Insomnia and the Risk of Atrial Fibrillation: A Population-Based Cohort Study.
BACKGROUND
Although advancements in the treatment of atrial fibrillation have improved patient prognosis for this persistent condition, interest in atrial fibrillation development is growing. Of note is the fact that additional attention is being focused on the accompanying effect of insomnia. The aim of the study was to investigate the effects of insomnia on the risk of atrial fibrillation development.


METHODS
This was a nationwide population-based retrospective cohort study using data from the Taiwan National health Insurance Research Database. We analyzed 64,421 insomnia cases and 128,842 matched controls without insomnia from January 1, 2000, to December 31, 2010. A Cox regression model was used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for atrial fibrillation development.


RESULTS
During the follow-up period, the incidence of atrial fibrillation development was significantly higher in the insomnia cases than in the comparison cohort (2.6% vs. 2.3%, p < 0.001). Insomnia was associated with an increased risk of atrial fibrillation (HR = 1.08, 95% CI: 1.01-1.14). Males, those > 65 years of age, and patients with peripheral artery disease who have insomnia had a higher rate of atrial fibrillation development.


CONCLUSIONS
The findings of this nationwide analysis support the hypothesis that insomnia is associated with a significant risk of atrial fibrillation development.
Institution of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health; ; Department of Internal Medicine, Taipei City Hospital, Zhongxing Branch.
Hsiu-Hao
HH
Lee
Graduate Institute of Medical Sciences, National Defense Medical Center; ; Division of Cardiology, Department of Internal Medicine, Taipei City Hospital, Renai Branch, Taipei.
Yueh-Chung
YC
Chen
Cardiovascular Center, National Taiwan University Hospital, Yun-Lin Branch, Douliou.
Jien-Jiun
JJ
Chen
Department of Internal Medicine, Taipei City Hospital, Zhongxing Branch.
Shih-Hsiang
SH
Lo
Institution of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health.
Yue-Liang
YL
Guo
Department of Education and Research, Taipei City Hospital; ; Department of Public Health, Institute of Public Health, National Yang Ming University, Taipei, Taiwan.
Hsiao-Yun
HY
Hu
Atrial fibrillation; Cohort study; Insomnia