Insomnia and Snoring in Relation to Future Psychological Distress and Daytime Symptoms in Women

Anxiety, depression and daytime symptoms (sleepiness, tiredness) are overrepresented in people with snoring and insomnia, but the associations are not completely understood. We aimed to investigate relationships between insomnia and snoring with future psychological distress and daytime symptoms. Longitudinal data in 5193 women (age 43.2 ± 15.3 years; BMI 24.0 ± 4.06 kg/m²), from the population-based study 'Sleep and Health in women', was used and included data on sleep, daytime symptoms, somatic health and psychological distress. Subgroups according to presence of snoring and insomnia at baseline and outcome variables (anxiety, depression, daytime sleepiness, daytime tiredness) were created. Adjusted logistic regression was performed. At baseline 5% of the women were snorers, 22% had insomnia and 2% indicated both. Of the women, 9.2% developed anxiety, 4.6% depression, 7.9% sleepiness and 8.7% tiredness. Anxiety was more likely at follow-up among women reporting baseline insomnia (OR 2.03, 95% CI 1.55-2.65) or snoring (1.83; 1.14-2.94). Depression was more frequent in the subgroup with insomnia alone (2.39; 1.74-3.28), but not isolated snoring or both. Insomnia but not snoring alone increased the risk of sleepiness (2.40; 1.84-3.13) and tiredness (3.07; 2.39-3.94) and individuals reporting both insomnia and snoring had the highest risk for both sleepiness (3.34; 1.74-6.40) and tiredness (4.26; 2.28-7.96). Insomnia appears as the strongest risk factor for future psychological distress in women. The combination of insomnia and snoring may have an additive effect on the development of both psychological distress and daytime symptoms and clinically assessing both snoring and insomnia may be of importance for targeting future negative outcomes.