RT Journal Article
SR Electronic
T1 Insomnia symptoms and risk of cardiovascular diseases among 0.5 million adults
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 10.1212/WNL.0000000000008581
DO 10.1212/WNL.0000000000008581
A1 Bang Zheng
A1 Canqing Yu
A1 Jun Lv
A1 Yu Guo
A1 Zheng Bian
A1 Mi Zhou
A1 Ling Yang
A1 Yiping Chen
A1 Xiaojun Li
A1 Ju Zou
A1 Feng Ning
A1 Junshi Chen
A1 Zhengming Chen
A1 Liming Li
A1 ,
YR 2019
UL http://n.neurology.org/content/early/2019/11/06/WNL.0000000000008581.abstract
AB Objective To examine the associations of individual insomnia symptoms with risks of incident cardio-cerebral vascular diseases (CVD) and possible moderating factors among Chinese adults.Methods The China Kadoorie Biobank is a prospective cohort study that recruited participants from 10 areas across China. Data from 487,200 adults 30 to 79 years of age who were free of stroke, coronary heart disease, and cancer at baseline were analyzed. Three insomnia symptoms were assessed with self-reported difficulties in initiating or maintaining sleep, early morning awakening, and daytime dysfunction for at least 3 d/wk at baseline. Incidences of CVD were followed up through disease registries and national health insurance databases until 2016.Results During a median of 9.6 years of follow-up, 130,032 cases of CVD were documented. Cox regressions showed that 3 insomnia symptoms were associated with increased risk of total CVD, with respective adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.09 (95% CI 1.07–1.11), 1.07 (95% CI 1.05–1.09), and 1.13 (95% CI 1.09–1.18). Participants with individual symptoms also had higher risks of ischemic heart disease (IHD; HR 1.13, 1.09, and 1.17) and ischemic stroke but not hemorrhagic stroke. Participants with all 3 symptoms were at an 18%, 22%, or 10% higher risk of CVD, IHD, or ischemic stroke compared to nonsymptomatic adults. Associations between 3 symptoms and CVD incidence were consistently stronger in younger adults or those without baseline hypertension (p for interaction <0.05).Conclusions Individual and coexisting insomnia symptoms are independent risk factors for CVD incidence, especially among young adults or adults who have not developed hypertension.