Midlife insomnia and subsequent mortality: the Hordaland health study

BMC Public Health

Simon Øverland³  Reidun Ursin¹  Grethe S Tell⁵  Paula Salo⁴  Bjørn Bjorvatn⁵  Nick Glozier⁶  Ståle Pallesen¹  Børge Sivertsen² 

[1] Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway;Department of Psychiatry, Helse Fonna HF, Haugesund, Norway;Department of Psychosocial Science, University of Bergen, Bergen, Norway;Department of Psychology, University of Turku, Turku, Finland;Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;Brain and Mind Research Institute, Sydney Medical School, The University of Sydney, Sydney, Australia

关键词: Sleep medication;    Sleep duration;    Mortality;    Risk factor;    Insomnia;   

Others  :  865012
DOI  :  10.1186/1471-2458-14-720

 received in 2014-03-12, accepted in 2014-07-10,  发布年份 2014

【 摘 要 】

Background

Previous research suggests a possible link between insomnia and mortality, but findings are mixed and well-controlled studies are lacking. The aim of the current study was to examine the effect of insomnia in middle age on all-cause mortality.

Methods

Using a cohort design with 13-15 years follow-up, mortality registry data were linked to health information obtained during 1997-99, as part of the community-based Hordaland Health Study (HUSK), in Western Norway. 6,236 participants aged 40–45 provided baseline information on self- reported insomnia using the Karolinska Sleep Questionnaire Scale (defined according to the 5^th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), sociodemographic factors, health behaviors, shift/night-work, obstructive sleep apnea symptoms, sleep duration, sleep medication use, anxiety, depression, as well as a range of somatic diagnoses and symptoms. Height, weight and blood pressure were measured. Information on mortality was obtained from the Norwegian Cause of Death Registry.

Results

Insomnia was reported by 5.6% (349/6236) at baseline and a significant predictor of all-cause-mortality (hazard ratio [HR] = 2.74 [95% CI:1.75-4.30]). Adjusting for all confounders did not attenuate the effect (HR = 3.34 [95% CI:1.67-6.69]). Stratifying by gender, the effect was especially strong in men (HR = 4.72 [95% CI:2.48-9.03]); but also significant in women (adjusted HR = 1.96 [95% CI:1.04-3.67]). The mortality risk among participants with both insomnia and short sleep duration (<6.5 hours) was particularly high, whereas insomnia in combination with normal/greater sleep duration was not associated with mortality.

Conclusions

Insomnia was associated with a three-fold risk of mortality over 13-15 years follow-up. The risk appeared even higher in males or when insomnia was combined with short sleep duration, although such unadjusted subgroup analyses should be interpreted with caution. Establishing prevention strategies and low-threshold interventions should consequently be a prioritized task for public health policy.

【 授权许可】

   
2014 Sivertsen et al.; licensee BioMed Central Ltd.

【 图 表 】

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