The authors compared two large samples of insomniac patients with a
group of control subjects. Sleep difficulty usually began before the age of
40 and generally persisted for many years (average duration, 14 years).
Several characteristic behaviors were correlated with the symptom of
insomnia. During the day and at bedtime, patients reported difficulty
relaxing and frequently described themselves as tense, anxious, overly
preoccupied, worried, and depressed. Reports of poor mental and physical
health were far more prevalent in the insomniac patients than in control
subjects. These results indicate that psychiatric factors need to be a
primary focus in the multidimensional treatment of chronic insomnia.