Do insomnia complaints cause hypertension or cardiovascular disease?
OBJECTIVE
We prospectively investigated odds ratios (ORs) for development of hypertension or cardiovascular disease by endorsement of sleep complaints.


METHODS
The Atherosclerosis Risk in Communities (ARIC) Study is a prospective, population-based study of cardiovascular disease. Our study sample was 8757 ARIC participants without hypertension and 11,863 ARIC participants without cardiovascular disease at baseline. We applied multivariate regression analysis to predict the ORs of development of hypertension or cardiovascular disease over 6 years of follow-up by endorsement of symptoms of difficulty falling asleep (DFA), waking up repeatedly (SCD), awakening tired and fatigued (NRS), or combinations of these symptoms. We controlled for age, sex, alcohol intake, income, smoking, diabetes, heart disease, menopausal status, depression, educational level, Body Mass Index, respiratory symptoms, and pulmonary function.


RESULTS
Endorsement of all 3 sleep complaints predicted a slightly increased risk of cardiovascular disease (OR 1.5, 1.1-2.0) but not of hypertension. Endorsement of either DFA or SCA predicted slightly increased risk of hypertension (OR 1.2, 1.03-1.3)


CONCLUSIONS
The definition of insomnia affects its impact. A combination of 3 sleep complaints (DFA, SCD, NRS) predicted a slightly increased risk of cardiovascular disease but not hypertension, and a complaint of either DFA or SCD predicted increased hypertensive risk. It is not clear whether these modest and inconsistent effects are of clinical significance.
Phillips
Barbara
B
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY 50636-0284, USA. bphil95@aol.com
Mannino
David M
DM
D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D015331:Cohort Studies; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology