{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:21:12Z","timestamp":1783081272681,"version":"3.54.6"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":183,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["8247010651"],"award-info":[{"award-number":["8247010651"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Depression and Anxiety"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Primary insomnia exhibits diverse clinical profiles across age groups, yet the underlying mechanisms remain unclear. This study aimed to explore age\u2010related differences in factors associated with insomnia severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Evaluating questionnaire scores and heart rate variability (HRV) parameters in young adult age (18\u201344 years,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009124) and old adult age (\u226545 years,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009120) patients with primary insomnia. All participants underwent comprehensive assessments using the Athens Insomnia Scale (AIS), Insomnia Severity Index (ISI), and multiple psychological scales, alongside HRV analysis to evaluate autonomic nervous system function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant between\u2010group differences were observed in Morningness\u2013Eveningness Questionnaire (MEQ) scores and State\u2013Trait Anxiety Inventory (STAI) state anxiety scores, with young adult patients showing a higher prevalence of evening chronotype. All HRV parameters except high\u2010frequency (HF) power differed significantly between age groups, indicating age\u2010related autonomic dysregulation. Regression analyses identified distinct predictors of insomnia severity: insomnia severity in young adults was independently associated with depressive symptoms and chronotype, whereas that in older adults was predicted by anxiety symptoms and HRV parameters reflecting autonomic imbalance (low\u2010frequency [LF]\/HF ratio, mean R\u2013R intervals [RRIs]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight age\u2010dependent associations between insomnia severity, psychological factors, and autonomic function, suggesting that young adult insomnia may be more linked to depressive symptoms and chronotype, whereas old adult insomnia is strongly associated with anxiety and autonomic imbalance. This may inform age\u2010tailored therapeutic strategies for primary insomnia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/da\/7711037","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:36:33Z","timestamp":1783078593000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age Differences in Factors Associated With Insomnia Severity: A Comparative Study of Questionnaire Scores and Heart Rate Variability Parameters"],"prefix":"10.1155","volume":"2026","author":[{"given":"Kong","family":"Xinyu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo","family":"Xiaodan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Mengmeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Haodong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5933-4249","authenticated-orcid":false,"given":"Xiao","family":"Fulong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2010.09.019"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2024.11.011"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.70103"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12264-019-00401-9"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-025-02152-6"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2025.105941"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2003.51356.x"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12663"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24432"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.13701"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-022-02720-0"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2022.11.243"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/nur.22278"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(00)00095-7"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.5.601"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/14.6.540"},{"key":"e_1_2_12_17_2","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1023\/A:1020818417949","article-title":"Validation of a Chinese Version of the Epworth Sleepiness Scale","volume":"11","author":"Chen N. 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