Identifying Major Life Stressors that Precipitate Incident Insomnia Disorder
Recommended Citation
Jennings MB, Kalmbach DA, Afaneh H, Cheng P, Drake CL. Identifying Major Life Stressors that Precipitate Incident Insomnia Disorder. Sleep Med 2026; 138:107335.
Document Type
Conference Proceeding
Publication Date
2-1-2026
Publication Title
Sleep Med
Abstract
Introduction: Insomnia disorder is a chronic condition affecting approximately 12.4% of adults globally, marked by persistent difficulty falling and/or staying asleep that leads to significant daytime impairment. Major life stressors—such as the death of a loved one or the onset of chronic illness—are often associated with adverse health outcomes and may trigger the development of insomnia. However, less is known about how specific stressors, or their cumulative impact, influence the onset and prevalence of insomnia over time. This study examined a large cohort of healthy adults over the course of one year to investigate the prospective effect of major life events on insomnia incidence. Materials and methods: 2,892 US adults with no history of insomnia or depression were assessed at baseline then again a year later. Life stressors were assessed using the Revised Social Readjustment Rating Scale (SRRS-R), which asks participants to indicate whether they experienced any of 52 distinct major life events, categorized into four domains: Interpersonal, Work, Home, and Network stressors. Insomnia diagnoses at 1-year follow-up were based on DSM-5 criteria. Both insomnia diagnoses and major life stressors were dichotomized (Yes/No). Initial bivariate associations between insomnia and each stress exposure were examined using chi-square tests of independence. Stressors significantly associated with insomnia in bivariate analyses (p<.05) were then entered into a multivariate logistic regression model to evaluate their unique contributions to predicting insomnia diagnoses. Results: Among 2,892 US adults, the one-year incidence rate for DSM-5 insomnia disorder was 9.1%. Bivariate analyses identified 20 of the 52 assessed life stressors were significantly associated with insomnia incidence. Each of the four broad categories of stressors was associated with an elevated relative risk (RR) of developing insomnia disorder compared to those not reporting the stressor: Interpersonal (RR=1.9–4.2; Insomnia incidence: 16.9-24.7%), Work (RR=1.6–2.7; Insomnia incidence: 13.6-24.2%), Home (RR=1.9–3.7; Insomnia incidence: 8.2-37.5%), and Network (RR=1.4–2.8; Insomnia incidence: 12.0-25.0%). In the multivariate logistic regression model, several specific stressors remained independently associated with increased risk for insomnia. The most robust predictors included: death of a spouse (Odds Ratio [OR]=4.4, p=.013), major injury or illness to self (OR=2.5, p<.001), separation or reconciliation with a partner (OR=2.5, p=.001), financial problems (OR=2.0, p<.001), and efforts to address personal addiction (OR=2.3, p=.010). Conclusions: Major life stressors, particularly those involving interpersonal loss, personal health crises, and financial or relational instability, predicted 1-year incidence of DSM-5 insomnia disorder. These findings highlight the importance of assessing major life events in both research and clinical contexts, as certain stressors place individuals at markedly higher risk for developing insomnia. Targeted screening and early intervention strategies may help mitigate sleep disturbance in those facing major life stress.
Volume
138
First Page
107335
