Comorbidities and Risk Factors Associated With Insomnia in the Elderly Population.
Level 4 - case-series / case-control
Retrospective cross-sectional electronic medical record review
PubMed 37070688 · doi:10.1177/21501319231168721
What was done
A retrospective electronic medical record review evaluated patients aged 65 years and older who visited a single suburban internal medicine practice between July 1, 2020, and June 30, 2021. Patients were categorized by the presence or absence of documented insomnia, and associated clinical comorbidities were compared using bivariate analysis and multivariable logistic regression.
What was found
Among 2,431 patients, 247 (10.2%) had documented insomnia. The insomnia and non-insomnia cohorts had comparable mean ages (77 ± 8.1 vs. 76 ± 7.5 years; P = .211). Insomnia was significantly more frequent in women (63.2% vs. 55.5%; P = .022) and was associated with higher prevalence of dementia (6.5% vs. 3.4%; P = .015), depression (30.8% vs. 14.9%; P < .001), anxiety disorder (34.4% vs. 17.4%; P < .001), atrial fibrillation (19.4% vs. 13.4%; P = .01), and chronic pain disorders (32.8% vs. 18.9%; P < .001). Logistic regression demonstrated significantly increased odds of insomnia among patients with depression (OR = 1.860, 95% CI 1.342–2.576; P < .001), anxiety (OR = 1.845, 95% CI 1.342–2.537; P < .001), and chronic pain disorders (OR = 1.901, 95% CI 1.417–2.549; P < .001).
Why it matters
This study highlights that chronic pain and psychiatric comorbidities are strongly associated with insomnia in older outpatients, emphasizing the need for comprehensive screening in primary care settings.
Limits
The study is limited by its retrospective, cross-sectional design at a single suburban clinic, precluding causal inferences and limiting generalizability. Diagnosis relied entirely on chart documentation rather than standardized sleep evaluation tools, and unmeasured confounders such as specific medication use or sleep apnea were not accounted for.
Cited by
- supports Sixty million Americans have sleep-related disorders.