![]() The second aim was to examine and compare factors associated with insomnia disorder specified by different duration quantifiers. The present study aims to identify the prevalence of insomnia disorder in older adults according to different duration quantifiers. In summary, factors associated with persistence of insomnia disorder in older adults warrant further investigation. However, the validity of the duration quantifiers of insomnia disorder in older adults has not been examined. Insomnia disorder can be classified as acute or chronic according to different duration quantifiers, which imply differential etiologies, associated factors, treatment strategies, and even outcomes. The DSM-V diagnostic criteria for insomnia disorder define insomnia of longer than 3 months as persistent insomnia. According to the International Classification of Diseases 10th edition (ICD-10) diagnostic criteria, insomnia lasting for longer than 1 month is termed chronic insomnia. Insomnia lasting for more than 6 months is classified as chronic insomnia. According to the International Classification of Sleep Disorders 2nd edition (ICSD-2) diagnostic criteria for psychophysiological insomnia, insomnia lasting less than 1 month is termed acute insomnia, whereas insomnia lasting for 1 to 6 months is termed sub-acute insomnia. According to the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) diagnostic criteria for primary insomnia, insomnia lasting for longer than 1 month is called persistent insomnia. In addition, with regard to the definition of persistent insomnia, the duration quantifier is not consistent across various diagnostic systems. To prevent insomnia from becoming chronic, it is important to investigate the factors associated with the persistence of insomnia disorder in older adults. Furthermore, to the best of knowledge, few studies have used a formal diagnostic system to examine the persistence of insomnia in older adults. Nevertheless, there is less knowledge about the natural course of insomnia in older adults. With respect to older adults, a 3-year, large-scale follow-up study reported a remission rate of insomnia of approximately 50 % in community-dwelling older adults. Because the course of insomnia fluctuates and persistence between follow-up points is questionable, it is difficult to evaluate the chronicity of insomnia in longitudinal studies. In the general population, only 31.6 to 51.5 % of insomnia remits, while 44.9 to 66.1 % of insomnia persists and the recurrence rate reaches as high as 11.8 %. Some insomnia episodes are resolved after acute events some insomnia persists even when the precipitating factors have been resolved. Because persistent insomnia greatly impairs general health and quality of life, it is important to examine clinical conditions which correlate with persistence of insomnia in older adults.ĭuring the natural course of insomnia, sleep condition fluctuates over time. Furthermore, it has been found that a bi-directional association exists between heart disease, hypertension, chronic pain, breathing, urinary, gastrointestinal disorders and persistent insomnia. Consequences of poor sleep in older adults include poor health, poor physical function, frequent falls, cognitive impairment and even mortality. ![]() Although the prevalence of insomnia symptoms is high in older adults, insomnia has been more closely associated with comorbidities rather than with age per se. Sleep disturbance is a common public health issue in the elderly. Duration quantifiers may be important in the identification of the etiology of insomnia and further studies with follow-ups are needed to examine the order of developing insomnia disorder and associated conditions.Īs the architecture of sleep changes along with aging, sleep becomes vulnerable in older adults. Correlates for less persistent and more persistent insomnia disorder appears to be partially different. The prevalence of persistent insomnia disorder is higher than short-term insomnia disorder. Pulmonary diseases were exclusively associated with 1–6 month insomnia disorder (OR: 2.57, 95 % CI: 1.46–4.52). The shared correlates for both 1–6 and 6-month insomnia disorders were gender (women), depression and moderate pain. The prevalence of DSM-IV defined insomnia disorder was 5.8 % two-thirds of these case lasted for ≥6 months. The Pittsburgh Sleep Quality Index and the duration of insomnia symptoms were used to identify DSM-IV 1–6 month and 6-month insomnia disorders. A total 4047 subjects over the age of 65 years completed the study (2259 men and 1788 women). MethodsĪ cross-sectional survey in the Shih-Pai area of Taipei City, Taiwan (The Shih-Pai Sleep Study). To examine the correlates of insomnia disorder with different durations in home-dwelling older adults.
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