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Jul 15, 2018
Research Papers / Insomnia: It's Effect on the Quality of Life [2]
This is a research paper in need of a Peer review: What are three areas of weakness in which can improve my paper?
Insomnia is the inability to sleep and the inability to stay a sleep. The condition is characterized by being an able to get quality sleep as required which in turn leads to increased chances of medical problems as well as mental disorders. In most cases, people who experience insomnia are unable to fall asleep, stay asleep or in some cases both. The result is that they end up not having good and quality sleep which if persist may lead to health-related problems and poor-quality life. Insomnia is categorized into two depending on its severity.
Medically, insomnia is the inability to sleep and the inability to stay a sleep. The condition is characterized by an individual being unable to get adequate and quality sleep as recommended which in turn lead to increased chances of medical problems as well as mental disorders. Some of the medical conditions and mental disorders that may be experienced due to insomnia include; stroke, heart disease, depression, anxiety, obesity, high blood pressure, frustration, bodily pain especially at the joints among other related problems. It can either be acute, which means short in nature or it can be chronic which means on-going and long. Acute insomnia is the most common type of insomnia that affects millions of people worldwide. It is usually short in nature and lasts between a few days and or weeks. It is usually caused by stress either at the work place or from home, it can also be brought about by a traumatic event. On the other hand, chronic insomnia may go for many months or even longer. Medical experts assert that chronic insomnia is usually secondary which means that they are side effects or symptoms of other problems such as some medicines, medical conditions and sleep disorders among other factors.
Medical experts believe that insomnia has direct impact on the quality of life as it affects the normal functioning of the human body as well as the functioning of the brain. Factors such as stress, anxiety, frustration, weak immune system and bodily pain are some few factors of insomnia that can lead to poor quality of life in individuals. There are many suggestions from many quotas as to what quality life is, however, the general agreeable definition of what Quality of Life (QOL) is that it is "the general well-being of people" (Katic 1332). This is a broad definition that encompasses a myriad of factors relating to being satisfied with life such as having wealth, good education, good health, freedom, safety, family, employment and finances among many other considerations. From the above definition of what quality of life is, it can be deduced that insomnia impacts on the health of individuals which then reduces their ability to lead quality lives. This article seeks to examine how insomnia as a condition influences the quality of life. Mounting evidence from recent researches by scientists relates insomnia with high risks of medical conditions and increased chances of mental health disorders leading to poor quality of life.
Causes of Insomnia
Some of the common factors that have been cited to cause insomnia include
·Stress that is chronic in nature
·Body pains which may make one not be able to fall a sleep at night
·Depression
·Anxiety
·Medical conditions and ailments such as asthma, diabetes, thyroid, cancer and chronic pains which may cause one to have sleepless nights.
·Uncomfortable environment with high noise, and uncomfortable temperatures such hot or cold which may make it impossible for one to fall asleep.
Impact of Insomnia on Quality of Life
Insomnia Increases risks of medical conditions. Studies show that insomnia maybe associated with a number of medical conditions in individuals such as obesity, stress, inflammations, seizures, high blood pressure, weak immune system, body pain, heart diseases and even diabetes. Many chronic diseases have been known to cause insomnia as highlighted below.
·Alzheimer's disease- This disease is also commonly referred to as "sundowning" is a condition where those diagnosed with it become increasingly confused and restless as dusk approaches. They are prone to lack of sleep and many often wander off during night time thereby not getting enough sleep leading to insomnia. According to available statistics, Alzheimer's disease is responsible for insomnia in half of all people with mild to moderate conditions of the disease.
·Arthritis is a disease characterized with sharp pains and inflammations especially in the joints which may cause a lot of discomfort during night time leading to extended periods of poor or no sleep which may lead such individuals to exhibit symptoms related to insomnia.
·Chronic Obstructive Pulmonary disease (COPD) is a chronic ailment that is similar to asthma in that it results in difficulty in breathing as the body struggles to generate enough oxygen in the blood vessels. The struggle and difficulty in breathing may lead to sleepless nights for persons with this disease leading to insomnia.
·Multiple Sclerosis is another chronic disease that may cause insomnia. It is a condition in which the immune system attacks the nerve cells in the spinal cord and those of the brain leading to the destruction of the entire Central Nervous System. With the brain nerves destroyed, the electrical activities of the brain such as communication is interfered with and in many cases results in the disruption of sleep-wake activity. This disease is characterized with symptoms such as dizziness, bodily pain, numbness, prolonged double vision. The disruption of sleep-wake cycle and intermittent pain may see patients losing sleep leading to insomnia.
