (2003) · Psychopharmacology · doi:10.1007/s00213-003-1565-0 · Cited by 103 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Morin, C. M., & Jarrin, D. C. (2022) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2022.03.003 · Cited by 907 · see citing works
Insomnia with objective short sleep duration: The most biologically severe phenotype of the disorder
Vgontzas, A. N., Fernandez-Mendoza, J., Liao, D., & Bixler, E. O. (2013) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2012.09.005 · Cited by 776 · see citing works
Self-citationGehrman, P., Seelig, A. D., Jacobson, I. G., Boyko, E. J., Hooper, T. I., Gackstetter, G. D., Ulmer, C. S., Smith, T. C., & Millennium Cohort Study Team (2013) · Sleep · doi:10.5665/sleep.2798 · Cited by 339 · see citing works
Sleep Patterns and Mental Health Correlates in US Adolescents
Zhang, J., Paksarian, D., Lamers, F., Hickie, I. B., He, J., & Merikangas, K. R. (2017) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.11.007 · Cited by 296 · see citing works
Hammerschlag, A. R., Stringer, S., de Leeuw, C. A., Sniekers, S., Taskesen, E., Watanabe, K., Blanken, T. F., Dekker, K., te Lindert, B. H. W., Wassing, R., et al. (2017) · Nature Genetics · doi:10.1038/ng.3888 · Cited by 289 · see citing works
The economic cost of inadequate sleep
Hillman, D., Mitchell, S., Streatfeild, J., Burns, C., Bruck, D., & Pezzullo, L. (2018) · Sleep · doi:10.1093/sleep/zsy083 · Cited by 278 · see citing works
Sleep: important considerations for the prevention of cardiovascular disease
Grandner, M. A., Alfonso-Miller, P., Fernandez-Mendoza, J., Shetty, S., Shenoy, S., & Combs, D. (2016) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000324 · Cited by 166 · see citing works
Self-citationInsomnia and incident depression: role of objective sleep duration and natural history
Fernandez‐Mendoza, J., Shea, S., Vgontzas, A. N., Calhoun, S. L., Liao, D., & Bixler, E. O. (2015) · Journal of Sleep Research · doi:10.1111/jsr.12285 · Cited by 148 · see citing works
Self-citationVgontzas, A. N., Fernandez-Mendoza, J., Miksiewicz, T., Kritikou, I., Shaffer, M. L., Liao, D., Basta, M., & Bixler, E. O. (2014) · International Journal of Obesity · doi:10.1038/ijo.2013.172 · Cited by 133 · see citing works
Self-citationFernandez-Mendoza, J., Vgontzas, A. N., Bixler, E. O., Singareddy, R., Shaffer, M. L., Calhoun, S. L., Karataraki, M., Vela-Bueno, A., & Liao, D. (2012) · SLEEP · doi:10.5665/sleep.1832 · Cited by 115 · see citing works
Lee, E., Cho, H. J., Olmstead, R., Levin, M. J., Oxman, M. N., & Irwin, M. R. (2013) · Sleep · doi:10.5665/sleep.3128 · Cited by 113 · see citing works
Insomnia as a cardiometabolic risk factor
Grandner, M. A., & Perlis, M. L. (2013) · SLEEP · doi:10.5665/sleep.2288 · Cited by 15 · see citing works
- Authors
- Vgontzas, A. N., Fernandez-Mendoza, J., Bixler, E. O., Singareddy, R., Shaffer, M. L., Calhoun, S. L., Liao, D., Basta, M., & Chrousos, G. P.
- Affiliations
- Pennsylvania State University (US)
- University of Crete (GR)
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Vgontzas, Alexandros N.
- ORCID
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-01
- Volume
- 35
- Issue
- 1
- Pages
- 61-68
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC3242689
- OpenAlex
- W2056848264
- Cited by
- 113
- References
- 11
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 5 · 2021: 13 · 2020: 7 · 2019: 7 · 2018: 4 · 2017: 5 · 2016: 10 · 2015: 9 · 2014: 12 · 2013: 17 · 2012: 5
- FWCI
- 14.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Pennsylvania
- Pennsylvania State University
- National Institutes of Health (RO1 40916, RO1 51931)
- U.S. Public Health Service (R01 51931, R01 64415, R01 40916)
- 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
- chronic insomnia, short sleep duration, mental health, insomnia remission, sleep apnea, smoking, caffeine consumption, alcohol consumption, risk factors for insomnia
- MeSH terms
- Mental Disorders, Female, Humans, Sleep Initiation and Maintenance Disorders, Longitudinal Studies, Male, Mental Health, Middle Aged, Personality Inventory, Psychiatric Status Rating Scales, Risk Factors, Sleep, 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
