Health and demographic discriminators of an insomnia identity and self-reported poor quantitative sleep

Objectives: To identify factors that most saliently characterize the profile of individuals who complain of chronic insomnia, with or without quantitative sleep impairment. Design: Community-dwelling adults reported on their demographics and functioning via questionnaires and completed 2 weeks of sleep diaries. Setting: Shelby County in the Memphis, TN, area. Participants: Population-based sample, stratified by sex and age to maximally represent sleep and health across the life span. Measurements: Participants were classified into 4 groups according to whether or not they endorsed a chronic insomnia complaint and whether they demonstrated good or poor quantitative sleep on diaries. Discriminant analysis determined which of the following variables significantly maximized spread among the sleep groups: age, sex, race, body mass index, household education, number of medications, frequency of substance use, number of medical conditions, depression, anxiety, fatigue, daytime sleepiness, and daytime insomnia impact. Results: On the most powerful discriminant function, participants with more medical conditions, greater depression and anxiety, and older age were more likely to complain of chronic insomnia than to not complain and, within these levels, to have poor rather than good quantitative sleep. A second function found African Americans particularly likely to be noncomplaining poor sleepers compared to Whites. Conclusions: Findings make progress in clarifying the profile of individuals who self-identify as having chronically poor sleep. Notably, general depression and anxiety surpassed sleep-related daytime impairment measures in discriminating complaining sleepers. Negativistic self-appraisals driving diffuse psychological symptoms may thus be viable intervention targets for reducing persistent insomnia complaints independently of sleep-specific concerns.