Insomnia among current and remitted common mental disorders and the association with role functioning: results from a general population study

Sleep Med. 2016 Sep;25:34-41. doi: 10.1016/j.sleep.2016.07.015. Epub 2016 Aug 26.


Objective and background: Insomnia is a neglected topic in psychiatric epidemiological studies. Despite the fact that insomnia is a common phenomenon and usually co-occurs with mental disorders, it remains to be addressed to what extent insomnia is associated with remitted and current common mental disorders and with impaired functioning in the population, after considering a wide variety of confounders.

Patients and methods: Data were used from three waves of the Netherlands Mental Health Survey and Incidence Study-2 (N = 4618), a nationally representative face-to-face survey of the general population. Insomnia was assessed at the third wave with the Women's Health Initiative Insomnia Rating Scale. Mental disorders were assessed at all waves with the Composite International Diagnostic Interview version 3.0. Confounders included sociodemographic characteristics, physical health, and psychotropic medication use. Role functioning was assessed with the Medical Outcomes Study Short Form Health Survey and work loss with the World Health Organization Disability Assessment Schedule.

Results: Forty-two per cent of the population reported none to mild insomnia, 35% moderate insomnia, and 23% severe insomnia. Both current and remitted anxiety disorder and current mood disorder were significantly associated with severe insomnia with adjusted odds ratios ranging from 1.8 to 3.3. Current and remitted substance use disorders were associated with moderate insomnia (adjusted OR range: 1.3-1.8). Moderate and severe insomnia were significantly associated with impaired role functioning and work loss after adjustment for confounders.

Conclusion: Insomnia is a prevalent problem across different categories of mental disorders, even in the remitted phase. As insomnia has a high impact on daily functioning, insomnia deserves wide clinical attention.

Keywords: Common mental disorders; Insomnia; Population survey; Remission; Role functioning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology*
  • Adult
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Cohort Studies
  • Female
  • Health Surveys
  • Humans
  • Male
  • Mental Disorders / complications
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Mood Disorders / diagnosis
  • Mood Disorders / epidemiology
  • Mood Disorders / psychology
  • Netherlands / epidemiology
  • Prevalence
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology