Original articlePrevalence and consequences of insomnia disorders in the general population of Italy
Introduction
Insomnia is a distressing and disabling condition that affects a large part of the general population. Epidemiological studies performed in Western Europe, the USA, and Japan have reported a prevalence of insomnia symptoms ranging from 10 to 48% [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23]. This variation in the prevalence can be narrowed when more specific criteria are used. Frequent insomnia, defined as having difficulty initiating or maintaining sleep ‘often’ or at least three times per week, has a prevalence between 6 and 15% [9], [10], [11], [12], [13], [14], [15]. ‘Major complaints of insomnia’, ‘being bothered by insomnia’, and ‘having a great or a very great problem with insomnia’ have a prevalence between 7 and 12% [16], [17], [18]. Sleep dissatisfaction has a prevalence between 7 and 18% [5], [6], [7], [8], [20], [21], [22], [23]. Therefore, the large variability of insomnia prevalence among the different studies is not only due to cultural differences, but also because of the idiosyncratic ways of defining insomnia. Furthermore, there is no consensus on how to define insomnia and how to measure it in the general population.
Consequences of these sleep disturbances are numerous and bear important health and economical issues: increased hospitalizations, absenteeism at work, higher risks of road accidents, mortality and higher risk of developing a mental disorder.
This study aims to assess the prevalence of insomnia and its treatment in Italy using DSM-IV classification, and to assess the consequences of insomnia.
Section snippets
Sample
A representative sample of the Italian population was interviewed by telephone between December 1996 and April 1997 about its sleep habits, sleep disorders and mental disorders. The targeted population consisted of 46,332,282 inhabitants representing all non-institutionalized Italians aged 15 years or older. The sample was drawn according to a two-stage procedure. First, telephone numbers were pulled within each of the 18 geographical areas of Italy with respect to the population distribution
Description of the sample
The subjects were aged between 15 and 99 years; 18.3% were 65 years and older. Women represented 52% of the sample. Most of the subjects were married with the exception of the youngest, who were mainly single, and the oldest, who were frequently widowed (Table 1).
Dissatisfaction with sleep quality or quantity
Sleep dissatisfaction was reported by 10.1% (95% CI: 9.2–11.0%) of the sample. Women reported being dissatisfied with their sleep twice as much as men (12.0 vs. 6.8%; P<0.0001). The prevalence of sleep dissatisfaction significantly
Discussion
This study aimed to assess the prevalence of insomnia in Italy, its treatment and its association with daytime sleepiness and road accidents. Insomnia was assessed using three different measures as found in the literature: dissatisfaction with sleep quality or quantity, a symptom and a diagnosis. This provided different figures of prevalence. In this study, sleep dissatisfaction was reported by one Italian in ten. Insomnia symptoms, i.e. difficulty in initiating or maintaining sleep or NRS,
Acknowledgements
This study was supported by the FRSQ (#971067) and an unrestricted educational grant from the Sanofi-Synthelabo group.
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