# Insomnia Symptoms, Mental Health Diagnosis, Mental Health Care Utilization, and Perceived Barriers in U.S. Males and Females

## TL;DR

This study shows that insomnia is linked to anxiety and depression in both genders, with stronger effects in younger adults and gender differences in accessing mental health care due to cost.

## Contribution

The study reveals gender-specific differences in mental health care utilization and barriers among individuals with insomnia symptoms.

## Key findings

- Insomnia symptoms are associated with anxiety and depression in both males and females.
- These associations are stronger in younger adults under 50 years of age.
- Females with insomnia symptoms face higher financial barriers to mental health care than males.

## Abstract

Objective: We aim to determine the association between insomnia symptoms and mental health in females and males and compare mental health care utilization and perceived barriers between females and males with insomnia symptoms. Methods: This is a cross-sectional study using the National Health Interview Survey. Insomnia symptoms included self-reported “trouble falling asleep”, ‘trouble staying asleep”, and “waking up feeling not well rested”. Mental health included self-reported anxiety and depression. Multivariable logistic regression was used to assess the association between insomnia symptoms and mental health in females and males. Results: A total of 26,691 adults were included. The mean age was 48.2 years; 51.4% were females, and 48.6% were males. Insomnia symptoms were associated with anxiety and depression for both females and males. These associations were stronger in younger adults (<50 years) than older adults (≥50 years). Females with insomnia symptoms were more likely to receive mental health care (OR = 1.7; 95% CI = 1.53, 1.87) but also to delay mental health care because of its cost (OR = 1.96; 95% CI: 1.67, 2.30) or needed mental health care but did not get it because of the cost (OR = 2.14; 95% CI: 1.82, 2.50) than their males counterpart. Conclusions: Insomnia symptoms were associated with mental health in females and males, being stronger in younger adults than older adults, with gender differences in mental health care utilization and financial barriers to mental health care. Holistic approaches involving prevention and better access to mental health care are warranted.