Insomnia disorder as a predictor of mental disorders and pain: a systematic review and meta analysis

Objectives/Instruction: Previous research has identified insomnia as a predictor for the onset of major depression. The aim of this meta‐analysis is to investigate whether insomnia also predicts the onset of other mental disorders and pain. Methods: The databases PubMed, Medline, PsycInfo, and PsycArticles were searched for longitudinal studies investigating the predictive value of the presence of insomnia at baseline for the presence of psychopathology or pain at follow‐up. Primary studies were eligible if they included insomnia diagnosed based on DSM criteria and no mental comorbidity/pain at baseline or a statistical control for baseline psychopathology/pain. Results: Fourteen primary studies were included in the meta‐analysis. Across all studies, the model found an odds ratio of 2.43 (confidence interval: 1.67–3.54), indicating that insomnia disorder is a significant predictor for later onset of psychopathology/pain. Subgroup analyses showed similar results, i.e. insomnia was identified as a predictor of depression, anxiety disorders, alcohol abuse, and pain. One study suggested that insomnia is also a predictor of psychotic disorders. The overall risk of bias in the primary studies was rated as moderate, whereby most problems arose from insufficient documentation of attrition and reasons for dropout. Conclusions: This meta‐analysis provides evidence that insomnia increases the risk for future onset of psychopathology and pain in general. A future research agenda should include more prospective studies evaluating insomnia diagnosis at baseline and long‐term follow‐up intervals assessing a wide range of mental disorders. In addition, prospective long‐term interventional studies investigating the efficacy of insomnia treatment for the prevention of mental disorders and pain are called for. Disclosure: Nothing to disclose.