title: Longitudinal trends of the healthcare-seeking prevalence and incidence of insomnia in Taiwan: an 8-year nationally representative study.
abstract: OBJECTIVE
  We used insurance claims of a nationally representative population-based cohort to assess the longitudinal healthcare-seeking prevalence and incidence of insomnia.
  
  
  METHODS
  Participants were identified from National Health Insurance enrollees in Taiwan during 2002 to 2009. Individuals with insomnia were identified using The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic and procedure codes of 780.52, 307.41, and 307.42.
  
  
  RESULTS
  In 2009 the prevalence of insomnia was 5.4% for women and 3.0% for men; the incidence of insomnia was 1.6% for women and 1.3% for men. Patients who were women (odds ratio [OR]), 1.82; 95% confidence interval [CI], 1.79-1.86), who were older (50-64 years: OR, 23.25; 95% CI, 21.07-25.64; ≥ 65 years: OR, 24.70; 95% CI, 22.40-27.24), and who were in the middle socioeconomic status (SES) group (OR, 1.19; 95% CI, 1.16-1.21) were more likely to have insomnia. An inverse U-shaped woman-to-man ratio trend for the insomnia prevalence was found, and this ratio reached a peak around the menopausal transitional period.
  
  
  CONCLUSIONS
  The persistence of healthcare-seeking behaviors with insomnia was more common in women. Our findings underscore the need to initiate treatment at an early stage as opposed to waiting for the spontaneous resolution of insomnia. Future research needs to identify causes of the persistence of insomnia and to develop proper interventions to reduce its rising prevalence. More active approaches toward preventive strategies for insomnia are needed, especially for women who are at higher risk for insomnia.
authors.affiliation: Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Hsu
authors.forename: Chung-Han
authors.initials: CH
authors.lastname: Ho
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.forename: Kuang-Yang
authors.initials: KY
authors.lastname: Hsieh
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
authors.forename: Ming-Ping
authors.initials: MP
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000628:therapy*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Asian; Incidence; Insomnia; Longitudinal; Persistence; Prevalence