Insomnia is a cardiovascular disease risk factor

  • Zheng B & al.
  • Neurology
  • 06.11.2019

  • von Susan London
  • Clinical Essentials
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Takeaway

  • Self-reported insomnia symptoms increased risk for cardiovascular disease (CVD), and risk rose with number of symptoms.

Why this matters

  • Insomnia may be a modifiable risk factor.

 Key results

  • 3 insomnia symptoms increased risk for total CVD:
    • Difficulties initiating/maintaining sleep (adjusted HR [aHR], 1.09; 95% CI, 1.07-1.11).
    • Early morning awakening (aHR, 1.07; 95% CI, 1.05-1.09).
    • Daytime dysfunction (aHR, 1.13; 95% CI, 1.09-1.18).
  • The 3 insomnia symptoms also increased risk for:
    • Ischemic heart disease individually (HRs, 1.13, 1.09, 1.17; P<.05 for each>
    • Ischemic stroke individually (HRs, 1.06, 1.07, 1.09; P<.05 for each>
  • Risks increased with number of symptoms.
  • Versus peers reporting none, individuals reporting all 3 had elevated risks for:
    • Total CVD (HR, 1.18; 95% CI, 1.13-1.24).
    • Ischemic heart disease (HR, 1.22; 95% CI, 1.13-1.32).
    • Ischemic stroke (HR, 1.10; 95% CI, 1.02-1.19).
  • Symptoms more strongly linked to risk in younger adults, nonhypertensive individuals.

Study design

  • Chinese prospective cohort study of 487,200 individuals aged 30-79 years free of stroke, coronary heart disease, cancer at baseline.
  • Main outcomes: total CVD, individual CVDs during median 9.6-year follow-up.
  • Funding: National Key Research and Development Program of China; others.

Limitations

  • Symptoms subjectively assessed.
  • Reliance on registries, insurance databases for outcomes.
  • Confounding.
  • Uncertain generalizability.