Association between insomnia phenotypes and subclinical myocardial injury: the Multi-Ethnic Study of Atherosclerosis

Sigurdardottir, Fjola D; Bertisch, Suzanne; Reid, Michelle; deFilippi, Christopher R.; Lima, João A.C.; Redline, Susan; Omland, Torbjørn

doi:10.1093/sleep/zsac318

Cited by 7 publications

(4 citation statements)

References 45 publications

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“…As shown in Figure 2, the ISSD phenotype has also been associated with specific adverse health outcomes in 37 studies: Cardiovascular (Bathgate et al, 2016; Bertisch et al, 2018; Fernandez‐Mendoza et al, 2012; Fernandez‐Mendoza et al, 2018; Hein et al, 2019a; Hein et al, 2019b; Huang et al, 2018; Nakazaki et al, 2012; Sigurdardottir et al, 2022; Vgontzas et al, 2009a). Metabolic (Castro‐Diehl et al, 2018; D'Aurea et al, 2015; Duan et al, 2023; Hein et al, 2018; Miner et al, 2022; Vasisht et al, 2013; Vgontzas et al, 2009b).…”

Section: Resultsmentioning

confidence: 99%

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Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes

Nyhuis

Fernández-Mendoza

2023

Journal of Sleep Research

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SummaryInsomnia nosology has significantly evolved since the Diagnostic and Statistical Manual (DSM)‐III‐R first distinguished between ‘primary’ and ‘secondary’ insomnia. Prior International Classification of Sleep Disorders (ICSD) nosology ‘split’ diagnostic phenotypes to address insomnia's heterogeneity and the DSM nosology ‘lumped’ them into primary insomnia, while both systems assumed causality for insomnia secondary to health conditions. In this systematic review, we discuss the historical phenotypes in prior insomnia nosology, present findings for currently proposed insomnia phenotypes based on more robust approaches, and critically appraise the most relevant ones. Electronic databases PsychINFO, PubMED, Web of Science, and references of eligible articles, were accessed to find diagnostic manuals, literature on insomnia phenotypes, including systematic reviews or meta‐analysis, and assessments of the reliability or validity of insomnia diagnoses, identifying 184 articles. The data show that previous insomnia diagnoses lacked reliability and validity, leading current DSM‐5‐TR and ICSD‐3 nosology to ‘lump’ phenotypes into a single diagnosis comorbid with health conditions. However, at least two new, robust insomnia phenotyping approaches were identified. One approach is multidimensional‐multimethod and provides evidence for self‐reported insomnia with objective short versus normal sleep duration linked to clinically relevant outcomes, while the other is multidimensional and provides evidence for two to five clusters (phenotypes) based on self‐reported trait, state, and/or life‐history data. Some approaches still need replication to better support whether their findings identify true phenotypes or simply different patterns of symptomatology. Regardless, these phenotyping efforts aim at improving insomnia nosology both as a classification system and as a mechanism to guide treatment.

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Section: Resultsmentioning

confidence: 99%

“…• Cardiovascular (Bathgate et al, 2016;Bertisch et al, 2018;Fernandez-Mendoza et al, 2012;Fernandez-Mendoza et al, 2018;Hein et al, 2019a;Hein et al, 2019b;Huang et al, 2018;Nakazaki et al, 2012;Sigurdardottir et al, 2022;Vgontzas et al, 2009a).…”

Section: Night-time Sleep Durationunclassified

Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes

Nyhuis

Fernández-Mendoza

2023

Journal of Sleep Research

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“…Several reasons might explain these divergent results. Differences in study populations, methodologies and definitions of insomnia can introduce variability [34]. Moreover, other confounding factors, such as lifestyle habits, comorbid conditions or medication usage, may not have been consistently accounted for across all studies.…”

Section: Discussionmentioning

confidence: 99%

Sex-specific cancer risk associated with insomnia: a prospective cohort study using the Korean genome and epidemiology study (KoGES) data

