The Natural History of Insomnia: the incidence of acute insomnia and subsequent progression to chronic insomnia or recovery in good sleeper subjects

Author:

Perlis Michael L1,Vargas Ivan2ORCID,Ellis Jason G3,Grandner Michael A4,Morales Knashawn H5,Gencarelli Amy6,Khader Waliuddin47,Kloss Jaqueline D1,Gooneratne Nalaka S8,Thase Michael E1

Affiliation:

1. Department of Psychiatry, University of Pennsylvania, Philadelphia

2. Department of Psychological Sciences, University of Arkansas, Fayetteville

3. Northumbria Center for Sleep Research, Northumbria University, Newcastle, UK

4. Department of Psychiatry, University of Arizona, Tucson

5. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia

6. Department of Psychology, East Carolina University, Greenville, NC

7. Department of Psychology, University of Arizona, Tucson

8. Department of Medicine, University of Pennsylvania, Philadelphia

Abstract

Abstract Study Objectives The primary aim of the present study was to estimate the incidence per annum of acute insomnia and to what extent those that develop acute insomnia recover good sleep or develop chronic insomnia. Unlike prior studies, a dense-sampling approach was used here (i.e. daily diaries) and this allowed for a more precise detection of acute insomnia and the follow-on states (the transitions to either recovery or chronic insomnia). Methods Good sleeper subjects (n = 1,248; 67% female) that were at least 35 years old participated in this prospective study on the natural history of insomnia. Subjects were recruited nationwide and completed online assessments for 1 year. The online measures consisted primarily of daily sleep diaries, as well as weekly/bi-weekly and monthly measures of sleep, stress, and psychological and physical health. Results The 1-year incidence rate of acute insomnia was 27.0% (n = 337). The incidence rate of chronic insomnia was 1.8% (n = 23). Of those that developed acute insomnia, 72.4% (n = 244) went on to recover good sleep. 19.3% (n = 65) of the acute insomnia sample continued to experience persistent poor sleep, but did not meet criteria for chronic insomnia. Conclusions The incidence rate of acute insomnia (3 or more nights a week for between 2 and 12 weeks) is remarkably high. This said, most incident cases resolve within a few days to weeks. Incident chronic insomnia only occurs in about 2 in 100 individuals.

Funder

Economic and Social Research Council

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Neurology (clinical)

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