objective short sleep duration and mental health problems are the strongest predictors of persistent insomnia. the aim of this study was to examine the role of objective short sleep duration, sdb, and mental and physical health in the persistence of insomnia in a large general random sample (the penn state cohort study) using psg and a longitudinal design. this cutoff point has been shown in previous studies to be predictive of significant medical morbidity and mortality.20,21–23 additional information obtained during the psg included that assessing sleep apnea. because the focus of the present study was the persistence and remission of insomnia, those individuals with poor sleep at baseline were excluded from further analysis.
we present the 3 sets of multinomial logistic regression models that examined the association of objective sleep duration with insomnia status after progressively adjusting for potential confounders in table 2. shorter objective sleep duration was associated with a significantly higher risk for persistent insomnia as compared to the normal sleep group. the main finding of the present study is that objective sleep duration and mental health problems are the major predictors of the persistence of insomnia over a period of 7.5 years. interestingly, although only marginally significant, the risk associated with decreased objective sleep duration for partially remitted insomnia was higher compared to fully remitted insomnia and lower compared to persistent insomnia. furthermore, because our cohort study was not designed to include a derivation sample and a validation sample, we cannot assess and confirm the optimal cutoff point of sleep duration in insomnia to predict, for example, persistent insomnia. furthermore, it may lead to the development of more specific treatments, i.e., biological treatment for insomniacs with objective short sleep duration and psychological treatment for insomniacs with normal sleep duration.
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