Insomnia with objective short sleep duration is associated with longer duration of insomnia in the Freiburg Insomnia Cohort compared to insomnia with normal sleep duration, but not with hypertension

Study objectives To replicate the association between insomnia with objective short sleep duration and hypertension, type 2 diabetes and duration of insomnia. Design Retrospective case-control study. Setting Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg. Participants 328 patients with primary insomnia classified according to DSM-IV criteria (125 males, 203 females, 44.3 +/- 12.2 years). Interventions N/A Measurements All participants were investigated using polysomnography, blood pressure measurements, and fasting routine laboratory. Results Insomnia patients with short sleep duration (< 6 hours) in the first night of laboratory sleep presented with a longer duration of insomnia compared to those with normal sleep duration (>= 6 hours) in the first night of laboratory sleep. Insomnia patients who were categorised as short sleepers in either night were not more likely to suffer from hypertension (systolic blood pressure of >= 140 mm Hg, diastolic blood pressure of >= 90 mm Hg, or a previously established diagnosis). Data analysis showed that insomnia patients with objective short sleep duration were not more likely to suffer from type 2 diabetes (fasting plasma glucose level of >= 126 mg/dl, or a previously established diagnosis). However, the diabetes analysis was only based on a very small number of diabetes cases. As a new finding, insomnia patients who were categorised as short sleepers in either night presented with increases in liver enzyme levels. Conclusions The finding on insomnia duration supports the concept of two distinct sub-groups of insomnia, namely insomnia with, and without, objectively determined short sleep duration. However, our data challenges previous findings that insomnia patients with short sleep duration are more likely to suffer from hypertension.