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Insomnia is the most common sleep disorder, yet little is known about the etiology, pathophysiology, and clinical course of this highly prevalent and chronic disorder.1–4 In the few published general population longitudinal studies, the estimated rate of persistent insomnia varies from 40% to 70%.5–10 Factors such as gender, age, body weight, physical disorders, depression, or alcohol consumption have been proposed to be associated with persistent insomnia, but the results are inconsistent.5–11 Furthermore, these studies have not included polysomnography (PSG), and, for example, the longitudinal association of sleep duration or sleep disordered breathing (SDB) with persistent insomnia has not yet been studied.Insomnia is frequently associated with physical and mental health disorders.1–4 Insomnia is a risk factor for the development of depression,12 and depression is a risk factor in the persistence of insomnia.5,7,11 As far as the association of chronic insomnia with the second most common sleep disorder (SDB), the findings have been mixed. Some but not all investigators have suggested that SDB is associated with chronic insomnia.13,14 However, no longitudinal study to date has examined whether SDB is a risk factor for the persistence of insomnia.
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