Table 1.
Summary of Current Data
| Study/Year | Type | Outcome | No. | Main Findings | Confounders |
|---|---|---|---|---|---|
| Fernandez-Mendoza et al6/2012 | Prospective, population-based | HTN | 786 | Twofold ↑ odds HTN, almost fourfold ↑ odds with objective short sleep and insomnia | Baseline + depression, SDB, DM, BP |
| Bathgate et al21/2016 | Cross-sectional, clinic-based | HTN | 255 | 3.59 ↑ risk HTN in patients with insomnia with < 6 h sleep duration | Baseline + use of hypnotic agents, ESS, AHI, DM, cholesterol, depression |
| Vgontzas et al7/2009 | Cross-sectional, population-based | HTN | 1,741 | 5.1 ↑ odds HTN in patients with insomnia with < 5 hours sleep duration | Baseline + DM, SDB, depression, sampling weight |
| Suka et al8/2003 | Cross-sectional, clinic-based | HTN | 255 | Almost twofold ↑ odds HTN with DIS or DMS | Age, BMI, tobacco or alcohol use, job stress |
| Meng et al62/2013 | Prospective, meta-analysis | HTN | 58,924 | 5% ↑ relative risk of HTN | … |
| Laugsand et al10/2011 | Prospective, population-based | CHD | 52,610 | 1.45 ↑ odds acute MI with DIS and 1.3 ↑ odds acute MI with DMS | Baseline (except race) + marital status, education, shift work, BP, lipid levels, DM, physical activity |
| Leineweber et al11/2003 | Prospective, hospital-based | CHD | 292, female only | Poor sleep quality associated with 2.5 ↑ risk recurrent CHD | Age, BMI, HF symptoms, HTN, DM, HDL, triglyceride levels, education, depression |
| Li et al12/2014 | Prospective, community-based sample of male health professionals | CHD | 23,447, men only | 25% ↑ risk mortality with DIS, 9% ↑ with DMS | Baseline + physical activity, Alternate Healthy Eating Index, marriage status, living status, anxiety, medications, sleep duration, snoring frequency, cholesterol level, HTN, DM, MI, stroke, LUTS |
| Mallon et al13/2002 | Prospective, population-based | CHD | 1,870, men only | 3.1 ↑ relative risk of CHD in men but not in women with DIS | Age, marriage, living alone, smoking, BMI > 28, HTN, cardiac disease, respiratory disease, DM, joint pain, GI disease, depression, sleep duration, DIS, DMS, snoring, sleeping aid use, urogenital disease |
| Meisinger et al14/2007 | Prospective, population-based | CHD | 6,896 | 12% ↑ relative risk in men and 53% ↑ in women with DMS, 16% ↑ in men and 30% in women with DIS | Baseline + lipid levels, education, family history of MI, physical activity, HTN, DM, menopause status |
| Coryell et al15/2013 | Cross-sectional, hospital-based | CHD | 102 | Prevalence of moderate or severe insomnia in patients with ACS = 37% | Descriptive study |
| Cappuccio et al16/2011 | Prospective, meta-analysis | CHD | 474,684 | Short sleep duration ↑ risk CHD by 48% | … |
| Hsu et al63/2015 | Prospective, population-based | CHD | 44,080 | 68% ↑ risk of future MI, 85% ↑ risk of stroke, ↑ 81% ↑ risk composite CVD | Age, sex, HTN, DM, lipid levels, PAD, CKD, CAD, CHF, chronic pulmonary disease |
| Ingelsson et al65/2007 | Prospective, population-based cohort | HF | 2,322, men only | 52% ↑ risk HF overall and 58% ↑ risk HF in overweight but not normal-weight participants | BP, DM, LVH by ECG, smoking, BMI |
| Laugsand et al17/2014 | Prospective, population-based cohort | HF | 54,279 | 4.53-fold ↑ risk HF in those with 3 symptoms of insomnia compared with those with no symptoms | Baseline + education, shift work, marital status, MI, BP, physical activity, lipid levels |
| Sofi et al67/2014 | Prospective, meta-analysis | CVD mortality | 122,501 | +45% ↑ risk of development of or death from CVD | … |
| Li et al23/2014 | Prospective, meta-analysis | CVD mortality | 311,260 | 41% ↑ risk MI, 28% ↑ risk CHD, 55% ↑ risk stroke, 33% ↑ risk CVD mortality | … |
| Parthasarathy et al40/2015 | Prospective, population-based | CVD mortality | 1,409 | 58% ↑ risk death in persistent, but not intermittent, insomnia | Baseline + physical activity, sedative use |
Baseline: age, race, sex, tobacco use, alcohol use, BMI.
ACS = acute coronary syndrome; AHI = apnea-hypopnea index; CAD = coronary artery disease; CHD = coronary heart disease; CKD = chronic kidney disease; CVD = cardiovascular disease; DIS = difficulty initiating sleep; DM = diabetes mellitus; DMS = difficulty maintaining sleep; ESS = Epworth Sleepiness Scale; HF = heart failure; HTN = hypertension; LUTS = lower urinary tract symptoms; LVH = left ventricular hypertrophy; MI = myocardial infarction; PAD = peripheral arterial disease; SDB = sleep disordered breathing.