·Parkinson's disease. This neurological disease is characterized by tremor or shaking, rigidity or stiffness, poor coordination and slow motor reactions often lead to patients with the condition experiencing serious sleep disorders because they are often forced to be awake for long periods during night time leading to insomnia.
The medical conditions enumerated above affect sleep in human beings leading to insomnia. In terms of health, the quality of life is determined by how such ailments impacts on individuals. Some diseases are debilitating, but not life threatening, some diseases or ailments are serious and even life-threatening but are not terminal, yet some diseases are very serious and life-threatening and are terminal in nature. Based on this parameter, insomnia in this case will be determined by how much a medical condition causes lack of sleep in an individual. (Wong 8). How much an individual loses sleep due to these ailments may determine whether one may experience acute insomnia or chronic insomnia which lasts long. Thus, individuals with chronic insomnia are bound to experience higher levels of poor life quality compared to those who experience acute cases of insomnia. Lack of sleep occasioned by these medical conditions will result in increased stress levels, bodily pain, and discomfort which may it impossible or difficult for such individuals to work normally, do daily chores, live normally which in turn will lower their quality of lives as their capacities and abilities are affected by poor state of their health.
Insomnia hampers everyday life. A study conducted by Stein, Belik, Jacobi, and Sareen (2008) entitled "Impairment associated with sleep problems in the community, relationship to physical and mental co-morbidity" show that insomnia directly impacts the physical and mental aspects of man. According to this study, Stein and co-authors found out that as many as 50% of all America's workers had taken off-days from work due to insomnia related problems. Further, Stein and co-authors assert that their study revealed that lack of sleep coupled with daytime fatigue give increased chances of low scores as far as physical functioning, physical health problems, mental health and vitality are concerned. Another study carried out by Leger (2001) which was aimed at comparing facts on good sleepers and patients of insomnia. According to the study, people with severe cases of insomnia were likely to experience some disruptions and impairments as far as daytime functioning is concerned. This comprehensive study by Leger found out that there were "significant independent association between insomnia and Quality of Life" (Wong 8). The study found out that even after a number of parameters such as health habits, sociodemographic factors, medical comorbidities and threshold depressions had been statistically controlled, there were enough evidence to prove that there was strong relation between insomnia and Quality of Life. The greatest observation from their study was that "Mild and severe insomnia were associated with diminished QOL across all SF-36 domains using logistic regression relative to patients without insomnia" (Fung 629). Going by these facts, one can conclude that quality of life is directly proportional to the degree of insomnia that one experiences.
According to the National Sleep Foundation, an adult human being requires an average of seven and nine hours of sleep per every night. This is so because the body needs this time to replenish and rejuvenate itself adequately as well as to institute healing process that is vital functioning of the body. The body asserts that those who chronically under-sleep increasingly faces numerous health challenges such as diabetes, heart disease and high blood pressure which may lead to imminent death. Some of the ways in which insomnia affects people's daily lives are as follows.
·Mood swings. A person who has had no or little sleep is likely to be very grumpy which in turn affects their sociability. Studies done by Harvard University indicate that sleep and mood are very closely related, i.e. a person who has very little sleep is likely to be in a bad mood compared to a person who had adequate sleep (Katic 1332). The recommendation is to have enough sleep to correct such mood swings.
·Difficulty in remembering things. Lack of enough sleep can impact on the brain in terms of ability to remember things. Studies show that adequate night sleep is essential for the brain the brain to relax in order for it to perform its core functions, key among them providing good memory for grasping, capturing, storing and remembering information.
·Low Self-esteem. Several studies by researchers have shown that there is direct relation between insomnia and low self-esteem. According one such research by National Sleep Foundation, people with sleep disorders often have low self-esteem and low confidence levels compared to people who get enough sleep at night on regular basis (Appleton 13). This is because people who experience insomnia are unable to perform well in class, at work and other spheres of life making them to have low self-esteem.
·Lack of concentration. In 2013, a study published in Sleep journal showed that people with insomnia are unable to perform tasks with efficiency while at the same time not being able to keep their brains or minds from wandering off regularly. Being unable to keep concentration is one of the side effects of insomnia. The severity of the insomnia dictates the severity of the lack of concentration and efficiency or lack of it in performing tasks.
There are other ways in which insomnia can have effect on one's daily life such as being tired and being fatigued. Lack of sleep deprives one the energy required to perform regular duties, chores and work leaving one feeling weak, confused and even disoriented in many instances. When one has not had enough sleep during the night, it is common to wake up with low levels of energy which in turn impacts negatively on one's motivation. Other ways in which insomnia can affect daily life is that one can become depressed and experience interruptions in their lives (Ancoli 347). Depression is likely to contribute to low quality of life because an individual is not able to operate optimally. The lack of control and predictability is another side effect of insomnia that can affect the quality of life. Lack of control refers to one's inability to control some functions of their body such as having slow reflexes leading to slow reactions. Lack of predictability on the other hand refer to a situation where mood swings make one's behavior unpredictable because one moment they act fine and the next moment, their actions are not in line with what people expect of them. They become erratic in their behavior which becomes a bit unpredictable for many people to deal with.
Consequences of Insomnia
Productivity
One of the negative consequences of insomnia which goes to affect quality of life is reduced productivity. Lack of sleep at night leaves one weak, stressed and frustrated which affects both the quality and quantity in terms of production. Many aspects of modern life is measured on one's productivity. School, work and jobs are all measured on quality and quantity of production. People experiencing insomnia are not able to be as productive as required by the virtue of the fact that they are not 'well.' This reduction in their productivity will affect the quality of lives they live because, high production is associated with much returns and vice versa.
Increased Chances of Accidents
As has been explained in this research, insomnia greatly weakens people's reflexes which lead to individuals being slow or reacting slower than usual. Slow reflexes increase an individual's vulnerability to accidents. For example, many drivers with insomnia may cause an accident mainly because they failed to respond to an emergency situation on the road because they did not respond fast enough (Buman 761). A good example is when a driver in front breaks suddenly, the driver behind will need to react to this situation by hitting the brakes hard to avoid a collision. Those with insomnia may not be in a position to react fast enough in such situations.
Worsening Medical Conditions
The many researchers on the relation between insomnia and medical conditions attest to the fact that insomnia can worsen existing medical conditions and, in some cases, though rare may lead to a medical condition. People with diabetes, heart diseases, and other chronic illnesses may see their conditions worsening because of the inability to get adequate sleep. Many doctors nowadays advice their patients on the importance of having as much sleep at night as possible because their recovery squarely lies on having enough sleep, medication and other factors.
Conclusion
Growing cases of mental disorders and medical conditions have been blamed on the ever-increasing cases of insomnia incidences. Insomnia has been found to expound medical conditions on individuals by making them worse. Medical doctors believe that by alleviating insomnia, many patients are able not only to witness their recovery but would also find their lives less stressful. Additionally, insomnia through chronic stress has been noticed to result in mental disorders where individuals are incapable of reasoning optimally. Some of the common causes that lead to insomnia include, stress that is chronic in nature, body pains which may make one not be able to fall a sleep at night, depression, anxiety and medical conditions and ailments such as asthma, diabetes, thyroid, cancer and chronic pains which may cause one to have sleepless nights. The negative consequences that insomnia may have on individuals which may result in low quality life are, loss of productivity, low self-esteem, low motivation, and loss of coordination and control, all of which may resign an individual to poor quality life. Based on the facts alluded to in this research, one can conclude that insomnia is directly related with high risks of medical conditions and increased chances of mental disorders leading to poor quality of life
Works Cited
Ancoli-Israel, Sonia, and Thomas Roth. "Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I."
Appleton, Sarah L., et al. "Prevalence and comorbidity of sleep conditions in Australian adults: 2016 Sleep Health Foundation national survey." Sleep health
Buman, Matthew P., et al. "Does nighttime exercise really disturb sleep? Results from the 2013 National Sleep Foundation Sleep in America Poll." Sleep Medicine
Fung, Constance H., et al. "Efficacy of cognitive behavioral therapy for insomnia in older adults with occult sleep-disordered breathing." Psychosomatic medicine
Katic, Bozena, et al. "New approach for analyzing self-reporting of insomnia symptoms reveals a high rate of comorbid insomnia across a wide spectrum of chronic diseases." Sleep medicine
Shi, Lang, Carol J., et al. "Co‐morbid OSA and insomnia increases depression prevalence and severity in men." Respirology
Reynolds, Amy C., et al. "Sickness absenteeism is associated with sleep problems independent of sleep disorders: results of the 2016 Sleep Health Foundation national survey." Sleep health
Wong, Maria M., Kirk J. Brower, and Elizabeth A. Craun. "Insomnia symptoms and suicidality in the national comorbidity survey-adolescent supplement." Journal of psychiatric research
This is a research paper in need of a Peer review: What are three areas of weakness in which can improve my paper?
Insomnia: It's Effect on the Quality of Life
Insomnia is the inability to sleep and the inability to stay a sleep. The condition is characterized by being an able to get quality sleep as required which in turn leads to increased chances of medical problems as well as mental disorders. In most cases, people who experience insomnia are unable to fall asleep, stay asleep or in some cases both. The result is that they end up not having good and quality sleep which if persist may lead to health-related problems and poor-quality life. Insomnia is categorized into two depending on its severity.
Medically, insomnia is the inability to sleep and the inability to stay a sleep. The condition is characterized by an individual being unable to get adequate and quality sleep as recommended which in turn lead to increased chances of medical problems as well as mental disorders. Some of the medical conditions and mental disorders that may be experienced due to insomnia include; stroke, heart disease, depression, anxiety, obesity, high blood pressure, frustration, bodily pain especially at the joints among other related problems. It can either be acute, which means short in nature or it can be chronic which means on-going and long. Acute insomnia is the most common type of insomnia that affects millions of people worldwide. It is usually short in nature and lasts between a few days and or weeks. It is usually caused by stress either at the work place or from home, it can also be brought about by a traumatic event. On the other hand, chronic insomnia may go for many months or even longer. Medical experts assert that chronic insomnia is usually secondary which means that they are side effects or symptoms of other problems such as some medicines, medical conditions and sleep disorders among other factors.
Medical experts believe that insomnia has direct impact on the quality of life as it affects the normal functioning of the human body as well as the functioning of the brain. Factors such as stress, anxiety, frustration, weak immune system and bodily pain are some few factors of insomnia that can lead to poor quality of life in individuals. There are many suggestions from many quotas as to what quality life is, however, the general agreeable definition of what Quality of Life (QOL) is that it is "the general well-being of people" (Katic 1332). This is a broad definition that encompasses a myriad of factors relating to being satisfied with life such as having wealth, good education, good health, freedom, safety, family, employment and finances among many other considerations. From the above definition of what quality of life is, it can be deduced that insomnia impacts on the health of individuals which then reduces their ability to lead quality lives. This article seeks to examine how insomnia as a condition influences the quality of life. Mounting evidence from recent researches by scientists relates insomnia with high risks of medical conditions and increased chances of mental health disorders leading to poor quality of life.
Causes of Insomnia
Some of the common factors that have been cited to cause insomnia include
·Stress that is chronic in nature
·Body pains which may make one not be able to fall a sleep at night
·Depression
·Anxiety
·Medical conditions and ailments such as asthma, diabetes, thyroid, cancer and chronic pains which may cause one to have sleepless nights.
·Uncomfortable environment with high noise, and uncomfortable temperatures such hot or cold which may make it impossible for one to fall asleep.
Impact of Insomnia on Quality of Life
Insomnia Increases risks of medical conditions. Studies show that insomnia maybe associated with a number of medical conditions in individuals such as obesity, stress, inflammations, seizures, high blood pressure, weak immune system, body pain, heart diseases and even diabetes. Many chronic diseases have been known to cause insomnia as highlighted below.
·Alzheimer's disease- This disease is also commonly referred to as "sundowning" is a condition where those diagnosed with it become increasingly confused and restless as dusk approaches. They are prone to lack of sleep and many often wander off during night time thereby not getting enough sleep leading to insomnia. According to available statistics, Alzheimer's disease is responsible for insomnia in half of all people with mild to moderate conditions of the disease.
·Arthritis is a disease characterized with sharp pains and inflammations especially in the joints which may cause a lot of discomfort during night time leading to extended periods of poor or no sleep which may lead such individuals to exhibit symptoms related to insomnia.
·Chronic Obstructive Pulmonary disease (COPD) is a chronic ailment that is similar to asthma in that it results in difficulty in breathing as the body struggles to generate enough oxygen in the blood vessels. The struggle and difficulty in breathing may lead to sleepless nights for persons with this disease leading to insomnia.
·Multiple Sclerosis is another chronic disease that may cause insomnia. It is a condition in which the immune system attacks the nerve cells in the spinal cord and those of the brain leading to the destruction of the entire Central Nervous System. With the brain nerves destroyed, the electrical activities of the brain such as communication is interfered with and in many cases results in the disruption of sleep-wake activity. This disease is characterized with symptoms such as dizziness, bodily pain, numbness, prolonged double vision. The disruption of sleep-wake cycle and intermittent pain may see patients losing sleep leading to insomnia.
·Parkinson's disease. This neurological disease is characterized by tremor or shaking, rigidity or stiffness, poor coordination and slow motor reactions often lead to patients with the condition experiencing serious sleep disorders because they are often forced to be awake for long periods during night time leading to insomnia.
The medical conditions enumerated above affect sleep in human beings leading to insomnia. In terms of health, the quality of life is determined by how such ailments impacts on individuals. Some diseases are debilitating, but not life threatening, some diseases or ailments are serious and even life-threatening but are not terminal, yet some diseases are very serious and life-threatening and are terminal in nature. Based on this parameter, insomnia in this case will be determined by how much a medical condition causes lack of sleep in an individual. (Wong 8). How much an individual loses sleep due to these ailments may determine whether one may experience acute insomnia or chronic insomnia which lasts long. Thus, individuals with chronic insomnia are bound to experience higher levels of poor life quality compared to those who experience acute cases of insomnia. Lack of sleep occasioned by these medical conditions will result in increased stress levels, bodily pain, and discomfort which may it impossible or difficult for such individuals to work normally, do daily chores, live normally which in turn will lower their quality of lives as their capacities and abilities are affected by poor state of their health.
Insomnia hampers everyday life. A study conducted by Stein, Belik, Jacobi, and Sareen (2008) entitled "Impairment associated with sleep problems in the community, relationship to physical and mental co-morbidity" show that insomnia directly impacts the physical and mental aspects of man. According to this study, Stein and co-authors found out that as many as 50% of all America's workers had taken off-days from work due to insomnia related problems. Further, Stein and co-authors assert that their study revealed that lack of sleep coupled with daytime fatigue give increased chances of low scores as far as physical functioning, physical health problems, mental health and vitality are concerned. Another study carried out by Leger (2001) which was aimed at comparing facts on good sleepers and patients of insomnia. According to the study, people with severe cases of insomnia were likely to experience some disruptions and impairments as far as daytime functioning is concerned. This comprehensive study by Leger found out that there were "significant independent association between insomnia and Quality of Life" (Wong 8). The study found out that even after a number of parameters such as health habits, sociodemographic factors, medical comorbidities and threshold depressions had been statistically controlled, there were enough evidence to prove that there was strong relation between insomnia and Quality of Life. The greatest observation from their study was that "Mild and severe insomnia were associated with diminished QOL across all SF-36 domains using logistic regression relative to patients without insomnia" (Fung 629). Going by these facts, one can conclude that quality of life is directly proportional to the degree of insomnia that one experiences.
According to the National Sleep Foundation, an adult human being requires an average of seven and nine hours of sleep per every night. This is so because the body needs this time to replenish and rejuvenate itself adequately as well as to institute healing process that is vital functioning of the body. The body asserts that those who chronically under-sleep increasingly faces numerous health challenges such as diabetes, heart disease and high blood pressure which may lead to imminent death. Some of the ways in which insomnia affects people's daily lives are as follows.
·Mood swings. A person who has had no or little sleep is likely to be very grumpy which in turn affects their sociability. Studies done by Harvard University indicate that sleep and mood are very closely related, i.e. a person who has very little sleep is likely to be in a bad mood compared to a person who had adequate sleep (Katic 1332). The recommendation is to have enough sleep to correct such mood swings.
·Difficulty in remembering things. Lack of enough sleep can impact on the brain in terms of ability to remember things. Studies show that adequate night sleep is essential for the brain the brain to relax in order for it to perform its core functions, key among them providing good memory for grasping, capturing, storing and remembering information.
·Low Self-esteem. Several studies by researchers have shown that there is direct relation between insomnia and low self-esteem. According one such research by National Sleep Foundation, people with sleep disorders often have low self-esteem and low confidence levels compared to people who get enough sleep at night on regular basis (Appleton 13). This is because people who experience insomnia are unable to perform well in class, at work and other spheres of life making them to have low self-esteem.
·Lack of concentration. In 2013, a study published in Sleep journal showed that people with insomnia are unable to perform tasks with efficiency while at the same time not being able to keep their brains or minds from wandering off regularly. Being unable to keep concentration is one of the side effects of insomnia. The severity of the insomnia dictates the severity of the lack of concentration and efficiency or lack of it in performing tasks.
