Results (
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As part of this protocol we also assessed for the presence of all sleep disorders, based on a standardized questionnaire completed by the subjects on the evening of their sleep laboratory visit. This questionnaire consists of 53 questions (7 demographic, 20 sleep related, and 26 general health questions). In addition, women responded to 8 questions related to menstrual history, menopause, and hormone therapy. Sleep related questions were qualified in terms of severity on a scale of 0-3 (0 = none, 1 = mild, 2 = moderate, 3 = severe) and duration. Health problems were also qualified in terms of severity, type of treatment (on a scale of 0-7), and duration. The presence of sleep difficulty was established on 3 levels of severity. First, insomnia was defined by a complaint of insomnia ≥ 1 year. Second, poor sleep was defined as a moderate to severe complaint (based on a mild to severe scale) of difficulty falling asleep, difficulty staying asleep, early final awakening, or unrefreshing sleep. Finally, normal sleeping was defined as the absence of either of these 2 categories.To control for possible confounding variables influencing the relationships tested, we ascertained whether the respondent was currently being treated for physical (e.g., hypertension, diabetes, thyroidism) and/or mental (e.g., depression, alcohol use, drug use) health problems. A composite variable for each general category of physical or mental health problems was calculated by indicating a positive response when at least one health problem within each category was present, as we have described elsewhere.22,24,27From the 1741 subjects, a total of 1300 validly completed a Minnesota Multiphasic Personality Inventory-2 (MMPI-2) at baseline. The MMPI-2 was administered following the standardized rules and scored accordingly.31,32 The scores in 9 clinical scales (Hypochondriasis [1-Hs], Depression [2-D], Hysteria [3-Hy], Psychopathic Deviate [4-Pd], Paranoia [6-Pa], Psychasthenia [7-Pt], Schizophrenia [8-Sc], Hypomania [9-Ma], Social Introversion [0-Si]), and 3 research scales [Depression [D], Anxiety [A], and Ego Strength [ES]) were studied.Follow-up measures taken through telephone interview included the standardized questionnaire that subjects completed at baseline during their sleep laboratory visit. Sleep related questions were also used to establish the presence of sleep difficulty at follow-up based on 3 levels of severity as defined above (i.e., normal sleeping, poor sleep, and insomnia).
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