Stress coping behaviors and sleep hygiene practices in a sample of Japanese adults with insomnia

This study examined the characteristics of behaviours for coping with stress and sleep hygiene practices utilized by adult people with insomnia. Self-administered questionnaire data from a representative sample of 24 551 adults (completed in 2000) were analyzed. Participants reported insomnia symptoms present during the last 1-month period, answering 11 items on physical and psychological conditions, 7 items on problem-solving and emotion-focused coping behaviors in response to stress (SCBs), 5 items on measures taken to ensure adequate sleep (SHPs), and the Center for Epidemiologic Studies Depression Scale (CES-D). Those presenting with insomnia symptoms accompanied by daytime complaints were defined as having insomnia. Multivariable logistic regressions were performed with sex, age, and the presence of stress as covariants to determine which SCBs and SHPs are factors associated with insomnia. Prevalence of insomnia was 43.4% (n = 10 653) and comorbidity of depression (CES-D > 26) occurred in 12.7% of participants (n = 1357, 5.5% of total sample). Logistic regression analysis controlling for other adjustment factors revealed that insomnia was positively associated with 4 emotion-focused SCBs ("Bearing", "Smoking", "Eating" and "TV/Radio"), negatively associated with "Problem-solving," and positively associated with 3 SHPs ("Alcohol", "Books/Music" and "Bath"). Insomnia comorbid with depression had a strong positive association with Bearing (OR = 3.44), but a strong negative association with Problem-solving (OR = 0.50). Japanese adults with insomnia might engage in various maladaptive SCBs and SHPs. The negative correlate of Problem-solving supports the importance of promoting self-help sleep practices in public health.