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Purpose: This study compared in one data set the relative importance of most previously examined risk factors for different symptoms of insomnia., Methods: Data were obtained from personal interviews of 1,588 adults in a rural area. Statistical methods evaluated the association of 42 risk factors with any insomnia and each of four insomnia subtypes: difficulty with initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), and restless sleep (RS)., Results: Insomnia rates were greater in this rural population than most U.S. studies and greater in the United States than other countries. The correlations between insomnia subtype and energy level was highest for RS, -0.29, and lowest for EMA, -0.11. All sleep disturbances increased monotonically with depressive symptoms, but the increase was greatest for RS (r = 0.57) and weakest for EMA (r = 0.24). Anxiety and pain also were independently associated with each insomnia subtype. Insomnia problems of spouses were uncorrelated. Other risk factors were independently associated with some insomnia subtypes but not others. For example, the association of age with difficulty maintaining sleep was independent of health measures., Conclusion: The results suggest that different insomnias have different rates and risk factors and therefore possibly different etiologies and management strategies.

Background: A growing body of epidemiological evidence suggests an association between short sleep duration and obesity. Recently, potential hormonal links have been observed that may account for the relationship. The possible connection between sleep duration and body mass index (BMI) has not been explored in rural populations. Rural populations are of interest because obesity rates are high and lifestyle patterns of nutrition, physical activity, work hours, and sleep may differ from those in urban and suburban populations. We conducted this study to determine whether short sleep duration is related to BMI and obesity in a rural population in southeast Iowa., Methods: We conducted a cross-sectional analysis of data collected in the Keokuk County Rural Health Cohort Study, 1999-2004. Study participants were from a population-based sample consisting of 990 employed adults in a rural community in southeastern Iowa. The main outcome measure was BMI. Multiple linear regression modeling was used to adjust for potential confounding variables., Results: Self-reported sleep duration on weeknights was negatively correlated (beta = -0.42; 95% confidence interval, -0.77 to -0.07) with higher BMI after adjusting for sex, age, educational achievement, physical job demand, household income, depressive symptoms, marital status, alcohol consumption, and snoring., Conclusion: These data support an association between short sleep duration and higher BMI in this rural population, which is consistent with the relationship found in other settings.