An important criterion, and pertinent to this study, is that the sleep disturbance must also be accompanied by significant daytime impairment, such as memory or concentration difficulties, daytime fatigue, sleepiness, and/or negative mood 3, 4. Insomnia disorder includes nocturnal symptoms of difficulties falling asleep, maintaining sleep and/or early morning awakenings with an inability to fall back to sleep 3. Insomnia disorder is estimated to affect approximately 770 million people worldwide, with an estimated 2.5 million individuals affected in Australia alone 1, 2. Findings may be therapeutically helpful by reassuring individuals with nocturnal insomnia symptoms alone that their longevity is unlikely to be impacted. Findings suggest daytime symptoms drive increased mortality risk associated with insomnia symptoms. Subsequent analyses showed this association was driven by daytime symptoms (adjusted HR Q1vsQ5 = 1.66,, p < .0001), since nocturnal symptoms alone were not associated with increased mortality (adjusted HR Q1vsQ5 = 0.89,, p = .28). Insomnia symptom severity was associated with increased mortality in the most severe quintile (adjusted HR Q1vsQ5 = 1.26, 95%CI, p = .02). In the median follow up of 9.2 years, there were 17,403 person-years at risk and the mortality rate was 8-per 100 person-years. Multivariable Cox models were conducted to assess associations between insomnia symptom severity and mortality risk. Frequency of symptoms were combined to calculate an insomnia symptom score ranging from 0 (no symptoms) to 24 (sever symptoms) and quintiles of the score were constructed to provide a range of symptom severity. Insomnia symptoms were defined by nocturnal symptoms (difficulty falling asleep, difficulty maintaining sleep, early morning awakenings) and daytime symptoms (concentration difficulties, effort, inability to get going). Data was used from 1969 older adults who participated in the Australian Longitudinal Study of Ageing. The current study examined the association between insomnia symptoms and all-cause mortality in older adults (≥ 65 years).
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