SLEEP - Clinical and Polysomnographic Predictors of the Natural History of Poor Sleep in the General Population

VOLUME 35, ISSUE 05

CLINICAL AND PSG PREDICTORS OF THE NATURAL HISTORY OF POOR SLEEP
Clinical and Polysomnographic Predictors of the Natural History of Poor Sleep in the General Population

http://dx.doi.org/10.5665/sleep.1832

Julio Fernandez-Mendoza, PhD¹; Alexandros N. Vgontzas, MD¹; Edward O. Bixler, PhD¹; Ravi Singareddy, MD¹; Michele L. Shaffer, PhD²; Susan L. Calhoun, PhD¹; Maria Karataraki, PsyD¹; Antonio Vela-Bueno, MD³; Duanping Liao, MD, PhD²

¹Sleep Research and Treatment Center, Department of Psychiatry; ²Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA; ³Department of Psychiatry, School of Medicine, Autonoma University, Madrid, Spain

Table of Contents

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Study Objectives:

Approximately 8-10% of the general population suffers from chronic insomnia, whereas another 20-30% of the population has insomnia symptoms at any given time (i.e., poor sleep). However, few longitudinal studies have examined risk factors of the natural history of poor sleep, and none have examined the role of polysomnographic (PSG) variables.

Design:

Representative longitudinal study.

Setting:

Sleep laboratory.

Participants:

From a random, general population sample of 1,741 individuals of the adult Penn State Cohort, 1,395 were followed up after 7.5 yr.

Measurements:

Full medical evaluation and 1-night PSG at baseline and telephone interview at follow-up.

Results:

The rate of incident poor sleep was 18.4%. Physical (e.g., obesity, sleep apnea, and ulcer) and mental (e.g., depression) health conditions and behavioral factors (e.g., smoking and alcohol consumption) increased the odds of incident poor sleep as compared to normal sleep. The rates of persistent, remitted, and poor sleepers who developed chronic insomnia were 39%, 44%, and 17%, respectively. Risk factors for persistent poor sleep were physical health conditions combined with psychologic distress. Shorter objective sleep duration and a family history of sleep problems were risk factors for poor sleep evolving into chronic insomnia.

Conclusions:

Poor sleep appears to be primarily a symptom of physical and mental health conditions, whereas the persistence of poor sleep is associated with psychologic distress. Importantly, sleep apnea appears to be associated with incident poor sleep but not with chronic insomnia. Finally, this study suggests that objective short sleep duration in poor sleepers is a biologic marker of genetic predisposition to chronic insomnia.

Citation:

Fernandez-Mendoza J; Vgontzas AN; Bixler EO; Singareddy R; Shaffer ML; Calhoun SL; Karataraki M; Vela-Bueno A; Liao D. Clinical and polysomnographic predictors of the natural history of poor sleep in the general population. SLEEP 2012;35(5):689-697.