Anyone can have occasional trouble falling asleep. These are worrying times, after all. But if inability to fall or stay asleep becomes a regular, extended pattern, it's chronic insomnia. Now a new study has found a shocking result: men with chronic insomnia are much more likely to die prematurely. The authors call for a broad public health campaign to encourage early diagnosis and treatment.
The insomnia study was conducted at the Pennsylvania State University College of Medicine, and published in the September 1 edition of the journal SLEEP. And the study is unique in that it does not rely on self-reported insomnia, since people tend to inaccurately perceive their own sleep patterns. Instead, this research was conducted in a sleep lab, and measured not only how long the men spent trying to sleep, but the duration of their actual sleep. "Our different results are based on our novel approach to define insomnia both on a subjective complaint and the objective physiological marker of short sleep duration measured in the sleep lab," said lead author Dr. Alexandros Vgontzas, professor of psychiatry at Penn State's College of Medicine. In other words, insomnia is both the time spent falling asleep, and the habit of waking up during the night—periods of wakefulness that the insomniac may not even be aware of.
The participants all had had insomnia for at least a year, and consisted of 1,000 women and 741 men. They described their sleep habits, had a physical exam, and slept in the sleep laboratory for a night to be monitored. After all that was done, the researchers still found that during the entire period of the study, 14 percent of the participants died: five percent of the women and 21 percent of the men. Insomnia with short sleep duration proved alarmingly deadly. Twice as many women as men in the study had very short sleep duration (under six hours), and yet those men suffered a 51.1 percent mortality rate. No such connection was found for the women.
This gender gap might close with more study: the women in this project were followed for 10 years, as opposed to 14 years for the men (though the researchers attempted to adjust for this). But this further research would only bring the women's numbers up to meet the men's. The researchers assert clearly, "The primary finding of our study is that insomnia, the most common sleep disorder, is associated with significant mortality in men." And the authors warn that recognizing it as a problem will take a public health campaign to change attitudes. "Given the high prevalence of the disorder in the general population and the widespread misconception that this is a disorder of the 'worried well,'" they write, "its diagnosis and appropriate treatment should become the target of public health policy."