Insomnia and the Risk of Acute Myocardial Infarction

Laugsand, Lars E.; Vatten, Lars J.; Platou, Carl; Janszky, Imre

doi:10.1161/circulationaha.111.025858

Cited by 369 publications

(276 citation statements)

References 34 publications

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“…Individuals reporting multiple insomnia Epidemiology of Insomnia 18 symptoms (i.e., difficulties initiating/maintaining sleep, early morning awakening) at baseline showed increased incident rates of coronary heart disease compared to those with only one or without any symptoms at baseline [84]. In particular, frequent reports of difficulty initiating and maintaining sleep, as well as nonrestorative sleep were associated with increased hazard ratios of 1.45, 1.30, and 1.27, respectively, for acute myocardial infarction [82]. Further, insomnia symptoms are significantly associated with cardiovascular-and all-cause mortality up to 17 years after the insomnia symptoms are detected [85].…”

Section: Long-term Consequences Of Insomniamentioning

confidence: 99%

“…Additional evidence suggests insomnia is a risk factor for future cardiac events including acute myocardial infarction [82] and coronary heart disease [83], even among individuals free of cardiovascular disease [80]. Individuals reporting multiple insomnia Epidemiology of Insomnia 18 symptoms (i.e., difficulties initiating/maintaining sleep, early morning awakening) at baseline showed increased incident rates of coronary heart disease compared to those with only one or without any symptoms at baseline [84].…”

Section: Long-term Consequences Of Insomniamentioning

confidence: 99%

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Epidemiology of Insomnia

Morin

Jarrin

2013

Sleep Medicine Clinics

190

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This paper summarizes recent epidemiological evidence on insomnia, including its prevalence, incidence, and risk factors, as well as its course and consequences. There is now substantial evidence that insomnia is a significant public health problem. It is a highly prevalent condition, both as a symptom and a syndrome, and is often a persistent condition over time. Its persistence is associated with increased risk for mental (major depression), physical (hypertension), and occupational health problems (disability). Chronic insomnia also carries heavy economic burden, both in terms of direct healthcare costs and, more importantly, in terms of human resources loss due to the illness and lack of treatment. These findings have direct implications for community-based prevention and intervention programs and for future research including the need for: a) longitudinal, population-based studies aimed at evaluating whether we can prevent insomnia among at-risk individuals; b) clinical studies evaluating whether the morbidity associated with chronic insomnia is reversible; and c) prospective health economic evaluations of prevention programs using different dissemination technologies. Key Points• The epidemiology of insomnia has received increased attention in the last decade and investigators have moved from a purely cross-sectional approach to a more prospective and longitudinal approach.• Progress on the epidemiology of insomnia has been hampered by important methodological shortcomings including, but not limited to, the lack of a consistent case definition and standardized assessment procedures across studies.• Additional prospective and longitudinal studies are needed to identify early precursors of insomnia and factors moderating its trajectories over time.• A better understanding of how insomnia evolves over time and what factors trigger an episode or perpetuate it over time is critical for developing effective prevention and treatment programs. Outline• Introduction • Nature of insomnia complaints and updated diagnostic criteria • Prevalence and correlates of insomnia • Incidence and risk factors • Course of Insomnia -persistence, remission, relapse • Consequences and burden of insomnia

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Section: Long-term Consequences Of Insomniamentioning

confidence: 99%

Section: Long-term Consequences Of Insomniamentioning

confidence: 99%

Epidemiology of Insomnia

Morin

Jarrin

2013

Sleep Medicine Clinics

190

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“…56 Risk of acute myocardial infarction is increased in a dose-dependent manner in persons with symptoms of insomnia. 57 The Penn State Cohort data showed four-fold increased odds of mortality in insomniacs who slept less than 6 hours compared to the those with no insomnia and normal sleep duration. 58 Analyses of data from the Finnish Twin Cohort showed a significant association between self-reported poor sleep and risk of mortality, especially in those with somatic disease (presumably including COPD).…”

Section: Impactmentioning

confidence: 99%

Sleep Disorders in Chronic Obstructive Pulmonary Disease: Etiology, Impact, and Management

