The Association between Insomnia and Increased Future Cardiovascular Events

A Nationwide Population-Based Study

Chien Yi Hsu, Yung Tai Chen, Mu Hong Chen, Chin Chou Huang, Chia Hung Chiang, Po Hsun Huang, Jaw Wen Chen, Tzeng Ji Chen, Shing Jong Lin, Hsin Bang Leu, Wan Leong Chan

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objectives Insomnia may increase the risk of cardiovascular disease (CVD), but the reported magnitude of the associations between sleep characteristics and CVD is inconsistent. We investigated the association between insomnia and the risk of developing acute myocardial infarction (AMI) and/or stroke by using a nationwide, population-based cohort database in Taiwan. Methods The analyses were conducted using information from a random sample of 1 million people enrolled in the nationally representative Taiwan National Health Insurance Research Database. A total of 44,080 individuals who were 20 years or older, including 22,040 people who had diagnosis of insomnia during the study period and an age-, sex-, comorbidity-matched group of 22,040 people without insomnia, were enrolled in our study. The study end points were the occurrence of cardiovascular events including AMI or stroke during follow-up. Results During a 10-year follow-up, 302 AMI events and 1049 stroke events were identified. The insomnia group had a higher incidence of AMI (2.25 versus 1.08 per 1000 person-years) and stroke (8.01 versus 3.69 per 1000 person-years, p <.001). Cox proportional hazard regression model analysis showed that insomnia was independently associated with a higher risk of future AMI (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.31-2.16, p <.001), stroke (HR = 1.85, 95% CI = 1.62-2.12, p <.001), and the composite event index (HR = 1.81, 95% CI = 1.61-2.05, p <.001), after adjusting for age, sex, and comorbidities. Conclusions Insomnia is associated with an increased risk of future cardiovascular events.

Original languageEnglish
Pages (from-to)743-751
Number of pages9
JournalPsychosomatic Medicine
Volume77
Issue number7
DOIs
Publication statusPublished - Sep 11 2015
Externally publishedYes

Fingerprint

Sleep Initiation and Maintenance Disorders
Stroke
Myocardial Infarction
Population
Confidence Intervals
Taiwan
Comorbidity
Cardiovascular Diseases
Databases
National Health Programs
Proportional Hazards Models
Sleep
Research Design
Regression Analysis
Incidence
Research

Keywords

  • cardiovascular disease prevention
  • insomnia
  • myocardial infarction
  • stroke

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

Cite this

The Association between Insomnia and Increased Future Cardiovascular Events : A Nationwide Population-Based Study. / Hsu, Chien Yi; Chen, Yung Tai; Chen, Mu Hong; Huang, Chin Chou; Chiang, Chia Hung; Huang, Po Hsun; Chen, Jaw Wen; Chen, Tzeng Ji; Lin, Shing Jong; Leu, Hsin Bang; Chan, Wan Leong.

In: Psychosomatic Medicine, Vol. 77, No. 7, 11.09.2015, p. 743-751.

Research output: Contribution to journalArticle

Hsu, CY, Chen, YT, Chen, MH, Huang, CC, Chiang, CH, Huang, PH, Chen, JW, Chen, TJ, Lin, SJ, Leu, HB & Chan, WL 2015, 'The Association between Insomnia and Increased Future Cardiovascular Events: A Nationwide Population-Based Study', Psychosomatic Medicine, vol. 77, no. 7, pp. 743-751. https://doi.org/10.1097/PSY.0000000000000199
Hsu, Chien Yi ; Chen, Yung Tai ; Chen, Mu Hong ; Huang, Chin Chou ; Chiang, Chia Hung ; Huang, Po Hsun ; Chen, Jaw Wen ; Chen, Tzeng Ji ; Lin, Shing Jong ; Leu, Hsin Bang ; Chan, Wan Leong. / The Association between Insomnia and Increased Future Cardiovascular Events : A Nationwide Population-Based Study. In: Psychosomatic Medicine. 2015 ; Vol. 77, No. 7. pp. 743-751.
@article{d818ea57753c4d18a1808a1c1d6f8568,
title = "The Association between Insomnia and Increased Future Cardiovascular Events: A Nationwide Population-Based Study",
abstract = "Objectives Insomnia may increase the risk of cardiovascular disease (CVD), but the reported magnitude of the associations between sleep characteristics and CVD is inconsistent. We investigated the association between insomnia and the risk of developing acute myocardial infarction (AMI) and/or stroke by using a nationwide, population-based cohort database in Taiwan. Methods The analyses were conducted using information from a random sample of 1 million people enrolled in the nationally representative Taiwan National Health Insurance Research Database. A total of 44,080 individuals who were 20 years or older, including 22,040 people who had diagnosis of insomnia during the study period and an age-, sex-, comorbidity-matched group of 22,040 people without insomnia, were enrolled in our study. The study end points were the occurrence of cardiovascular events including AMI or stroke during follow-up. Results During a 10-year follow-up, 302 AMI events and 1049 stroke events were identified. The insomnia group had a higher incidence of AMI (2.25 versus 1.08 per 1000 person-years) and stroke (8.01 versus 3.69 per 1000 person-years, p <.001). Cox proportional hazard regression model analysis showed that insomnia was independently associated with a higher risk of future AMI (hazard ratio [HR] = 1.68, 95{\%} confidence interval [CI] = 1.31-2.16, p <.001), stroke (HR = 1.85, 95{\%} CI = 1.62-2.12, p <.001), and the composite event index (HR = 1.81, 95{\%} CI = 1.61-2.05, p <.001), after adjusting for age, sex, and comorbidities. Conclusions Insomnia is associated with an increased risk of future cardiovascular events.",
keywords = "cardiovascular disease prevention, insomnia, myocardial infarction, stroke",
author = "Hsu, {Chien Yi} and Chen, {Yung Tai} and Chen, {Mu Hong} and Huang, {Chin Chou} and Chiang, {Chia Hung} and Huang, {Po Hsun} and Chen, {Jaw Wen} and Chen, {Tzeng Ji} and Lin, {Shing Jong} and Leu, {Hsin Bang} and Chan, {Wan Leong}",
year = "2015",
month = "9",
day = "11",
doi = "10.1097/PSY.0000000000000199",
language = "English",
volume = "77",
pages = "743--751",
journal = "Psychosomatic Medicine",
issn = "0033-3174",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - The Association between Insomnia and Increased Future Cardiovascular Events

