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VOLUME 30, ISSUE 07


Chronic Insomnia as a Risk Factor for Developing Anxiety and Depression

Dag Neckelmann MD, PhD1; Arnstein Mykletun, PhD2; Alv A. Dahl MD, PhD3

1Department of Psychiatry, Clinic of Psychosomatic Medicine, Haukeland University Hospital, Bergen, Norway; 2Research Centre for Health Promotion (HEMIL), University of Bergen, Norway and the Norwegian Institute of Public Health, Division of Mental Health; 3The Cancer Clinic, Rikshospitalet-Radiumhospitalet Medical Center, University of Oslo, Norway



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Study Objective:

To study prospectively the relations of insomnia to the development of anxiety disorders and depression in a population-based sample.
Design: Cohort study based on data from 2 general health surveys of the adult population.

Setting:

Two general health surveys in the adult population in Nord-Trøndelag County of Norway, HUNT-1 performed in 1984-6 and HUNT-2 in 1995-7

Participants:

Participants without significant anxiety and depression in HUNT-1 were categorized according to the presence and absence of insomnia in the 2 surveys (N="25,130).


Measurements and Results:

Anxiety disorders and depression in HUNT-2 were assessed by the Hospital Anxiety and Depression Scale and analyzed using multivariate logistic regression analysis adjusted for age, gender, education, comorbid depression/anxiety, and history of insomnia. Anxiety disorders in HUNT-2 were significantly associated with the group with insomnia in HUNT-1 only (OR 1.6; 95% CI, 1.1-2.3), the group with insomnia in HUNT-2 only (OR 3.4; 95% CI, 3.1-3.8), as well as with the group with insomnia in both surveys (OR 4.9; 95% CI, 3.8-6.4). Depression in HUNT-2 was significantly associated with the group with insomnia in HUNT-2 only (OR 1.8; 95% CI, 1.6-2.0), but not with the groups with insomnia in HUNT-1 only or with insomnia in both surveys.

Conclusions:

Only a state-like association between insomnia and depression was found. In addition to being a state marker, insomnia may be a trait marker for individuals at risk for developing anxiety disorders. Results are consistent with insomnia being a risk factor for the development of anxiety disorders.
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