Insomnia Severity Index data reveals 41% of Italian psychiatric outpatients have clinically significant insomnia

Insomnia disorder is a common and debilitating comorbidity in psychiatric patients, often exacerbating distress and complicating treatment. Despite clinical guidelines emphasizing its assessment and treatment as a distinct disorder, even alongside mental health conditions, systematic screening in real-world community mental health settings remains inconsistent. This gap leads to under-identification of patients who could benefit from targeted, evidence-based interventions like CBT-I, which is recommended as the primary approach.

Researchers analyzed anonymized real-world data collected during routine practice at an Italian community mental health center over a three-month period in 2025. Psychiatric outpatients completed the Insomnia Severity Index (ISI), a brief self-report questionnaire measuring subjective insomnia symptoms, consequences, and associated distress. The study aimed to assess the prevalence of clinically significant insomnia and its association with diagnostic groups and medication use.

The study found that a substantial proportion of psychiatric outpatients experienced clinically significant insomnia.

Specifically, 41% of patients scored within the range indicating clinically significant insomnia on the Insomnia Severity Index. Insomnia severity showed a modest variation across different diagnostic groups, with depressive disorders being particularly associated with a higher probability of clinically significant insomnia. Furthermore, the analysis revealed a strong association between benzodiazepine prescriptions and clinically significant insomnia. Patients receiving a greater variety of psychotropic medications also demonstrated a higher likelihood of reporting clinically significant insomnia, suggesting a potential link between polypharmacy and sleep disturbance in this population.