Insomnia is a difficult and persistent sleep disorder, one that can come about for many reasons and, once evident, can linger for months or even years. It's also a sleep disorder that is on the rise in the United Kingdom. The results of a recent, large-scale and long-term study show that over the past decade and a half, insomnia has increased among UK residents.
Researchers from several universities around the United Kingdom collaborated on this broad and long-term study, which sought to track the prevalence of insomnia, examine patterns of sleep medication use, and analyse the demographic traits associated with higher risk for insomnia and sleep disturbances.
This study is significant because it offers the opportunity for a longer-term evaluation of the frequency of insomnia in a population. It's not often we're able to see the pattern of change of a sleep disorder like insomnia over this many years among a large population. The researchers relied on data from three separate national surveys, conducted in 1993, 2000 and 2007. More than 20,000 UK residents ages 16-64 were included. The surveys included questions about insomnia and sleep disturbances, and used the same measurement of insomnia and the same insomnia definitions. The surveys defined insomnia four different ways, to account for varying degrees of severity and symptoms:
1) Insomnia symptoms: difficulty falling asleep or staying asleep within one month
2) Insomnia of (at least) moderate severity: spending an hour or more trying to fall asleep or fall back asleep four or more times in the previous week.
3) Insomnia and fatigue: having difficulty sleeping accompanied with significant daytime fatigue in the previous week.
4) Insomnia diagnosis: experiencing insomnia of moderate severity with daytime fatigue for a period of six or more months.
Researchers also looked at a wide range of demographics in relation to insomnia, examining age, gender, education, employment and marital status, as well as the presence of depression.
As you might imagine, a study covering this much ground returned a lot of interesting and noteworthy results: Over the 15-year period from 1993-2007, greater numbers of people reported having sleep problems that fit each of the four definitions of insomnia:
• The biggest increase over the study period was for "insomnia diagnosis," the most severe form of insomnia. The frequency with which this degree of insomnia was reported nearly doubled over 15 years.
• Insomnia of all four types was more likely to affect women, the unemployed, people who were divorced, separated or widowed, as well as those with the least amount of education and those at the low end of the economic spectrum.
• Age was a factor with two of the insomnia definitions: insomnia symptoms, the least severe, and insomnia diagnosis, the most severe. For these two types of insomnia, being older presented a greater risk.
• "Worry" was the most commonly reported reason for sleep problems, reported across all three surveys spanning 15 years.
• The number of people using sleep medication doubled between the 1993 survey and the 2000 survey.
These results align broadly with another long-term, national study of the prevalence of insomnia. Researchers in Finland used national survey data to analyze the prevalence of insomnia over a period of 33 years, from 1972 to 2005. They found an increase in insomnia in the working-age population during the final 10-year period of their study, from 1995-2005.
I've written about the relationship between sleep disturbance and stress, and recent reports that show stress is a primary cause of sleeplessness for many adults in the UK. Even more troubling is how often these symptoms go untreated. This recent UK study found that 63%--nearly two thirds--of people with insomnia and psychological distress have not seen a doctor or sought medical help for their problems.
Sleep problems that go untreated are likely to worsen on their own and become more difficult to treat in the end. They also can cause secondary health problems, put people at higher risk for chronic and serious disease, and disrupt relationships, personal happiness, and productivity.
We must do a better job of identifying sleep problems and actually getting these problems treated, especially for those at higher risk: women, the elderly, the poor. Targeted treatments, both for specific demographic groups and for different types of insomnia, can help us reverse this upward trend. Treating sleep problems begins with paying attention to your own sleep and your loved ones' sleep. Taking action before sleep disturbances grow serious can help protect your health and your quality of life.
Michael J. Breus, PhD
The Sleep Doctor™
Everything you do, you do better with a good night's sleep™