Clinical Correlates of Insomnia in Patients With Chronic Illness

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Abstract
INSOMNIA AFFECTS approximately one third of the general population and has a major impact on health.1,2 In the Alameda County study, the number of hours of sleep, combined with data on 6 other health practices, was a significant predictor of subsequent health and mortality.3,4 Patients with chronic insomnia are more likely to develop affective disorders,5,6 and sleep disturbance is associated with the persistence of depressive symptoms in older persons with depression.7 In addition to its psychological consequences, insomnia may worsen somatic symptoms.8 Insomnia has also been associated with clinically significant decrements in key quality-of-life domains, such as physical functioning and mental health in generally healthy, working adults9 and in patients with chronic conditions.10 Finally, insomnia (and associated daytime sleepiness) is associated with increased risk of automobile and work-related accidents11,12 and increased use of medical services.13,14 Thus, there is great need for the development of effective prevention and treatment strategies for this disorder.