Insomnia disorders are associated with increased cardiometabolic disturbances and death risks from cardiovascular diseases in psychiatric patients treated with weight-gain-inducing psychotropic drugs: results from a Swiss cohort

Abstract

Study objectives Insomnia disorders as well as cardiometabolic disorders are highly prevalent in the psychiatric population compared to the general population. We aimed to investigate their association and evolution over time in a Swiss psychiatric cohort. Methods Data for 2861 patients (8954 observations) were obtained from two prospective cohorts (PsyMetab and PsyClin) with metabolic parameters monitored routinely during psychotropic treatment. Insomnia disorders were based on the presence of ICD-10 “F51.0" diagnosis (non-organic insomnia), the prescription of sedatives before bedtime or the discharge letter. Metabolic syndrome was defined using the International Diabetes Federation definition, while the 10-year risk of cardiovascular event or death was assessed using the Framingham Risk Score and the Systematic Coronary Risk Estimation, respectively. Results Insomnia disorders were observed in 30% of the cohort, who were older, predominantly female, used more psychotropic drugs carrying risk of high weight gain (olanzapine, clozapine, valproate) and were more prone to suffer from schizoaffective or bipolar disorders. Multivariate analyses showed that patients with high body mass index (OR = 2.02, 95%CI [1.51–2.72] for each ten-kg/m2 increase), central obesity (OR = 2.20, [1.63–2.96]), hypertension (OR = 1.86, [1.23–2.81]), hyperglycemia (OR = 3.70, [2.16–6.33]), high density lipoprotein hypocholesterolemia in women (OR = 1.51, [1.17–1.95]), metabolic syndrome (OR = 1.84, [1.16–2.92]) and higher 10-year risk of death from cardiovascular diseases (OR = 1.34, [1.17–1.53]) were more likely to have insomnia disorders. Time and insomnia disorders were associated with a deterioration of cardiometabolic parameters. Conclusions Insomnia disorders are significantly associated with metabolic worsening and risk of death from cardiovascular diseases in psychiatric patients.

Publisher Correction: Insomnia disorders are associated with increased cardiometabolic disturbances and death risks from cardiovascular diseases in psychiatric patients treated with weight-gain-inducing psychotropic drugs: results from a Swiss cohort

“…Correction for multiple testing was applied using false discovery rate. Abbreviations: BMI body mass index, N number The original article [1] has been corrected.…”

“…Author details 1 • support for research data, including large and complex data types • gold Open Access which fosters wider collaboration and increased citations maximum visibility for your research: over 100M website views per year…”

“…Following the publication of the original article [1], the authors identified errors in the figure captions.…”

“…Models were adjusted for age, sex, smoking status, and psychotropic medication (classified by the risk of weight gain), except the model for CVD which was adjusted only for psychotropic medication. 1 Models fitted with random effect at observation level. 2 Models fitted with random effect at patient level.…”

Effects of electrostatic therapy on nighttime sleep and daytime symptoms in patients with chronic insomnia: Evidences from an open label study

“…Insomnia does not only manifest as nighttime symptoms (i.e., difficulty falling or staying asleep, waking too early), but also accompanied by daytime functional impairment (i.e., fatigue, daytime sleepiness, and attention impairment) (Sutton, 2021). Previous studies have shown that insomnia is associated with increased risk of psychiatric (i.e., depression and anxiety) (Riemann, 2007;Staner, 2010;Li et al, 2016;Chellappa and Aeschbach, 2022) and cardiometabolic morbidity (Vgontzas et al, 2009a,b;Li et al, 2015;Bertisch et al, 2018;Laaboub et al, 2022), as well as an economic burden on the overall healthcare system (Taddei-Allen, 2020;Streatfeild et al, 2021). Cognitive behavioral treatment -insomnia (CBT-I) is considered "first line" treatment, however there is a large number of patients that do not respond well to this treatment modality (Bathgate et al, 2017) and may respond better to biological treatments (Vgontzas et al, 2020;Li et al, 2021).…”