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Association of chronic insomnia symptoms and recurrent extreme sleep duration over 10 years with well-being in older adults: a cohort study
  1. Jessica G Abell1,
  2. Martin J Shipley1,
  3. Jane E Ferrie1,2,
  4. Mika Kivimäki1,
  5. Meena Kumari1,3
  1. 1Department of Epidemiology and Public Health, University College London, London, UK
  2. 2School of Social and Community Medicine, University of Bristol, Bristol, UK
  3. 3Institute for Social and Economic Research, University of Essex, Colchester, UK
  1. Correspondence to Dr Jessica G Abell; jessica.abell{at}


Objectives The extent to which aspects of sleep affect well-being in the long-term remains unclear. This longitudinal study examines the association between chronic insomnia symptoms, recurrent sleep duration and well-being at older ages.

Setting A prospective cohort of UK civil servants (the Whitehall II study).

Participants 4491 women and men (25.2% women) with sleep measured 3 times over 10 years and well-being once at age 55–79 years. Insomnia symptoms and sleep duration were assessed through self-reports in 1997–1999, 2003–2004 and 2007–2009.

Primary outcome measures Indicators of well-being, measured in 2007–2009, were the Control, Autonomy, Self-realisation and Pleasure measure (CASP-19) of overall well-being (range 0–57) and the physical and mental well-being component scores (range 0–100) of the Short Form Health Survey (SF-36).

Results In maximally adjusted analyses, chronic insomnia symptoms were associated with poorer overall well-being (difference between insomnia at 3 assessments vs none −7.0 (SE=0.4) p<0.001), mental well-being (difference −6.9 (SE=0.4), p<0.001) and physical well-being (difference −2.8 (SE=0.4), p<0.001) independently of the other sleep measures. There was a suggestion of a dose–response pattern in these associations. In addition, recurrent short sleep (difference between ≤5 h sleep reported at 3 assessments vs none −1.7 (SE=0.7), p<0.05) and recurrent long sleep (difference between >9 h reported at 2 or 3 assessments vs none −3.5 (SE=0.9), p<0.001) were associated with poorer physical well-being.

Conclusions We conclude that in older people, chronic insomnia symptoms are negatively associated with all aspects of well-being, whereas recurrent long and short sleep is only associated with reduced physical well-being.

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