This study investigated the patterns of volume changes across neurofunctionally distinct hippocampal subfields in patients with chronic insomnia. The results suggested that L1 and R2 atrophy increased the risk of developing chronic insomnia approximately 3-fold, and negative emotion positively acted on the causal path of insomnia severity leading to R1 atrophy. In addition, we developed a practical and visual nomogram of individual competing risks for predicting chronic insomnia risk with high accurate predictive power based on these hippocampal subfields. Neurofunctional hippocampal subfield atrophy was a risk factor leading to chronic insomnia, contributing to understand of the etiology of insomnia.
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