T2 - A Nationwide Population-Based Study

AU - Hsu, Chien Yi

AU - Chen, Yung Tai

AU - Chen, Mu Hong

AU - Huang, Chin Chou

AU - Chiang, Chia Hung

AU - Huang, Po Hsun

AU - Chen, Jaw Wen

AU - Chen, Tzeng Ji

AU - Lin, Shing Jong

AU - Leu, Hsin Bang

AU - Chan, Wan Leong

PY - 2015/9/11

Y1 - 2015/9/11

N2 - Objectives Insomnia may increase the risk of cardiovascular disease (CVD), but the reported magnitude of the associations between sleep characteristics and CVD is inconsistent. We investigated the association between insomnia and the risk of developing acute myocardial infarction (AMI) and/or stroke by using a nationwide, population-based cohort database in Taiwan. Methods The analyses were conducted using information from a random sample of 1 million people enrolled in the nationally representative Taiwan National Health Insurance Research Database. A total of 44,080 individuals who were 20 years or older, including 22,040 people who had diagnosis of insomnia during the study period and an age-, sex-, comorbidity-matched group of 22,040 people without insomnia, were enrolled in our study. The study end points were the occurrence of cardiovascular events including AMI or stroke during follow-up. Results During a 10-year follow-up, 302 AMI events and 1049 stroke events were identified. The insomnia group had a higher incidence of AMI (2.25 versus 1.08 per 1000 person-years) and stroke (8.01 versus 3.69 per 1000 person-years, p <.001). Cox proportional hazard regression model analysis showed that insomnia was independently associated with a higher risk of future AMI (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.31-2.16, p <.001), stroke (HR = 1.85, 95% CI = 1.62-2.12, p <.001), and the composite event index (HR = 1.81, 95% CI = 1.61-2.05, p <.001), after adjusting for age, sex, and comorbidities. Conclusions Insomnia is associated with an increased risk of future cardiovascular events.

AB - Objectives Insomnia may increase the risk of cardiovascular disease (CVD), but the reported magnitude of the associations between sleep characteristics and CVD is inconsistent. We investigated the association between insomnia and the risk of developing acute myocardial infarction (AMI) and/or stroke by using a nationwide, population-based cohort database in Taiwan. Methods The analyses were conducted using information from a random sample of 1 million people enrolled in the nationally representative Taiwan National Health Insurance Research Database. A total of 44,080 individuals who were 20 years or older, including 22,040 people who had diagnosis of insomnia during the study period and an age-, sex-, comorbidity-matched group of 22,040 people without insomnia, were enrolled in our study. The study end points were the occurrence of cardiovascular events including AMI or stroke during follow-up. Results During a 10-year follow-up, 302 AMI events and 1049 stroke events were identified. The insomnia group had a higher incidence of AMI (2.25 versus 1.08 per 1000 person-years) and stroke (8.01 versus 3.69 per 1000 person-years, p <.001). Cox proportional hazard regression model analysis showed that insomnia was independently associated with a higher risk of future AMI (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.31-2.16, p <.001), stroke (HR = 1.85, 95% CI = 1.62-2.12, p <.001), and the composite event index (HR = 1.81, 95% CI = 1.61-2.05, p <.001), after adjusting for age, sex, and comorbidities. Conclusions Insomnia is associated with an increased risk of future cardiovascular events.

KW - cardiovascular disease prevention

KW - insomnia

KW - myocardial infarction

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=84941203203&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941203203&partnerID=8YFLogxK

U2 - 10.1097/PSY.0000000000000199

DO - 10.1097/PSY.0000000000000199

M3 - Article

VL - 77

SP - 743

EP - 751

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 7

ER -