title: Association of chronic insomnia symptoms and recurrent extreme sleep duration over 10 years with well-being in older adults: a cohort study.
abstract: OBJECTIVE
  The extent to which aspects of sleep affect well-being in the long-term remains unclear. This longitudinal study examines the association between chronic insomnia symptoms, recurrent sleep duration and well-being at older ages.
  
  
  METHODS
  A prospective cohort of UK civil servants (the Whitehall II study).
  
  
  METHODS
  4491 women and men (25.2% women) with sleep measured 3 times over 10 years and well-being once at age 55-79 years. Insomnia symptoms and sleep duration were assessed through self-reports in 1997-1999, 2003-2004 and 2007-2009.
  
  
  METHODS
  Indicators of well-being, measured in 2007-2009, were the Control, Autonomy, Self-realisation and Pleasure measure (CASP-19) of overall well-being (range 0-57) and the physical and mental well-being component scores (range 0-100) of the Short Form Health Survey (SF-36).
  
  
  RESULTS
  In maximally adjusted analyses, chronic insomnia symptoms were associated with poorer overall well-being (difference between insomnia at 3 assessments vs none -7.0 (SE=0.4) p<0.001), mental well-being (difference -6.9 (SE=0.4), p<0.001) and physical well-being (difference -2.8 (SE=0.4), p<0.001) independently of the other sleep measures. There was a suggestion of a dose-response pattern in these associations. In addition, recurrent short sleep (difference between ≤ 5 h sleep reported at 3 assessments vs none -1.7 (SE=0.7), p<0.05) and recurrent long sleep (difference between >9 h reported at 2 or 3 assessments vs none -3.5 (SE=0.9), p<0.001) were associated with poorer physical well-being.
  
  
  CONCLUSIONS
  We conclude that in older people, chronic insomnia symptoms are negatively associated with all aspects of well-being, whereas recurrent long and short sleep is only associated with reduced physical well-being.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Abell
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shipley
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK Institute for Social and Economic Research, University of Essex, Colchester, UK.
authors.forename: Meena
authors.initials: M
authors.lastname: Kumari
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012008:Recurrence; D012890:Sleep / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology / Q000523:psychology*; D013997:Time Factors
keywords: EPIDEMIOLOGY; MENTAL HEALTH; PUBLIC HEALTH; SOCIAL MEDICINE
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