2024

JOMH

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The interaction effect of sex and insomnia on the risk of cancer remains unclear. Our study aimed to examine the association between insomnia and cancer development, and through stratified analysis, to determine if this association is modified based on sex. We used the Korean Genome Epidemiology Study (KoGES), which initiated two distinct prospective cohort investigations in 2001. The main exposure variable are sex and insomnia and the main outcome is cancer occurrence. The occurrence of cancer was considered the main outcome, and Cox regression analysis was utilized to estimate hazard ratios and 95% confidence interval. Additionally, stratified analysis was conducted to evaluate the interaction effect of sex and insomnia on cancer risk. In our study, the incidence of cancer per 1000 person-years was 5.23 in the insomnia group and 5.33 in the non-insomnia group, with no significant difference in adjusted hazard ratio (aHR: 1.01 (0.81-1.26)). Stratifying by sex, incidence rates were 4.86 for males and 5.72 for females per 1000 person-years, with females presenting a significantly higher aHR (1.30 (1.03-1.71)). No significant interaction was observed for both "insomnia × sex" and "sex × insomnia". Notably, females on insomnia medication had a substantially increased cancer risk )). Our study revealed that females, especially those undergoing insomnia medication treatment, exhibited a heightened cancer risk, though insomnia alone did not significantly influence this risk. These findings suggest a potential protective effect of male gender against cancer incidence.

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“…Unfortunately, the previously mentioned studies did not contain control groups that would allow for a direct comparison of our results. Our analysis of the existing literature found that PSG variables such as total sleep time (TST) and sleep efficiency were found to be different in certain groups of patients [ 16 , 45 , 46 ]. On the other hand, we did not observe these correlations in our study because these differences found in other research may influence group profiles such that they consist of only insomnia patients who were not present in our study.…”

Section: Discussionmentioning

confidence: 99%

Sleep Bruxism and Sleep Structure in Comorbid Insomnia and Obstructive Sleep Apnea (COMISA) Syndrome: A Polysomnographic Study

Blaszczyk,

Meira e Cruz,

Waliszewska-Prosol

et al. 2024

JCM

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Introduction: Comorbid insomnia and obstructive sleep apnea (COMISA) is not a well-identified sleep disorder, despite having a significant impact on health. This study investigates the relationship between sleep bruxism (SB) and sleep architecture in patients with COMISA, obstructive sleep apnea (OSA), and in those without any sleep disorders. Methods: 119 patients were included in the study and divided into three groups: OSA, COMISA, and a control group. Polysomnographic (PSG) examination provided parameters related to sleep architecture, OSA, and characteristics of SB. Results: The bruxism episode index (BEI) and other SB parameters were not found to be statistically different between the three groups (p > 0.05). There was no statistical difference in measured sleep architecture between the COMISA and OSA groups (p > 0.05). In comparison to the control group, participants in the COMISA group were found to have an increased apnea–hypopnea index (AHI), oxygen desaturation index (ODI), respiratory disturbance index (RDI), all arousals (AA), and respiratory arousals (RA) (p < 0.05). Among COMISA patients, AA and RA were shown to have a positive linear correlation with the number of bradycardia events per hour (r = 0.49, r = 0.48, p < 0.05). Conclusions: SB does not occur in patients with COMISA more frequently than in patients with OSA or those without any sleep disorders. PSG parameters are not specific for COMISA; therefore, in order to differentiate this disorder from OSA alone, a comprehensive patient assessment has to be performed.

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Association between insomnia phenotypes and subclinical myocardial injury: the Multi-Ethnic Study of Atherosclerosis

Cited by 7 publications

References 45 publications

Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes

Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes

Sex-specific cancer risk associated with insomnia: a prospective cohort study using the Korean genome and epidemiology study (KoGES) data

Sleep Bruxism and Sleep Structure in Comorbid Insomnia and Obstructive Sleep Apnea (COMISA) Syndrome: A Polysomnographic Study

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