TY - JOUR
T1 - Association of co-morbid insomnia and sleep apnoea symptoms with all-cause mortality
T2 - Analysis of the NHANES 2005-2008 data
AU - Sweetman, Alexander
AU - Lechat, Bastien
AU - Appleton, Sarah
AU - Reynolds, Amy
AU - Adams, Robert
AU - Melaku, Yohannes Adama
PY - 2022/12
Y1 - 2022/12
N2 - BackgroundCo-morbid insomnia and sleep apnoea (COMISA) is a highly prevalent condition associated with negative health outcomes. This population-based study aimed to investigate the association between COMISA and all-cause mortality.MethodsSleep data in 6,877 participants (Age median [IQR]=45 [33,57], 50.1% male) were drawn from the National Health and Nutrition Examination Survey (2005-2008). Insomnia was defined as difficulties initiating sleep, long awakenings, and/or early morning awakenings on ≥16 nights/month, with daytime impairment. The STOP-Bang questionnaire was used to identify participants at high risk of obstructive sleep apnoea (OSA). COMISA was defined if participants met criteria for insomnia and high risk OSA. The median (IQR) follow-up for mortality was 8.6 (7.8, 9.8) years. Cox regression models were used to determine the association between COMISA and all-cause mortality, controlling for socio-demographic characteristics, behavioural factors and chronic conditions.ResultsThe prevalence of no insomnia/OSA, insomnia-alone, OSA-alone, and COMISA were 73.5, 3.0, 20.1, and 3.3%, respectively, and 6.7% of participants died by 11-year follow-up. Compared to participants with no insomnia/OSA, higher mortality risk was observed in participants with COMISA (HR=1.9; 95%CI=1.3-2.8) and insomnia alone (HR=1.5; 95%CI=1.0-2.3) after adjusting for socio-demographic characteristics, and behavioural factors. The relationship between COMISA and mortality persisted after additionally controlling for chronic conditions, sleep duration and sleeping pill use (HR=1.6; 95%CI=1.1-2.3), but the relationship between insomnia-alone and mortality did not (HR=1.4; 95%CI=0.9-2.3).ConclusionCo-morbid insomnia and high-risk OSA is associated with increased risk of all-cause mortality. More research is needed to identify effective treatments for COMISA.
AB - BackgroundCo-morbid insomnia and sleep apnoea (COMISA) is a highly prevalent condition associated with negative health outcomes. This population-based study aimed to investigate the association between COMISA and all-cause mortality.MethodsSleep data in 6,877 participants (Age median [IQR]=45 [33,57], 50.1% male) were drawn from the National Health and Nutrition Examination Survey (2005-2008). Insomnia was defined as difficulties initiating sleep, long awakenings, and/or early morning awakenings on ≥16 nights/month, with daytime impairment. The STOP-Bang questionnaire was used to identify participants at high risk of obstructive sleep apnoea (OSA). COMISA was defined if participants met criteria for insomnia and high risk OSA. The median (IQR) follow-up for mortality was 8.6 (7.8, 9.8) years. Cox regression models were used to determine the association between COMISA and all-cause mortality, controlling for socio-demographic characteristics, behavioural factors and chronic conditions.ResultsThe prevalence of no insomnia/OSA, insomnia-alone, OSA-alone, and COMISA were 73.5, 3.0, 20.1, and 3.3%, respectively, and 6.7% of participants died by 11-year follow-up. Compared to participants with no insomnia/OSA, higher mortality risk was observed in participants with COMISA (HR=1.9; 95%CI=1.3-2.8) and insomnia alone (HR=1.5; 95%CI=1.0-2.3) after adjusting for socio-demographic characteristics, and behavioural factors. The relationship between COMISA and mortality persisted after additionally controlling for chronic conditions, sleep duration and sleeping pill use (HR=1.6; 95%CI=1.1-2.3), but the relationship between insomnia-alone and mortality did not (HR=1.4; 95%CI=0.9-2.3).ConclusionCo-morbid insomnia and high-risk OSA is associated with increased risk of all-cause mortality. More research is needed to identify effective treatments for COMISA.
KW - COMISA
KW - Co-morbid insomnia
KW - Insomnia
KW - Mortality
KW - NHANES
KW - OSA
KW - Sleep apnea
KW - Sleep disordered breathing
KW - STOP-Bang
U2 - 10.1016/j.sleepe.2022.100043
DO - 10.1016/j.sleepe.2022.100043
M3 - Article
SN - 2667-3436
VL - 2
JO - Sleep Epidemiology
JF - Sleep Epidemiology
M1 - 100043
ER -