Difficulty maintaining sleep is the most common insomnia symptom, according to a study in the Aug. 1 issue of SLEEP.  The study involved an analysis of data from 6,791 adults who participated in the America Insomnia Survey (AIS), a cross-sectional telephone survey.  

Insomnia in the 30 days before interview was assessed with the Brief Insomnia Questionnaire (BIQ).  A diagnosis of insomnia was defined according to standardized criteria.

Among respondents who meet criteria for a diagnosis of insomnia, the prevalence of insomnia symptoms was 61 percent for difficulty maintaining sleep, 52 percent for early morning awakening, 38 percent for difficulty initiating sleep, and 25 percent for nonrestorative sleep.  More than half of all respondents with insomnia had two or more of these symptoms.

The study also assessed the presence in the 12 months before interview of 21 conditions documented in the literature to be significantly associated with elevated rates of insomnia. The most highly prevalent of these conditions among respondents with insomnia were chronic back and neck pain, other chronic pain, and seasonal allergies.  Inspection of bivariate associations of insomnia with the 21 conditions also found that four conditions had consistently high odds ratios across the four insomnia symptoms: chronic headaches, restless legs syndrome, generalized anxiety disorder, and depression.