There are other ways in which insomnia can have effect on one's daily life such as being tired and being fatigued. Lack of sleep deprives one the energy required to perform regular duties, chores and work leaving one feeling weak, confused and even disoriented in many instances. When one has not had enough sleep during the night, it is common to wake up with low levels of energy which in turn impacts negatively on one's motivation. Other ways in which insomnia can affect daily life is that one can become depressed and experience interruptions in their lives (Ancoli 347). Depression is likely to contribute to low quality of life because an individual is not able to operate optimally. The lack of control and predictability is another side effect of insomnia that can affect the quality of life. Lack of control refers to one's inability to control some functions of their body such as having slow reflexes leading to slow reactions. Lack of predictability on the other hand refer to a situation where mood swings make one's behavior unpredictable because one moment they act fine and the next moment, their actions are not in line with what people expect of them. They become erratic in their behavior which becomes a bit unpredictable for many people to deal with.
Consequences of Insomnia
Productivity
One of the negative consequences of insomnia which goes to affect quality of life is reduced productivity. Lack of sleep at night leaves one weak, stressed and frustrated which affects both the quality and quantity in terms of production. Many aspects of modern life is measured on one's productivity. School, work and jobs are all measured on quality and quantity of production. People experiencing insomnia are not able to be as productive as required by the virtue of the fact that they are not 'well.' This reduction in their productivity will affect the quality of lives they live because, high production is associated with much returns and vice versa.
Increased Chances of Accidents
As has been explained in this research, insomnia greatly weakens people's reflexes which lead to individuals being slow or reacting slower than usual. Slow reflexes increase an individual's vulnerability to accidents. For example, many drivers with insomnia may cause an accident mainly because they failed to respond to an emergency situation on the road because they did not respond fast enough (Buman 761). A good example is when a driver in front breaks suddenly, the driver behind will need to react to this situation by hitting the brakes hard to avoid a collision. Those with insomnia may not be in a position to react fast enough in such situations.
Worsening Medical Conditions
The many researchers on the relation between insomnia and medical conditions attest to the fact that insomnia can worsen existing medical conditions and, in some cases, though rare may lead to a medical condition. People with diabetes, heart diseases, and other chronic illnesses may see their conditions worsening because of the inability to get adequate sleep. Many doctors nowadays advice their patients on the importance of having as much sleep at night as possible because their recovery squarely lies on having enough sleep, medication and other factors.
Conclusion
Growing cases of mental disorders and medical conditions have been blamed on the ever-increasing cases of insomnia incidences. Insomnia has been found to expound medical conditions on individuals by making them worse. Medical doctors believe that by alleviating insomnia, many patients are able not only to witness their recovery but would also find their lives less stressful. Additionally, insomnia through chronic stress has been noticed to result in mental disorders where individuals are incapable of reasoning optimally. Some of the common causes that lead to insomnia include, stress that is chronic in nature, body pains which may make one not be able to fall a sleep at night, depression, anxiety and medical conditions and ailments such as asthma, diabetes, thyroid, cancer and chronic pains which may cause one to have sleepless nights. The negative consequences that insomnia may have on individuals which may result in low quality life are, loss of productivity, low self-esteem, low motivation, and loss of coordination and control, all of which may resign an individual to poor quality life. Based on the facts alluded to in this research, one can conclude that insomnia is directly related with high risks of medical conditions and increased chances of mental disorders leading to poor quality of life
Works Cited
Ancoli-Israel, Sonia, and Thomas Roth. "Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I."
Appleton, Sarah L., et al. "Prevalence and comorbidity of sleep conditions in Australian adults: 2016 Sleep Health Foundation national survey." Sleep health
Buman, Matthew P., et al. "Does nighttime exercise really disturb sleep? Results from the 2013 National Sleep Foundation Sleep in America Poll." Sleep Medicine
Fung, Constance H., et al. "Efficacy of cognitive behavioral therapy for insomnia in older adults with occult sleep-disordered breathing." Psychosomatic medicine
Katic, Bozena, et al. "New approach for analyzing self-reporting of insomnia symptoms reveals a high rate of comorbid insomnia across a wide spectrum of chronic diseases." Sleep medicine
Shi, Lang, Carol J., et al. "Co‐morbid OSA and insomnia increases depression prevalence and severity in men." Respirology
Reynolds, Amy C., et al. "Sickness absenteeism is associated with sleep problems independent of sleep disorders: results of the 2016 Sleep Health Foundation national survey." Sleep health
Wong, Maria M., Kirk J. Brower, and Elizabeth A. Craun. "Insomnia symptoms and suicidality in the national comorbidity survey-adolescent supplement." Journal of psychiatric research
