The Effects of Stress- and Sleep-Related Variables on the Quality of Life in Insomnia Patients

Young Chan Lim; Seong Jae Kim; Hyo Jeong Kwon; Jung Hie Lee

doi:10.4306/jknpa.2016.55.3.277

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Lim, Kim, Kwon, and Lee: The Effects of Stress- and Sleep-Related Variables on the Quality of Life in Insomnia Patients

Original Article

Journal of Korean Neuropsychiatric Association 2016; 55(3): 277-285.

Published online: 31 August 2016

DOI: https://doi.org/10.4306/jknpa.2016.55.3.277

The Effects of Stress- and Sleep-Related Variables on the Quality of Life in Insomnia Patients

Young Chan Lim, MD¹, Seong Jae Kim, MD, PhD², Hyo Jeong Kwon, RN¹, Jung Hie Lee, MD, PhD^1,³

¹Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea.

²Department of Psychiatry, Yesarang Hospital, Cheongju, Korea.

³Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea.

Address for correspondence: Jung Hie Lee, MD, PhD. Department of Psychiatry, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon 24289, Korea. Tel +82-33-258-2000, Fax +82-33-258-2027, jhielee@kangwon.ac.kr

Received 31 May 2016 Revised 6 July 2016 Accepted 25 July 2016

Abstract

Objectives

We examined the effects of sleep variables and emotional factors including stress, anxiety and depression on the quality of life in insomnia patients.

Methods

We recruited 153 insomnia patients and 96 normal control (NC) subjects who visited three Public Health Centers in Kangwon-do from 2013 until 2015. The Pittsburgh Sleep Quality Index (PSQI), Korean version of Morningness-Eveningness Questionnaire (MEQ-K), Korean version of Epworth Sleepiness Scale, Ford Insomnia Response to Stress Test (FIRST), Hyperarousal Scale (HAS), Perceived Stress Scale (PSS), Anxiety-Sensitivity Index (ASI), Beck Depression Inventory (BDI), and Short Form-12 Health Survey Questionnaire (SF-12) were administered for each subject. We compared the scores of the above scales between the insomnia and control groups, using analysis of covariance to control for age. Stepwise regression analysis assessed the association of these variables with SF-12 scores.

Results

The scores of PSQI, FIRST, HAS, ASI, BDI in insomnia patients were significantly higher than those of NC subjects, but the Mental Component Summary (MCS) scores of SF-12 were lower. Stepwise regression analysis showed the scores of PSS and MEQ-K significantly predicted the MCS scores in NC subjects, and the BDI score predicted scores in insomnia patients.

Conclusion

In our study, greater subjective stress and evening preference could explain lower mental quality of life in NC subjects. In insomnia patients, greater depression is an additional factor.

Keywords: Insomnia, Sleep, Stress, Depression, Quality of life

Figures and Tables

Table 1

Demographic characteristics in the normal control (NC) group and insomnia group

Values are presented as mean (standard deviation). ^* : p<0.05, ^** : p<0.01 (^† : Independent t-test, ^‡ : χ²-test, ^§ : Analysis of covariance controlling for age)

Table 2

The scores of sleep- and stress-related questionnaires and health-related quality of life scale (SF-12) in the normal control (NC) group and insomnia group

Values are presented as mean (standard deviation). ^* : p<0.05, ^** : p<0.01 (analysis of covariance controlling for age). SF-12 : Short Form-12 Health Survey Questionnaire, PSQI : Pittsburgh Sleep Quality Index, MEQ-K : Korean version of Morningness-Eveningness Questionnaire, KESS : Korean version of Epworth Sleepiness Scale, FIRST : Ford Insomnia Response to Stress Test, HAS : Hyperarousal Scale, ASI : Anxiety-Sensitivity Index, PSS : Perceived Stress Scale, BDI : Beck Depression Inventory, MCS : Mental Component Summary in SF-12, PCS : Physical Component Summary in SF-12

Table 3

Correlations between the scores of sleep- and stress-related questionnaires and health-related quality of life scale (SF-12) in the normal control group (n=96)

^* : p<0.05, ^** : p<0.01 (partial correlation, age-controlled). SF-12 : Short Form-12 Health Survey Questionnaire, PSQI : Pittsburgh Sleep Quality Index, MEQ-K : Korean version of Morningness-Eveningness Questionnaire, KESS : Korean version of Epworth Sleepiness Scale, FIRST : Ford Insomnia Response to Stress Test, HAS : Hyperarousal Scale, ASI : Anxiety-Sensitivity Index, PSS : Perceived Stress Scale, BDI : Beck Depression Inventory, MCS : Mental Component Summary in SF-12, PCS : Physical Component Summary in SF-12

Table 4

Correlations between the scores of sleep- and stress-related questionnaires and health-related quality of life scale (SF-12) in the insomnia group (n=153)

Table 5

Stepwise regression analysis for Mental Component Summary Score (MCS) in SF-12 in the normal control group (n=96)

SF-12 : Short Form-12 Health Survey Questionnaire, PSS : Perceived Stress Scale, MEQ-K : Korean version of Morningness-Eveningness Questionnaire

Table 6

Stepwise regression analysis for Mental Component Summary Score (MCS) in SF-12 in the insomnia group (n=153)

SF-12 : Short Form-12 Health Survey Questionnaire, PSS : Perceived Stress Scale, BDI : Beck Depression Inventory, MEQ-K : Korean version of Morningness-Eveningness Questionnaire

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

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