Anxiety, Depression as Possible Predisposing Factors for Insomnia in Adults

Anxiety, depression, and high levels of perceived stress may be predisposing factors for insomnia, while loss of income and increased pain may serve as precipitating factors, according to study results presented at the 2023 Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society, held from June 3 to 7 in Indianapolis, Indiana.

Insomnia is one of the most prevalent health conditions, often negatively affecting patients’ physical and mental health. Thus, for the study, researchers aimed to assess factors that may predispose or protect patients from the onset of insomnia.

The researchers took data from a Canadian epidemiological cohort study, analyzing the development and course of insomnia among adults categorized as “good sleepers” at baseline. Risk and protective factors were measured over a 5-year period via questionnaires that reported on sleep quality, mental health status, and perceived stress, among other factors.

Of the 1,709 patients included in the study, 202 developed insomnia syndrome within 5 years.

Notably, physical activity was not deemed a protective factor for insomnia (P =.54).  

There may be a greater risk of developing insomnia in patients with:

• anxiety (hazard ratio [HR], 1.037; P = .018),
• depression (HR, 1.082; P <.001),
• high levels of perceived-stress (HR, 1.073; P <.001),
• greater occurrence of negative life events (HR, 1.478; P =.02),
• worse perception of personal health (HR, 2.061; P =.006),
• high levels of perceived pain (HR, 1.475; P =.002),
• susceptibility to stress (HR, 1.089; P <.001), and
• poor emotional coping skills (HR, 1.044; P <.001).

Certain predispositions may also be precipitating factors, including increased levels of anxiety (HR, 1.070; P <.001), depression (HR, 1.119; P <.001), and high levels of self-perceived stress (HR, 1.083; P =.001). Additionally, loss of income (HR, 1.346; P =.03), deteriorating perception of personal health (P =.006), and increasing pain levels (HR, 1.353; P =.013) may also be precipitating factors.

“These results provide new information that could be helpful to prevent the onset and chronicity of insomnia by targeting specific precipitating factors, and people with predisposing factors for insomnia,” the researchers wrote.

The researchers noted the importance of understanding insomnia and implementing public health interventions to decrease the physical and emotional burden on these patients.