How a general population perceives its sleep and how this relates to the complaint of insomnia

The traditional indicators of insomnia (i.e. difficulty initiating sleep, difficulty maintaining sleep, non-restorative sleep, early morning awakening) were assessed in a representative sample of 1,722 French-speaking Montrealers (Canada) aged 15 to 100 years. These subjects were interviewed over the telephone (81.3% of contacted sample) by means of the Sleep-Eval software. Subjects were classified as either satisfied or dissatisfied with quality of sleep (SQS or Dos), with or without insomnia indicators (+I or -I). Sociodemographics, sleep-wake schedules, evening activities, medication intake, recent medical consultations, and social life were also investigated. DQS subjects composed 17.8% of the population (DQS+I: 11.2%; DOS-I: 6.5%), and 21.7% of subjects were classified as either DQS+I or SQS+I. Overall, 3.8% of subjects reported using a sleep-enhancing medication. Nonrestorative sleep did not significantly distinguish SQS and DQS subjects. The complaint of nonrestorative sleep is not a useful indicator of insomnia, despite its inclusion in all medical classifications. DQS -I and SQS +I subjects defy traditional classifications. A better understanding of sleep complaints and more accurate classifications will help physicians identify patients with insomnia and meet their needs more appropriately.