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SF-36: Evaluation of Quality of Life in Severe and Mild Insomniacs Compared With Good Sleepers

From Centre du Sommeil (D.L., K.S., P.P., M.P.), Hôtel-Dieu de Paris, Paris, France; and the Sleep Disorders Clinic (C.G.), Stanford University, Stanford, California.

Address reprint requests to: Damien Léger, MD, Centre du Sommeil, Hôtel-Dieu de Paris, 1 Place du Parvis Notre-Dame, 75151 Paris Cedex 04, France.

OBJECTIVE: Despite many studies, the impact of chronic insomnia on daytime functioning is not well understood. The aim of our study was to detect this impact by evaluating quality of life (QoL) using a validated instrument, the 36-item Short Form Health Survey of the Medical Outcomes Study (SF-36), in three matched groups of severe insomniacs, mild insomniacs, and good sleepers selected from the general population.

METHODS: Three matched groups of 240 severe insomniacs, 422 mild insomniacs, and 391 good sleepers were recruited from the general French population after eliminating those with DSM-IV criteria for anxiety or depression. All subjects were asked to complete the SF-36. Scores for each QoL dimension were calculated and compared statistically among the three groups.

RESULTS: Severe insomniacs had lower QoL scores in eight dimensions of the SF-36 than mild insomniacs and good sleepers. Mild insomniacs had lower scores in the same eight dimensions when compared with good sleepers. No dimension was significantly more altered than the other.

CONCLUSIONS: The mental health status and role of emotional QoL dimensions were worse in severe and mild insomniacs than in good sleepers. This result held even though we screened for psychiatric diseases, which shows a clear interrelation between insomnia and emotional state. General health status was also worse in severe and mild insomniacs than in good sleepers. However, we could conclude only that insomnia was related to a worse health status and not whether it was a cause or consequence of this worse health status. Finally, the degradation of QoL scores was correlated with the severity of insomnia.

Key Words: insomnia • quality of life • sleep.

Abbreviations: ANOVA = analysis of variance; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, fourth edition; ICSD = International Classification of Sleep Disorders; MSLT = multiple sleep latency test; QoL = quality of life; SF-36 = 36-item Short Form Health Survey of the Medical Outcomes Study.

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