Comparison in mean Functional Outcomes of Sleep Questionnaire general productivity scores across groups. Nocturnal insomnia symptoms include difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening. ***P < 0.001 when compared with any other group. #No statistically significant difference between normal sleep and nocturnal insomnia symptoms only (P = 0.670). Multivariable analysis was adjusted for age, sex, poverty income ratio, ethnicity, educational level, marital status, habitual sleep duration, habitual snoring, PHQ-9, lifetime smoking, clinician-diagnosed sleep apnea, restless legs syndrome, habitual sleeping pill use, and number of medical conditions. Error bars = SEM.