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The Relationship Between Insomnia and Health-Related Quality of Life in Patients With Chronic Illness

The Journal of Family Practice. 2002 March;51(3):229-235
March 1, 2002|The Journal of Family Practice
David A. Katz, MD, MSc
Author and Disclosure Information

DAVID A. KATZ, MD, MSC
COLLEEN A. MCHORNEY, PHD
Madison, Wisconsin, and Indianapolis, Indiana
From the Departments of Medicine and Preventive Medicine, University of Wisconsin Medical School, Madison, Wis. (D.A.K.), and the Departments of Internal Medicine and Geriatrics, Regenstrief Institute for Health Care, Indiana University Center for Aging Research, and the Roudebush VAMC, Indiana University School of Medicine, Indianapolis (C.A.M.). The authors report no competing interests. This work was previously presented in part at the annual meeting of the Society of Medical Decision Making, Toronto, Ontario, Canada, Oct. 15, 1996. Reprint requests should be addressed to David Katz, MD, MSc, University of Wisconsin–Madison, WARF Building, Room 707, 610 Walnut St., Madison, WI 53705. E-mail: dak@medicine.wisc.edu.

While depression and insomnia (one of the diagnostic criteria for depression) overlap considerably, pharmacologic and behavioral approaches, including light therapy49-52 and exercise,53 have potential to significantly lessen the burden of chronic insomnia and its effect on HRQOL.54 In addition, clinicians should identify (and treat, if possible) predisposing conditions associated with insomnia.28,36,42 Finally, future clinical trials involving treatment of insomnia should incorporate measures, such as the SF-36, that can detect clinically meaningful effects of insomnia on HRQOL in addition to standard laboratory and self-reported measures of sleep disturbance.

Conclusions

Even after accounting for the presence of chronic medical comorbidities, depression, and anxiety, insomnia is associated with significantly worsened HRQOL, particularly in the domains of mental health, vitality, and general health perceptions. By identifying and treating chronic insomnia, including any predisposing conditions that may perpetuate insomnia, clinicians can significantly improve the quality of life of patients with chronic illness.

Acknowledgments

Dr Katz’s work on this study was supported by institutional funds from the University of Wisconsin Medical School, Graduate School, and Department of Medicine. Dr McHorney’s work on this study was supported by the Department of Veterans Affairs (HSR&D HFP #96-001; RR&D C-2016; HSR&D IIR #95-033). Dr Katz is a Robert Wood Johnson Generalist Physician Faculty Scholar.

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