Budhiraja

Siddiqi

Quan

2015

Journal of Clinical Sleep Medicine

151

125

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Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be complicated by sleep disorders. Insomnia and obstructive sleep apnea are commonly encountered in patients with COPD. Nocturnal hypoxemia is also prevalent in COPD may occur despite adequate awake oxygenation and can be especially severe in rapid eye movement sleep. Additionally, several factors-some of them unique to COPD-can contribute to sleep-related hypoventilation. Recognition of hypoventilation can be vital as supplemental oxygen therapy itself can acutely worsen hypoventilation and lead to disastrous consequences. Finally, accruing data establish an association between restless leg syndrome and COPDan association that may be driven by hypoxemia and/or hypercapnia. Comorbid sleep disorders portend worse sleep quality, diminished quality of life, and multifarious other adverse consequences. The awareness and knowledge regarding sleep comorbidities in COPD has continued to evolve over past many years. There are still several lacunae, however, in our understanding of the etiologies, impact, and therapies of sleep disorders, specifi cally in patients with COPD. This review summarizes the latest concepts in prevalence, pathogenesis, diagnosis, and management of diverse sleep disorders in COPD. Keywords: COPD, insomnia, obstructive sleep apnea, restless legs syndrome, hypoventilation Citation: Budhiraja R, Siddiqi TA, Quan SF. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management. J Clin Sleep Med 2015;11(3):259-270.pii: jc-00080-14 http://dx.doi.org/10.5664/jcsm.4540 T hat sleep is adversely affected in chronic obstructive pulmonary disease (COPD) has been long recognized. 1 COPD affects 5% to 10% of the adult population in the United States and is a major contributor to global disease burden. 2 The prevalence of insomnia symptoms, insomnia disorder, restless leg syndrome, and hypoxemia is increased in COPD. [3][4][5] Furthermore, polysomnographic (PSG) evaluation generally reveals decreased sleep effi ciency and lower mean overnight oxygen saturation in COPD patients compared to controls. 6 In COPD, the pathogenesis of sleep disorders appears to be a complex and multifactorial process, likely consequent to one or more of the following: physiological changes associated with sleep, hypoxemia, hypercapnia, infl ammation, COPD medications, and/or nicotine use. Comorbid disorders as well as primary sleep disturbances may also contribute to disrupted sleep in COPD patients. For example, nocturnal gastroesophageal refl ux (GERD) is associated with both symptoms of sleep apnea and COPD, and may contribute to the pathogenesis, and concomitant occurrence of both disorders.7 GERD may also infl uence sleep quality which could potentially contribute to some of the sleep complaints reported by persons with COPD. 8 The following sections describe the diverse sleep disorders and sleep-related abnormalities encountered in patients with COPD. Sleep Disorders in Chronic Obstructiv...

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“…Так, в проведенном F. Sofi [4] метаанализе проспективных когортных исследо-ваний по результатам наблюдения в течение 20 лет за когортой из 122501 пациентов было показано, что бессонница определяла повышенный риск (+45%) формирования кардиоваскулярного заболевания или смерти от болезни (относительный риск -1,45; дове-рительный интервал -1,29-1,62; р<0,00001). По результатам исследования, проведенного швед-скими авторами [5], относительный риск развития инфаркта миокарда составил 1,3 (1,10-1,68) у лиц с нарушениями поддержания сна и 1,27 (1,03-1,57) у пациентов, жаловавшихся на не восстанавливаю-щий сон при первичном обследовании. В ряде работ было установлено также, что люди, предъявлявшие жалобы на бессонницу, также имели повышенный риск возникновения инсульта (относительный риск -1,54 (1,38-1,72) [6].…”

Section: Discussionunclassified

Sleep Disorders and Chronic Stress as Cardiovascular Risk Factors

2015

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Цель. Провести оценку роли хронических вариантов нарушения засыпания/ поддержания сна и клинико-инструментальных индикаторов рабочего стресса в качестве предикторов и/или факторов риска неблагоприятного течения кар-диоваскулярных заболеваний у работников умственного труда и определить направления профилактических мероприятий. Материал и методы. В 2008-2009гг сформирована группа из 167 пациентов реабилитационного центра, работников умственного труда (85 мужчин, 82 женщины, ср. возраст -51,7+7,5 лет), не имевших значимых нарушений дыхания во время сна. 49 пациентов имели подтвержденный диагноз иБс, 55 -гипертонической болезни 2-3 ст., 63 больных составили контрольную группу. исходное исследование предусматривало сбор клинико-анамнести-ческих данных, выявление психосоциальных маркеров рабочего стресса, диагностику расстройств сна, включающую в себя ночное полисомнографи-ческое исследование. Повторное исследование, проведенное в 2012-2013гг, предусматривало изучение клинических исходов течения кардиоваскуляр-ных заболеваний. Результаты. Хроническая бессонница выявлялась у 30 (61%) пациентов с иБс, у 33 (60%) пациентов с гипертонической болезнью и у 29 (46%) больных контрольной группы. Повышенные уровни рабочего стресса, определяемые в соответствии с моделью "усилие-вознаграждение", выявлены у 26 (53%) больных с иБс, у 29 (53%) с ГБ и у 25 (40%) контрольной группы. У больных с кардиоваскулярными заболеваниями и расстройствами сна выявлялись инструментальные признаки нарушений сна (снижение эффективности сна, % содержания медленноволнового сна) и преобладание активирующих влияний на ЭЭГ. По данным проспективного наблюдения наличие хронической бессон-ницы, по данным исходного обследования, было ассоциировано с повышен-ным риском формирования новых случаев гипертонической болезни (ОШ=2,1) и иБс (ОШ=1,9).Заключение. Нарушения засыпания и поддержания сна могут рассматри-ваться в качестве индикаторов хронического стресса у больных с кардиова-скулярными заболеваниями. Программы кардиологической реабилитации должны включать мероприятия по выявлению стресса и нарушений сна. Российский

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Insomnia and the Risk of Acute Myocardial Infarction

Abstract: Insomnia is associated with a moderately increased risk for AMI.

Cited by 369 publications

References 34 publications

Epidemiology of Insomnia

Epidemiology of Insomnia

Sleep Disorders in Chronic Obstructive Pulmonary Disease: Etiology, Impact, and Management

Sleep Disorders and Chronic Stress as Cardiovascular Risk Factors

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