Incidence and remission of insomnia among elderly adults in a biracial cohort

Sleep. 1999 May 1:22 Suppl 2:S373-8.


Objectives: To determine the incidence and remission rates of insomnia in older adults according to race and associated risk factors in a three-year longitudinal study.

Methods: 2,971 men and women, aged 65 years and older, completed questionnaires administered by trained interviewers at baseline and three years later. Data concerning difficulty falling asleep or early morning arousal (insomnia), along with self-reports of physical disability, respiratory symptoms, depressive symptomatology, perceived health status, and use of prescribed sedative medication, were collected and analyzed.

Results: Overall, 15% of the participants without symptoms of insomnia at baseline reported chronic difficulty falling asleep or early morning arousal three years later in follow-up interviews. African-American women had a significantly (p < 0.01) higher incidence of insomnia (19%) compared with African-American men (12%) or with white men and women (both 14%). Men were more likely than women to no longer report symptoms at follow-up (64% vs 42%; p < 0.01). For both races, the presence of depressed mood was a risk factor for the incidence of insomnia, and the absence of depressed mood was a predictor of remission.

Conclusions: Insomnia occurs more frequently in African-American women than in African-American men or than in white men or women. Regardless of race, women are less likely than men to resolve their insomnia. The high prevalence and incidence of morbidity in elderly African-American women may contribute to their high rate of insomnia.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Depression / etiology
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Incidence
  • Male
  • North Carolina / epidemiology
  • Racial Groups
  • Remission, Spontaneous
  • Rural Population / statistics & numerical data
  • Sex Distribution
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Surveys and Questionnaires
  • Urban Population / statistics & numerical data