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Age Differences in Factors Associated With Insomnia Severity: A Comparative Study of Questionnaire Scores and Heart
Kong Xinyu1, Guo Xiaodan1, Wang Mengmeng2
1Department of Sleep Medicine, Peking University People's Hospital, Beijing, China, pku.edu.cn.
Depression and Anxiety
|July 6, 2026
Summary
Young adults with insomnia show links to depression and chronotype, while older adults experience insomnia related to anxiety and autonomic imbalance. These findings suggest age-tailored insomnia treatments are needed.
Area of Science:
- Sleep Medicine
- Gerontology
- Psychophysiology
Background:
- Primary insomnia presents varied clinical profiles across different age groups.
- Understanding the underlying mechanisms and age-related differences in insomnia severity is crucial.
Purpose of the Study:
- To explore age-related differences in factors associated with insomnia severity.
- To investigate the distinct predictors of insomnia severity in young adult and older adult primary insomnia patients.
Main Methods:
- Evaluated questionnaire scores (AIS, ISI, MEQ, STAI) and heart rate variability (HRV) parameters in young adults (18-44) and older adults (≥45) with primary insomnia.
- Assessed autonomic nervous system function using HRV analysis.
- Employed regression analyses to identify independent predictors of insomnia severity in each age group.
Main Results:
- Young adults exhibited higher evening chronotype (MEQ scores) and state anxiety (STAI scores).
- Significant differences in HRV parameters (except HF power) indicated age-related autonomic dysregulation.
- Insomnia severity was linked to depressive symptoms and chronotype in young adults, and anxiety and autonomic imbalance (LF/HF ratio, mean RRIs) in older adults.
Conclusions:
- Insomnia severity associations with psychological factors and autonomic function are age-dependent.
- Young adult insomnia may be more influenced by depressive symptoms and chronotype.
- Older adult insomnia is strongly associated with anxiety and autonomic imbalance, informing age-tailored therapeutic strategies.
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